Table of Contents
Table of Contents 2
Release/expiration dates 44
Overview 44
Target audience 44
Need for this content 44
Learning objectives 44
Accreditation and credit designation statements 45
Optional posttest and CME credit instructions (see p. 441) 46
Disclosures 46
Authors/developers 46
Disclosure of off-label use 47
Disclaimer 47
Cultural and linguistic competency 47
Provider 47
Support 48
Patient evaluation on intake 59
Psychiatric history 59
Social and personal history 60
Medical history 61
Family history 61
Medication history 61
Psychotherapy history 61
Patient evaluation on initial visit 61
Current medications 62
Question 62
Attending physician’s mental notes: initial evaluation 62
Question 63
Attending physician’s mental notes: initial evaluation (continued) 63
Further investigation 63
Case outcome: first interim follow-up visit four weeks later 64
Question 65
Case outcome: second interim follow-up visit at two months 65
Attending physician’s mental notes: interim follow-up visit at three months 66
Question 66
Attending physician’s mental notes: second interim follow-up visit at three months 67
Case outcome: interim follow-up visits through six months 67
Question 68
Attending physician’s mental notes: interim follow-up visits through 12 months 68
Case outcome: interim follow-up visits through 24 months 68
Case debrief 69
Take-home points 70
Performance in practice: confessions of a psychopharmacologist 70
Tips and pearls 71
Psychotherapy moment 72
Psychopharmacology components 73
Psychotherapy 74
Documentation 74
Two-minute tutorial 75
Patient evaluation on intake 79
Psychiatric history 79
Social and personal history 80
Medical history 80
Family history 80
Current psychiatric medications 80
Question 81
Attending physician’s mental notes: initial evaluation 81
Further investigation 81
Question 82
Attending physician’s mental notes: initial evaluation (continued) 82
Case outcome: interim follow-ups through six months 83
Question 84
Attending physician’s mental notes: nine months 84
Case outcome: interim follow-ups through nine months 85
Question 85
Attending physician’s mental notes: nine-month follow-ups 85
Question 85
Attending physician’s mental notes: interim follow-up through nine months (continued) 86
Case outcome and multiple interim follow-ups to 24 months 87
Case debrief 88
Take-home points 88
Performance in practice: confessions of a psychopharmacologist 89
Tips and pearls 89
Two-minute tutorial 90
Tardive dyskinesia 90
Tardive dyskinesia facts 90
Tardive dyskinesia treatments 91
Pretest self-assessment question (answer at the end of the case) 94
Patient evaluation on intake 94
Psychiatric history 94
Social and personal history 95
Medical history 95
Family history 95
Current psychiatric medications 95
Current medical medications 96
Question 96
Attending physician’s mental notes: initial evaluation 96
Further investigation 97
Question 98
Attending physician’s mental notes: initial evaluation (continued) 98
Case outcome: interim follow-ups through four months 99
Question 99
Attending physician’s mental notes: nine months 99
Case outcome: interim follow-ups through nine months 100
Question 101
Attending physician’s mental notes: 9–12 month follow-ups 101
Question 101
Case outcome: interim follow-ups through 12 months 102
Case outcome: multiple interim follow-ups through 16 months 103
Attending physician’s mental notes: 16-month follow-ups 104
Case debrief 104
Take-home points 105
Performance in practice: confessions of a psychopharmacologist 105
Tips and pearls 106
Abnormal Involuntary Movement Scale (AIMS) 108
AIMS instructions 108
Case outcome: use of outcome measures 111
Posttest self-assessment question and answer 112
Patient evaluation on intake 114
Psychiatric history 114
Social and personal history 115
Medical history 115
Family history 115
Current psychiatric medications 115
Current medical medications 116
Question 116
Attending physician’s mental notes: initial evaluation 116
Further investigation 117
Question 118
Attending physician’s mental notes: initial evaluation (continued) 118
Case outcome: interim follow-ups through three months 119
Question 119
Attending physician’s mental notes: four months 120
Question 120
Case outcome: interim follow-ups through six months 121
Attending physician’s mental notes: interim follow-up, nine months (continued) 121
Case outcome and multiple interim follow-ups to 12–120 months 122
Case debrief 122
Take-home points 123
Performance in practice: confessions of a psychopharmacologist 124
Tips and pearls 124
Mechanism of action moment 125
How does VNS theoretically work? 125
