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Файл:Prescriber's Guide_ Stahl's Ess - Stephen M. Stahl.docx
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- •Table of Contents
- •If It Works 224
- •If It Works 234
- •If It Doesn’t Work 234
- •If It Works 246
- •If It Doesn’t Work 246
- •If It Works 260
- •If It Doesn’t Work 261
- •If It Works 274
- •If It Doesn’t Work 274
- •If It Works 315
- •If It Doesn’t Work 316
- •If It Works 330
- •If It Doesn’t Work 330
- •If It Works 339
- •If It Doesn’t Work 340
- •If It Works 351
- •If It Doesn’t Work 351
- •If It Works 361
- •If It Doesn’t Work 362
- •If It Works 369
- •If It Doesn’t Work 369
- •If It Works 378
- •If It Doesn’t Work 378
- •If It Works 386
- •If It Doesn’t Work 386
- •If It Works 398
- •If It Doesn’t Work 399
- •If It Works 404
- •If It Doesn’t Work 405
- •If It Works 411
- •If It Works 423
- •If It Doesn’t Work 424
- •If It Works 433
- •If It Doesn’t Work 433
- •If It Works 445
- •If It Doesn’t Work 445
- •If It Works 457
- •If It Doesn’t Work 458
- •If It Works 472
- •If It Doesn’t Work 472
- •If It Works 483
- •If It Doesn’t Work 483
- •If It Works 493
- •If It Doesn’t Work 494
- •If It Works 503
- •If It Doesn’t Work 504
- •If It Works 517
- •If It Doesn’t Work 518
- •If It Works 530
- •If It Doesn’t Work 530
- •If It Works 544
- •If It Doesn’t Work 544
- •If It Works 556
- •If It Doesn’t Work 557
- •If It Works 564
- •If It Doesn’t Work 564
- •If It Works 580
- •If It Doesn’t Work 580
- •If It Works 587
- •If It Doesn’t Work 587
- •If It Works 597
- •If It Doesn’t Work 597
- •If It Works 611
- •If It Doesn’t Work 612
- •If It Works 627
- •If It Doesn’t Work 628
- •If It Works 641
- •If It Doesn’t Work 641
- •If It Works 652
- •If It Doesn’t Work 652
- •If It Works 659
- •If It Doesn’t Work 660
- •If It Works 667
- •If It Doesn’t Work 668
- •If It Works 674
- •If It Doesn’t Work 674
- •If It Works 683
- •If It Doesn’t Work 683
- •If It Works 696
- •If It Doesn’t Work 697
- •If It Works 706
- •If It Doesn’t Work 707
- •If It Works 718
- •If It Doesn’t Work 719
- •If It Works 726
- •If It Doesn’t Work 726
- •If It Works 740
- •If It Works 752
- •If It Doesn’t Work 752
- •If It Works 762
- •If It Doesn’t Work 762
- •If It Works 770
- •If It Doesn’t Work 770
- •If It Works 783
- •If It Doesn’t Work 783
- •If It Works 790
- •If It Doesn’t Work 790
- •If It Works 802
- •If It Doesn’t Work 803
- •If It Works 815
- •If It Doesn’t Work 816
- •If It Works 830
- •If It Doesn’t Work 830
- •If It Works 839
- •If It Works 855
- •If It Works 863
- •If It Doesn’t Work 863
- •If It Works 886
- •If It Doesn’t Work 886
- •If It Works 899
- •If It Doesn’t Work 900
- •If It Works 912
- •If It Doesn’t Work 913
- •If It Works 923
- •If It Doesn’t Work 923
- •If It Works 933
- •If It Doesn’t Work 933
- •If It Works 939
- •If It Doesn’t Work 940
- •If It Works 953
- •If It Doesn’t Work 954
- •If It Works 967
- •If It Doesn’t Work 967
- •If It Works 980
- •If It Doesn’t Work 981
- •If It Works 987
- •If It Doesn’t Work 987
- •If It Works 998
- •If It Doesn’t Work 998
- •If It Works 1033
- •If It Doesn’t Work 1033
- •If It Works 1041
- •If It Doesn’t Work 1041
- •If It Works 1048
- •If It Doesn’t Work 1048
- •If It Works 1061
- •If It Doesn’t Work 1061
- •If It Works 1072
- •If It Doesn’t Work 1072
- •If It Works 1085
- •If It Doesn’t Work 1085
- •If It Works 1094
- •If It Doesn’t Work 1095
- •If It Works 1103
- •If It Doesn’t Work 1103
- •If It Works 1110
- •If It Doesn’t Work 1110
- •If It Works 1118
- •If It Doesn’t Work 1119
- •If It Works 1130
- •If It Doesn’t Work 1130
- •If It Works 1144
- •If It Doesn’t Work 1145
- •If It Works 1159
- •If It Doesn’t Work 1160
- •If It Works 1169
- •If It Works 1180
- •If It Doesn’t Work 1180
- •If It Works 1195
- •If It Doesn’t Work 1195
- •If It Works 1209
- •If It Doesn’t Work 1210
- •If It Works 1218
- •If It Doesn’t Work 1219
- •If It Works 1230
- •If It Doesn’t Work 1230
- •If It Works 1244
- •If It Doesn’t Work 1244
- •If It Works 1252
- •If It Doesn’t Work 1253
- •If It Works 1262
- •If It Doesn’t Work 1263
- •If It Works 1272
- •If It Doesn’t Work 1272
- •If It Works 1279
- •If It Works 1288
- •If It Doesn’t Work 1288
- •If It Works 1297
- •If It Doesn’t Work 1297
- •If It Works 1309
- •If It Doesn’t Work 1309
- •If It Works 1317
- •If It Doesn’t Work 1318
- •If It Works 1331
- •If It Doesn’t Work 1331
- •If It Works 1339
- •If It Doesn’t Work 1339
- •If It Works 1349
- •If It Doesn’t Work 1350
- •If It Works 1366
- •If It Doesn’t Work 1366
- •If It Works 1377
- •If It Doesn’t Work 1378
- •If It Works 1396
- •If It Doesn’t Work 1396
- •If It Works 1406
- •If It Doesn’t Work 1406
- •If It Works 1420
- •If It Doesn’t Work 1421
- •If It Works 1428
- •If It Doesn’t Work 1429
- •If It Works 1438
- •If It Doesn’t Work 1438
- •If It Works 1445
