Psychotropic drugs current

Chapter /, Modem Psychopharmaceuticals, written by Dr Hossein Fatemi, and Chapter 5, Psychopharmaceuticals and the Treatment of Mental Disorders, provide succinct, up to date, and well-referenced information on how to use the major classes of psychotropic drugs. The latter chapter discusses in a frank and balanced manner the ambivalence towards the use of pharmacologic agents in mental disorders felt by some, and the limitations on the achievements of current drugs as ideal therapies for schizophrenia, bipolar disorder and major depression in particular. Clearly, much has been accomplished, but many needs, especially for prevention of relapse, removal of specific types of symptoms, and restoraton of work and social function, remain to be accomplished by drug and psychosocial therapies. 

Currently, there is no rational way to predict which antidepressant is more likely than another to work in any depressed patient or which antipsychotic would be best for a given schizophrenic patient. Such selections often are made by trial and error. Perhaps certain genetic characteristics will predict the likelihood of a better therapeutic response or better tolerability of one drug over another. To date, no such genetic factors are yet known that can assist the prescriber in selecting psychotropic drugs for individual patients. 

The importance of ECT, insulin coma therapy and the other physical treatments for understanding the current state of psychiatry is that they helped to encourage a confidence that mental illness could be cured with physical means. By the mid-20th century psychiatrists finally really believed they could resolve the problems experienced by people under their care by acting on what they presumed was the bodily basis of the problem. This was the context into which a new generation of psychotropic drugs arrived in the 1950s. 

Skin Psoriasis Determination of the relative risk of psoriasis as a function of psychotropic medication has been studied in the UK General Practice Research Database [54 ], in which 36 702 cases of psoriasis were identified and the same number of matched controls. Use of psychotropic drugs was determined by current and four previous prescriptions. Long-term lithium... 

The elimination half-lives of a number of commonly used hypnotics are shown in Table 10.1. It should be noted that many of the drugs in current use have active metabolites which considerably prolong the duration of their pharmacological effect. This is particularly true for the elderly patient in whom the half-life of the hypnotic is prolonged due to decreased metabolism and renal clearance such individuals are also more sensitive to the sedative effects of any psychotropic medication. 

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