Two-minute tutorial 126
VNS side effects 126
Neurostimulation and neuromodulatory devices other than VNS 127
Patient evaluation on intake 132
Psychiatric history 132
Social and personal history 133
Medical history 133
Family history 134
Current psychiatric medications 134
Current medical medications 134
Question 134
Attending physician’s mental notes: initial evaluation 134
Further investigation 135
Question 136
Attending physician’s mental notes: initial evaluation (continued) 137
Case outcome: interim follow-ups through one month 137
Question 138
Case outcome: interim follow-ups through two months 138
Case outcome: interim follow-ups through three months 139
Question 139
Attending physician’s mental notes: four-month follow-ups 139
Question 140
Case outcome: interim follow-ups through four months (continued) 140
Attending physician’s mental notes: interim follow-ups through four months 140
Case outcome and multiple interim follow-ups to six months 141
Case debrief 142
Take-home points 142
Performance in practice: confessions of a psychopharmacologist 143
Tips and pearls 144
Two-minute tutorial 144
Is quetiapine (Seroquel) an antipsychotic, anti-manic, antidepressant, anxiolytic, or a hypnotic? 144
Pharmacodynamics of quetiapine and norquetiapine 145
Pretest self-assessment question (answer at the end of the case) 149
Patient evaluation on intake 149
Psychiatric history 149
Social and personal history 151
Medical history 151
Family history 151
Current psychiatric medications 151
Current medical medications 151
Question 151
Attending physician’s mental notes: initial evaluation 152
Further investigation 153
Attending physician’s mental notes: initial evaluation (continued) 153
Case outcome: interim follow-ups through one month 154
Case outcome: interim follow-ups through two months 156
Attending physician’s mental notes: two months 157
Question 157
Case outcome: interim follow-ups through two months 157
Case outcome: interim follow-ups through three months 158
Question 159
Case outcome and multiple interim follow-ups up to six months 159
Case debrief 160
Take-home points 161
Performance in practice: confessions of a psychopharmacologist 162
Pharmacodynamic moment 162
Two-minute tutorial 163
What is worse in causing escalated mania or mixed features, antidepressants or stimulants? 163
Should unipolar antidepressants be used in bipolar disorder? 163
Does clonazepam (Klonopin) work in bipolar mania? 164
Posttest self-assessment question and answer 164
Patient evaluation on intake 167
Psychiatric history 167
Question 168
Case outcome 168
Case debrief 169
Take-home points 170
Tips and pearls 170
Patient evaluation on intake 174
Psychiatric history 174
Social and personal history 175
Medical history 176
Family history 176
Current psychiatric medications 176
Current medical medications 176
Question 176
Attending physician’s mental notes: initial evaluation 177
Further investigation 177
Question 178
Attending physician’s mental notes: initial evaluation (continued) 178
Case outcome: interim follow-ups through three months 178
Question 179
Attending physician’s mental notes: four months 180
Case outcome: interim follow-ups through six months 180
Case outcome: interim follow-ups through nine months 181
Question 181
Attending physician’s mental notes: nine-month follow-ups 182
Attending physician’s mental notes: interim follow-up, nine months (continued) 182
Case outcome and multiple interim follow-ups to 24 months 183
Case debrief 184
Take-home points 185
Performance in practice: confessions of a psychopharmacologist 185
Tips and pearls 186
Two-minute tutorial 187
Treating AAWG with metformin 188
Posttest self-assessment question and answer 189
Patient evaluation on intake 192
Psychiatric history 192
Social and personal history 193
Medical history 193
Family history 193
Current psychiatric medications 194
Current medical medications 194
Question 194
Attending physician’s mental notes: initial evaluation 194
Further investigation 195
Question 195
Attending physician’s mental notes: initial evaluation (continued) 196
Case outcome: interim follow-ups through six months 196
Attending physician’s mental notes: six months 197
Case outcome: interim follow-ups through nine months 198
Case outcome: interim follow-ups through 18 months 198
Attending physician’s mental notes: through 20 months 198
Question 199
Case outcome: interim follow-ups through 24 months 199
Question 199
Attending physician’s mental notes: 24-month follow-ups 199
Case outcome: interim follow-up, 36 months 200
Attending physician’s mental notes: 48-month follow-ups 201
Question 202