- •If It Doesn’t Work 1445
- •If It Works 1456
- •If It Doesn’t Work 1457
- •If It Works 1466
- •If It Works 1476
- •If It Doesn’t Work 1476
- •If It Works 1483
- •If It Works 1494
- •If It Doesn’t Work 1494
- •If It Works 1507
- •If It Doesn’t Work 1507
- •If It Works 1517
- •If It Doesn’t Work 1517
- •If It Works 1525
- •If It Doesn’t Work 1526
- •If It Works 1535
- •If It Doesn’t Work 1535
- •If It Works 1551
- •If It Doesn’t Work 1552
- •If It Works 1565
- •If It Works 1578
- •If It Doesn’t Work 1579
- •If It Works 1586
- •If It Doesn’t Work 1586
- •If It Works 1600
- •If It Doesn’t Work 1600
- •If It Works 1612
- •If It Doesn’t Work 1613
- •If It Works 1623
- •If It Doesn’t Work 1623
- •If It Works 1631
- •If It Doesn’t Work 1632
- •If It Works 1646
- •If It Doesn’t Work 1646
- •If It Works 1655
- •If It Works 1662
- •If It Doesn’t Work 1662
- •If It Works 1670
- •If It Doesn’t Work 1670
- •If It Works 1680
- •If It Doesn’t Work 1681
- •Prescriber’s Guide
- •Stahl’s Essential Psychopharmacology Prescriber’s Guide
- •Contents
- •Introduction
- •Introduction
- •List of icons
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Amisulpride
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works (for adhd)
- •If It Doesn’t Work (for adhd)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •How Long Until It Works
- •If It Works (for adhd)
- •If It Doesn’t Work (for adhd)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Aripiprazole: side effects How Drug Causes Side Effects
- •Dosing Tips – Oral
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Aripiprazole
- •How the Drug Works
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an a typical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Asenapine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Dosing Tips
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Asenapine
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Atomoxetine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting any atypical antipsychotic
- •Monitoring after starting any atypical antipsychotic
- •Dosing Tips
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Bupropion: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work (for bipolar disorder)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Chlorpromazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Citalopram: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Clozapine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Weight Gain
- •Sedation
- •What to Do About Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Clozapine
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Cyamemazine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Desipramine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Desvenlafaxine: side effects How Drug Causes Side Effects
- •Overdose
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Doxepin: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Duloxetine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Escitalopram: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Fluoxetine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Flupenthixol: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Fluphenazine: side effects How Drug Causes Side Effects
- •Dosing Tips – Oral
- •Dosing Tips – Depot
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Fluvoxamine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work (for neuropathic pain or bipolar disorder)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Gabapentin: special populations Renal Impairment
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Haloperidol: side effects How Drug Causes Side Effects
- •Dosing Tips – Oral
- •Dosing Tips – Depot
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Iloperidone
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work (for bipolar disorder)
- •Best Augmenting Combos for Partial Response or Treatment Resistance (for bipolar disorder)
- •Weight Gain
- •Sedation
- •What to Do About Side Effects
- •Best Augmenting Agents for Side Effects
- •Lamotrigine: dosing and use Usual Dosage Range
- •Dosage Forms
- •How to Dose
- •Dosing Tips
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work (for bipolar disorder or neuropathic pain)
- •Levetiracetam: special populations Renal Impairment
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Levomilnacipran: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works (for adhd)
- •If It Doesn’t Work (for adhd)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Lisdexamfetamine: the art of psychopharmacology Potential Advantages
- •Potential Disadvantages
- •Primary Target Symptoms
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Loxapine: side effects How Drug Causes Side Effects
- •Dosing Tips
- •Drug Interactions