Case outcome and multiple interim follow-ups to 48 months 202
Case debrief 205
Take-home points 206
Performance in practice: confessions of a psychopharmacologist 207
Tips and pearls 207
Two-minute tutorial 207
Techniques for switching antipsychotics 208
Risperidone (Risperdal) 210
Olanzapine (Zyprexa) 210
Quetiapine (Seroquel-XR) 211
Ziprasidone (Geodon) 211
Aripiprazole (Abilify) 211
Paliperidone (Invega) 211
Asenapine (Saphris) 211
Iloperidone (Fanapt) 211
Lurasidone (Latuda) 211
Brexpiprazole (Rexult) 212
Cariprazine (Vraylan) 212
Pretest self-assessment question (answer at the end of the case) 215
Patient evaluation on intake 215
Psychiatric history 215
Question 216
Case outcome 217
Case debrief 217
Two-minute tutorial 218
Clozapine sialorrhea statistics and etiology 218
Possible antidotes for CIS 219
Posttest self-assessment question and answer 219
Patient evaluation on intake 221
Psychiatric history 221
Social and personal history 222
Medical History 222
Family History 222
Current psychiatric medications 222
Current medical medications 223
Question 223
Attending physician’s mental notes: initial evaluation 223
Further investigation 224
Question 224
Attending physician’s mental notes: initial evaluation (continued) 224
Case outcome: interim follow-ups through three months 225
Attending physician’s mental notes: six months 226
Case outcome: interim follow-ups through nine months 226
Case outcome: interim follow-ups through 12 months 227
Case outcome: interim follow-ups through 12 months (continued) 227
Question 228
Attending physician’s mental notes: 12 month follow-ups 228
Case outcome: interim follow-up, 24 months 228
Attending physician’s mental notes: 36-month follow-ups 229
Case outcome and multiple interim follow-ups to 60 months 230
Case debrief 231
Take-home points 231
Performance in practice: confessions of a psychopharmacologist 232
Tips and pearls 232
A pharmacodynamic moment 233
Antihistamine and the sleep–wake switch 234
Serotonin receptor antagonism and sleep 235
What about 5-HT1D receptor antagonism? 236
What about 5-HT7 receptor antagonism? 237
Patient evaluation on intake 240
Psychiatric history 240
Social and personal history 241
Medical history 241
Family history 241
Medication history 242
Psychotherapy history 242
Patient evaluation on initial visit 242
Current medications 242
Question 242
Attending physician’s mental notes: initial evaluation 243
Question 243
Attending physician’s mental notes: initial evaluation (continued) 243
Further investigation 244
Case outcome: first interim follow-up visit four weeks later 244
Question 244
Case outcome: second interim follow-up visit at two months 244
Attending physician’s mental notes: second interim follow-up visit at two months 245
Question 245
Case outcome: interim follow-up visits through seven months 246
Question 246
Attending physician’s mental notes: interim follow-up visits through seven months 247
Case outcome: interim follow-up visits through 24 months 247
Case debrief 248
Take-home points 249
Performance in practice: confessions of a psychopharmacologist 249
Tips and pearls 250
Mechanism of action moment 250
Two-minute tutorial 251
Patient evaluation on intake 256
Psychiatric history 256
Social and personal history 257
Medical history 258
Family history 258
Medication history 258
Psychotherapy history 258
Patient evaluation on initial visit 259
Current medications 259
Question 260
Attending physician’s mental notes: initial evaluation 260
Question 260
Attending physician’s mental notes: initial evaluation (continued) 261
Further investigation 262
Case outcome: first interim follow-up visit eight weeks later 262
Question 262
Case outcome: second and third interim follow-up visits at three months 263
Attending physician’s mental notes: second interim follow-up visit at three months 263
Question 264
Attending physician’s mental notes: second interim follow-up visit at three months (continued) 264
Case outcome: interim follow-up visits through five months 264
Question 265
Attending physician’s mental notes: interim follow-up visits through nine months 265
Case outcome: interim follow-up visits through 12 months 265
Attending physician mental notes 266
Case outcome: interim follow-up visits through 15 months 266
Question 267
Case debrief 268
Take-home points 269
Performance in practice: confessions of a psychopharmacologist 269
Tips and pearls 270
Pharmacoeconomic and regulatory moment 271
Two-minute tutorial 272
How many ways can a drug be turned into a slow-release preparation? 272
Pretest self-assessment question (answer at the end of the case) 276
Patient evaluation on intake 276