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting any atypical antipsychotic
- •Monitoring after starting any atypical antipsychotic
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Lurasidone
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Mesoridazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works (for adhd)
- •If It Doesn’t Work (for adhd)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •How Long Until It Works
- •If It Works (for adhd)
- •If It Doesn’t Work (for adhd)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •How to Dose
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Milnacipran: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Moclobemide: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How the Drug Works
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Molindone: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Other Warnings/Precautions
- •Dosing Tips
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Nefazodone: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Olanzapine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips – Oral
- •Dosing Tips – Depot
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Oral Olanzapine
- •Switching from Oral Antipsychotics to Olanzapine lai
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Dosing Tips
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic:
- •Monitoring after starting an atypical antipsychotic:
- •Paliperidone: side effects How Drug Causes Side Effects
- •Dosing Tips – Oral
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Paliperidone er
- •Switching from Oral Antipsychotics to Paliperidone Palmitate
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Paroxetine: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Perphenazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Phenelzine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Other Warnings/Precautions
- •Pimozide: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Pipothiazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work (for neuropathic pain)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Pregabalin: special populations Renal Impairment
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Protriptyline: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Quetiapine: side effects How Drug Causes Side Effects
- •Dosing Tips
- •Children and Adolescents
- •Pregnancy
- •Switching from Oral Antipsychotics to Quetiapine
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How the Drug Works
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Risperidone: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips – Oral Formulation
- •Dosing Tips – Long-Acting Microsphere Depot Formulation
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Risperidone: the art of psychopharmacology Potential Advantages
- •Potential Disadvantages
- •Primary Target Symptoms
- •Switching from Oral Antipsychotics to Risperidone
- •Switching from Oral Antipsychotics to Risperidone lai
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Selegiline: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Life-Threatening or Dangerous Side Effects
- •Drug Interactions
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Sertraline: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Sertraline: the art of psychopharmacology Potential Advantages
- •Potential Disadvantages
- •Primary Target Symptoms
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Sulpiride: side effects How Drug Causes Side Effects
- •Children and Adolescents
- •Pregnancy
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Thioridazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Thiothixene: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work (for neuropathic pain or anxiety disorders)
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Pregnancy
- •Breast Feeding
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Dosing Tips
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Trifluoperazine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •If It Doesn’t Work (for depression)
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Best Augmenting Combos for Partial Response or Treatment Resistance (for bipolar disorder)
- •How to Dose
- •Dosing Tips
- •Other Warnings/Precautions
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Venlafaxine: side effects How Drug Causes Side Effects
- •Pharmacokinetics
- •Drug Interactions
- •Other Warnings/Precautions
- •Elderly
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Vilazodone: side effects How Drug Causes Side Effects
- •Notable Side Effects
- •Other Warnings/Precautions
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Vortioxetine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Pregnancy
- •Breast Feeding