Psychiatric history 276
Medication history 277
Psychotherapy history 278
Social and personal history 278
Medical history 279
Family history 279
Patient evaluation on initial visit 279
Current medications 279
Question 279
Attending physician’s mental notes: initial evaluation 280
Question 280
Attending physician’s mental notes: initial evaluation (continued) 281
Further investigation 281
Case outcome: first interim follow-up visit four to six weeks later 282
Question 282
Attending physician’s mental notes: interim follow-up visits through three months 282
Case outcome: interim follow-up visits through three months 282
Question 283
Attending physician’s mental notes: interim follow-up visits through three months (continued) 283
Case outcome: interim follow-up visits through six months 284
Attending physician’s mental notes: interim follow-up visits through six months 284
Case debrief 285
Take-home points 285
Performance in practice: confessions of a psychopharmacologist 286
Tips and pearls 286
Two-minute tutorial 287
Overview 288
Classification 289
Clinical manifestations 290
Therapy and management 291
Posttest self-assessment question and answer 291
Pretest self-assessment question (answer at the end of the case) 293
Patient evaluation on intake 293
Psychiatric history 293
Social and personal history 295
Medical history 295
Family history 295
Medication history 295
Psychotherapy history 295
Patient evaluation on initial visit 295
Current medications 296
Question 296
Attending physician’s mental notes: initial evaluation 296
Question 296
Attending physician’s mental notes: initial evaluation (continued) 297
Further investigation 297
Case outcome: first interim follow-up visit six weeks later 298
Question 299
Attending physician’s mental notes: interim follow-up visits through six months 299
Case outcome: interim follow-up visits through six months 299
Question 300
Attending physician’s mental notes: interim follow-up visit through six months (continued) 300
Case outcome: interim follow-up visits through nine months 300
Question 301
Attending physician’s mental notes: interim follow-up visits through nine months 301
Case outcome: interim follow-up visits through 15 months 301
Case debrief 302
Take-home points 302
Performance in practice: confessions of a psychopharmacologist 302
Tips and pearls 304
Neurocircuitry moment 304
Two-minute tutorial 305
Treatments for OCD 305
Posttest-self assessment question and answer 306
Patient evaluation on intake 308
Psychiatric history 308
Social and personal history 309
Medical history 309
Family history 310
Medication history 310
Psychotherapy history 310
Patient evaluation on initial visit 310
Current medications 310
Question 311
Attending physician’s mental notes: initial evaluation 311
Question 311
Attending physician’s mental notes: initial evaluation (continued) 312
Further investigation 312
Case outcome: first interim follow-up visit four weeks later 312
Question 313
Attending physician’s mental notes: second interim follow-up visit at two months 313
Case outcome: second interim follow-up visit at two months 313
Question 314
Attending physician’s mental notes: second interim follow-up visit at two months (continued) 314
Case outcome: interim follow-up visits through four months 315
Question 315
Attending physician’s mental notes: interim follow-up visits through four months 315
Case outcome: interim follow-up visits through nine months 316
Attending physician’s mental notes: interim follow-up visits through 12 months 317
Case outcome: interim follow-up visits through 18 months 317
Case debrief 319
Take-home points 319
Performance in practice: confessions of a psychopharmacologist 320
Tips and pearls 321
Mechanism of action moment 321
Two-minute tutorial 322
Diagnosis 323
Etiology 323
RLS and comorbidity 324
RLS treatment 325
Posttest self-assessment question and answer 325
Patient evaluation on intake 327
Psychiatric history 327
Social and personal history 328
Medical history 328
Family history 328
Medication history 328
Psychotherapy history 328
Patient evaluation on initial visit 329
Current medications 329
Question 329
Attending physician’s mental notes: initial evaluation 329
Question 331
Attending physician’s mental notes: initial evaluation (continued) 331
Further investigation 332
Case outcome: first interim follow-up visit four weeks later 333
Question 334
Attending physician’s mental notes: second interim follow-up visit at two months 334
Case outcome: second interim follow-up visit at two months 335
Question 335
Attending physician’s mental notes: second interim follow-up visit at two months (continued) 336
Case outcome: interim follow-up visits at three months 336
Question 338
Case outcome: interim follow-up visit at four months 338
Attending physician’s mental notes: interim follow-up visits through four months 339
Case outcome: interim follow-up visits through six months 339
Case debrief 340
Take-home points 341
Performance in practice: confessions of a psychopharmacologist 341
Tips and pearls 342
Pharmacokinetic moment 343
Patient evaluation on intake 349
Psychiatric history 349
Social and personal history 350
Medical history 350
Family history 350
Medication history 350
Psychotherapy history 351
Patient evaluation on initial visit 351
Current medications 351
Question 351
Attending physician’s mental notes: initial evaluation 352
Question 352
Attending physician’s mental notes: initial evaluation (continued) 353
Further investigation 353
Case outcome: first interim follow-up visit four weeks later 353
Question 354
Attending physician’s mental notes: second interim follow-up visit at three months 354
Case outcome: second interim follow-up visit at three months 354
Question 355
Attending physician’s mental notes: second interim follow-up visit at three months (continued) 355
Case outcome: interim follow-up visits through 12 months 355
Question 356
Attending physician’s mental notes: interim follow-up visits through 24 months 358
Case debrief 360
Take-home points 360
Performance in practice: confessions of a psychopharmacologist 361
Tips and pearls 362
Two-minute tutorial 362
Patient evaluation on intake 366
Psychiatric history 366
Social and personal history 368
Medical history 368
Family history 368
Medication history 368
Psychotherapy history 368
Patient evaluation on initial visit 368
Current medications 369
Question 369
Attending physician’s mental notes: initial evaluation 369
Question 369
Attending physician’s mental notes: initial evaluation (continued) 370
Further investigation 370
Case outcome: first interim follow-up visit three months later 371
Question 371
Case outcome: first interim follow-up visit three months later (continued) 372
Question 372
Attending physician’s mental notes: second interim follow-up visit at six months 373
Case outcome: second interim follow-up visit at six months 373
Question 373
Case outcome: interim follow-up visits through nine months 374
Question 374
Attending physician’s mental notes: interim follow-up visits through nine months 375
Case outcome: interim follow-up visits through 36 months 375
Question 375
Case outcome: interim follow-up visits through 48 months 375
Case debrief 377
Take-home points 377
Performance in practice: confessions of a psychopharmacologist 378
Tips and pearls 379
Two-minute tutorial 379
Patient evaluation on intake 384
Psychiatric history 384
Psychotherapy history 385
Social and personal history 385
Medical history 385
Family history 385
Medication history 385
Patient evaluation on initial visit 386
Current medications 386
Question 386
Attending physician’s mental notes: initial evaluation 387
Question 387
Attending physician’s mental notes: initial evaluation (continued) 387
Further investigation 388
Case outcome: first interim follow-up visits four and eight weeks later 389
Question 389
Attending physician’s mental notes: second interim follow-up visit at three months 390
Case outcome: second interim follow-up visit at three months 390
Question 391
Attending physician’s mental notes: second interim follow-up visit at three months (continued) 391
Case outcome: interim follow-up visits through six months 392
Question 392
Attending physician’s mental notes: interim follow-up visits through six months 392
Case outcome: interim follow-up visits through nine months 393
Attending physician’s mental notes: interim follow-up visits through nine months 394
Question 394
Case outcome: interim follow-up visits through 15 months 394
Case debrief 395
Take-home points 396
Performance in practice: confessions of a psychopharmacologist 397
Tips and pearls 398
Neuropsychiatric moment 398
Causes, incidence, and risk factors 398
Symptoms 399
Signs and tests 400
Treatment 401
Prognosis 402
Pharmacodynamic moment 402
Patient evaluation on intake 406
Psychiatric history 406
Social and personal history 406
Medical history 407
Family history 407
Medication history 407
Psychotherapy history 407
Patient evaluation on initial visit 407
Current medications 408
Question 408
Attending physician’s mental notes: initial evaluation 408
Question 409
Attending physician’s mental notes: initial evaluation (continued) 409
Further investigation 409
Case outcome: first interim follow-up visit four weeks later 410