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Tests Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Ziprasidone: side effects How Drug Causes Side Effects
- •Dosing Tips
- •Children and Adolescents
- •Pregnancy
- •Breast Feeding
- •Ziprasidone: the art of psychopharmacology Potential Advantages
- •Potential Disadvantages
- •Primary Target Symptoms
- •Switching from Oral Antipsychotics to Ziprasidone
- •Dosing Tips
- •Other Warnings/Precautions
- •How Long Until It Works
- •If It Works
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Before starting an atypical antipsychotic
- •Monitoring after starting an atypical antipsychotic
- •Zotepine: side effects How Drug Causes Side Effects
- •Other Warnings/Precautions
- •Elderly
- •If It Doesn’t Work
- •Best Augmenting Combos for Partial Response or Treatment Resistance
- •Zuclopenthixol: side effects How Drug Causes Side Effects
- •Dosing Tips
- •Other Warnings/Precautions
- •Children and Adolescents
- •Pregnancy
- •Index by Drug Name
- •Index by Use
- •Valproate (divalproex) 711
- •Valproate (divalproex) 711
- •Valproate (divalproex) 711
- •Index by Class
- •Abbreviations
If It Doesn’t Work
• Consider switching to another agent or adding an appropriate augmenting agent
• Consider psychotherapy, especially cognitive behavioral psychotherapy
• Consider presence of concomitant substance abuse
• Consider presence of alprazolam abuse
• Consider another diagnosis, such as a comorbid medical condition
Best Augmenting Combos for Partial Response or Treatment Resistance
• Benzodiazepines are frequently used as augmenting agents for antipsychotics and mood stabilizers in the treatment of psychotic and bipolar disorders
• Benzodiazepines are frequently used as augmenting agents for SSRIs and SNRIs in the treatment of anxiety disorders
• Not generally rational to combine with other benzodiazepines
• Caution if using as an anxiolytic concomitantly with other sedative hypnotics for sleep
• Could consider augmenting alprazolam with either gabapentin or pregabalin for treatment of anxiety disorders
Tests
• In patients with seizure disorders, concomitant medical illness, and/or those with multiple concomitant long-term medications, periodic liver tests and blood counts may be prudent
ALPRAZOLAM: SIDE EFFECTS
How Drug Causes Side Effects
• Same mechanism for side effects as for therapeutic effects – namely due to excessive actions at benzodiazepine receptors
• Long-term adaptations in benzodiazepine receptors may explain the development of dependence, tolerance, and withdrawal
• Side effects are generally immediate, but immediate side effects often disappear in time
Notable Side Effects
✽ Sedation, fatigue, depression
✽ Dizziness, ataxia, slurred speech, weakness
✽ Forgetfulness, confusion
✽ Hyperexcitability, nervousness
• Rare hallucinations, mania
• Rare hypotension
• Hypersalivation, dry mouth
Life-Threatening or Dangerous Side Effects
• Respiratory depression, especially when taken with CNS depressants in overdose
• Rare hepatic dysfunction, renal dysfunction, blood dyscrasias
Weight Gain
• Reported but not expected
Sedation
• Occurs in significant minority
• Especially at initiation of treatment or when dose increases
• Tolerance often develops over time
What to Do About Side Effects
• Wait
• Wait
• Wait
• Lower the dose
• Switch to alprazolam XR
• Take largest dose at bedtime to avoid sedative effects during the day
• Switch to another agent
• Administer flumazenil if side effects are severe or life-threatening
Best Augmenting Agents for Side Effects
• Many side effects cannot be improved with an augmenting agent
ALPRAZOLAM: DOSING AND USE
Usual Dosage Range
• Anxiety: alprazolam IR: 1–4 mg/day
• Panic: alprazolam IR: 5–6 mg/day
• Panic: alprazolam XR: 3–6 mg/day
Dosage Forms
• Alprazolam IR tablet 0.25 mg scored, 0.4 mg (Japan), 0.5 mg scored, 0.8 mg (Japan), 1 mg scored, 2 mg multiscored
• Alprazolam IR orally disintegrating tablet 0.25 mg, 0.5 mg, 1 mg, 2 mg
• Alprazolam IR solution, concentrate 1 mg/mL
• Alprazolam XR (extended-release) tablet 0.5 mg, 1 mg, 2 mg, 3 mg
How to Dose
• For anxiety, alprazolam IR should be started at 0.75–1.5 mg/day divided into 3 doses; increase dose every 3–4 days until desired efficacy is reached; maximum dose generally 4 mg/day
• For panic, alprazolam IR should be started at 1.5 mg/day divided into 3 doses; increase 1 mg or less every 3–4 days until desired efficacy is reached, increasing by smaller amounts for dosage over 4 mg/day; may require as much as 10 mg/day for desired efficacy in difficult cases
• For panic, alprazolam XR should be started at 0.5–1 mg/day once daily in the morning; dose may be increased by 1 mg/day every 3–4 days until desired efficacy is reached; maximum dose generally 10 mg/day
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