Question 410
Attending physician’s mental notes: second interim follow-up visit at two months 411
Case outcome: second interim follow-up visit at two months 411
Question 411
Case outcome: interim follow-up visits through five years 412
Question 412
Attending physician’s mental notes: interim follow-up visits through five years 412
Case outcome: interim follow-up visits through six years 412
Question 413
Attending physician’s mental notes: interim visits through year six 414
Case outcome: interim follow-up visits through six years (continued) 414
Question 415
Attending physician’s mental notes: interim visits through year six (continued) 415
Case debrief 416
Take-home points 416
Performance in practice: confessions of a psychopharmacologist 417
Tips and pearls 417
Mechanism of action moment 418
Two-minute tutorial 421
Patient evaluation on intake 424
Psychiatric history 424
Social and personal history 425
Medical history 425
Family history 425
Medication history 425
Psychotherapy history 426
Patient evaluation on initial visit 426
Current medications 426
Question 427
Attending physician’s mental notes: initial evaluation 427
Question 428
Attending physician’s mental notes: initial evaluation (continued) 428
Further investigation 428
Case outcome: first interim follow-up visits one to two weeks later 429
Question 429
Attending physician’s mental notes: second interim follow-up visit at three to four weeks 430
Case outcome: second interim follow-up visit at three to four weeks 430
Question 430
Case outcome: interim follow-up visits through four to six weeks later 431
Question 432
Attending physician’s mental notes: interim follow-up visits through six weeks 433
Case outcome interim follow-up visits through 10 weeks 433
Case debrief 434
Take-home points 435
Performance in practice: confessions of a psychopharmacologist 435
Tips and pearls 435
Two-minute tutorial 436
Chronic risks 436
Acute risks predictive of future suicide attempt include* 437
Summary 437
Posttest self-assessment question and answer 438
Patient evaluation on intake 440
Psychiatric history 440
Social and personal history 441
Medical history 441
Family history 441
Medication history 441
Psychotherapy history 442
Patient evaluation on initial visit 442
Current medications 442
Question 442
Attending physician’s mental notes: initial evaluation 442
Question 443
Attending physician’s mental notes: initial evaluation (continued) 443
Further investigation 443
Case outcome: first interim follow-up visits through six months 444
Question 444
Case outcome: second interim follow-up visits through 12 months 445
Question 445
Case outcome: second interim follow-up visits through 12 months (continued) 445
Question 446
Attending physician’s mental notes: interim visits through 18 months 446
Case outcome: interim follow-up visits through 18 months 447
Question 447
Case outcome: interim follow-up visits through 24 months 447
Question 448
Attending physician’s mental notes: interim follow-up visits through 24 months 448
Case outcome: interim follow-up visits through 24 months (continued) 449
Case debrief 449
Take-home points 450
Performance in practice: confessions of a psychopharmacologist 450
Tips and pearls 451
Two-minute tutorial 452
GABA-A receptors and the positive allosteric modulation of the BZs 452
Why does this happen? 453
Patient evaluation on intake 456
Psychiatric history 456
Social and personal history 457
Medical history 457
Family history 457
Medication history 457
Psychotherapy history 457
Patient evaluation on initial visit 458
Current medications 458
Question 458
Attending physician’s mental notes: initial evaluation 458
Question 458
Attending physician’s mental notes: initial evaluation (continued) 459
Further investigation 459
Case outcome: first interim follow-up visits through three months 459
Question 460
Case outcome: interim follow-up visits through four months 460
Question 460
Case outcome: interim follow-up visits through six months 461
Question 461
Attending physician’s mental notes: visits through six months 462
Case outcome: interim follow-up visits through nine months 462
Question 463
Case outcome: interim follow-up visits through nine months (continued) 463
Case debrief 463
Take-home points 464
Performance in practice: confessions of a psychopharmacologist 464
Tips and pearls 465
Two-minute tutorial 465
Pretest self-assessment question (answer at the end of the case) 469
Patient evaluation on intake 469
Psychiatric history 469
Social and personal history 470
Medical history 470
Family history 470
Medication history 470
Psychotherapy history 470
Patient evaluation via initial phone call 471
Current psychiatric medications 471
Current medical medications 471
Question 471
Attending physician’s mental notes: initial phone evaluation 472
Question 472
Attending physician’s mental notes: initial phone evaluation (continued) 472
Case outcome: via telephone 472
Further investigation 472
Case outcome: first interim follow-up six hours later 473
Question 473
Attending physician’s mental notes: six hours later 474
Question 474
Attending physician’s mental notes: interim follow-up information through 72 hours 474
Case outcome: interim follow-up information through 72 hours 475
Case outcome: interim follow-up visits through 80 hours 476
Attending physician’s mental notes: interim follow-up information through 72 hours (continued) 476
Question 477
Case outcome: interim follow-up information through 92 hours 477
Case debrief 478
Take-home points 478
Performance in practice: confessions of a psychopharmacologist 479
Tips and pearls 479
Two-minute tutorial 480
Delirium primer 480
Posttest self-assessment question and answer 483
Pretest self-assessment question (answer at the end of the case) 485
Patient evaluation on intake 485
Psychiatric history 485
Social and personal history 487
Medical history 487
Family history 487
Medication history 487
Psychotherapy history 487
Patient evaluation on initial visit 487
Current psychiatric medications 488
Question 488
Attending physician’s mental notes: initial evaluation 488
Question 488
Attending physician’s mental notes: initial evaluation (continued) 489
Case outcome: initial visit 489
Further investigation 490
Question 490
Case outcome: first interim follow-up visit one week later 490
Case debrief 491
Take-home points 492
Performance in practice: confessions of a psychopharmacologist 492
Tips and pearls 493
Mechanism of action moment 495
Two-minute tutorial 496
Disulfiram (Antabuse) 497
Naltrexone (ReVia) 497
Acamprosate (Campral) 497
Posttest self-assessment question and answer 498
Patient evaluation on intake 500
Psychiatric history 500
Social and personal history 501
Medical history 502
Family history 502
Medication history 502
Psychotherapy history 502
Patient evaluation on initial visit 503
Current psychiatric medications 503
Question 503
Attending physician’s mental notes: initial evaluation 503
Question 504
Attending physician’s mental notes: initial evaluation (continued) 504
Case outcome: initial visit 504
Further investigation 505
Case outcome: first interim follow-up visit two months later 506
Question 506
Case outcome: interim follow-up visits three to six months later 507
Attending physician’s mental notes: follow-up visit, six months 507
Case outcome: interim follow-up visits eight to 12 months later 508
Case debrief 508
Take-home points 509
Performance in practice: confessions of a psychopharmacologist 510
Tips and pearls 511
Two-minute tutorial 512
Medication management of ADHD in children versus adults 512
Posttest self-assessment question and answer 513
Patient evaluation on intake 515
Psychiatric history 515
Social and personal history 515
Medical history 516
Family history 516
Medication history 516
Patient evaluation on initial visit 516
Question 517
Attending physician’s mental notes: initial evaluation 517
Case outcome: initial visit 519
Question 520
Attending physician’s mental notes: initial evaluation (continued) 520
Case outcome: interim visit at six weeks 521
Case debrief 522
Take-home points 522
Two-minute tutorial 523
Patient’s genetic summary 526
Patient evaluation on intake 531
Psychiatric history 531
Social and personal history 531
Medical history 531
Family history 531
Patient evaluation on initial visit 531
Question 532
Attending physician’s mental notes: initial evaluation 532
Case outcome: initial visit 533
Question 534
Attending physician’s mental notes: initial evaluation (continued) 534
Case outcome: interim visit at four weeks 535
Case debrief 535
Take-home points 536
Two-minute tutorial 536
A short tutorial on the scientific background of this case 536
Patient’s genetic summary 540
Patient evaluation on intake 544
Psychiatric history 544
Social and personal history 545
Medical history 545
Family history 545
Patient evaluation on initial visit 545
Question 545
Attending physician’s mental notes: initial evaluation 545
Case outcome: initial visit 547
Question 548
Attending physician’s mental notes: initial evaluation (continued) 549
Case outcome: interim visit through 16 weeks 549
Case debrief 549
Take-home points 550
CME online posttest and certificate instructions 553
Case Studies
Stahl’s Essential Psychopharmacology
Volume 2