Cambridge University Press 978-1-108-45074-4 — Practical Psychopharmacology Joseph Goldberg , Stephen Stahl Index More Information

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Index

Locators in bold refer to tables; those in italic to figures FGAs vs. SGAs 357–378 gastrointestinal upsets 199 5HT gene family; see also serotonin receptor hepatic dysfunction 199–200 commercially available tests 168 histamine receptor binding affinities 212 single-nucleotide polymorphisms 92, 167 histamine receptor binding affinities of SGAs 205 hyperhidrosis 200 ABCB1 gene 165, 167 hyperparathyroidism 200, 200 abrupt cessation of drugs 172, 174, 184; see also drug discontinuation hyperprolactinemia 200–201, 201 absolute risk reduction, epidemiology 156 kidney damage 197–198 acamprosate 24, 77, 86, 429, 430–431, 441 lupus erythematosus 198–199, 199 acetylcholinesterase inhibitors (ACHIs), cognitive function 376, 489–490, 492, 499 nephrogenic diabetes insipidus 202 acne, adverse drug effects 193 neuroleptic malignant syndrome 202 active comparators, research studies 66 nocebo effect 192, 193 acute dystonia, adverse drug effects 203 nutraceuticals 231 acute stress disorder 452; see also trauma and PTSD polypharmacy 108 adaptogens, nutraceuticals 228, 243 QTc interval prolongation 196–197, 196, 197 addiction 439; see also alcohol abuse/dependence sedation/somnolence 205 behavioral 438–439, 446 seizures 205 cannabis 436 serotonin receptor binding affinities 212–213 case vignettes 438 serotonin syndrome 205 contingency management 426 sexual dysfunction 206, 216 drug toxicology screens, false positives 441 sialorrhea 206 measures/assessment 427 tolerance optimization 219, 220 methamphetamine use disorder 436 suicidal ideation 206–207 opiates 437, 437, 445 SIADH 207 post-acute withdrawal syndrome 437 tardive dyskinesia 207–209, 208, 208 reward pathway disorders 425–427, 426 tics 210 stimulant and cocaine addiction 434–436, 443 tremor 210 substances of abuse/detection windows 440 weight gain/obesity 210–213, 213, 217, 218 ADHD (attention deficit hyperactivity disorder); see also psychostimulants affect, negative symptoms 389–390 children and adolescents 268, 269 affective disorders see mood disorders cognitive function in adults 493–497 affective instability/lability 308 comorbidity 32, 33 borderline personality disorder 470–471 diagnostic complexity/symptom overlap 27 differential transdiagnostic treatment 31 effect sizes of differing pharmacotherapies 493 psychostimulants 495–497 heritability 150 transdiagnostic treatment 31, 36, 41 off-label drug uses 13 age factors/age at onset placebo effects 86, 87 diagnostic complexity/symptom overlap 2 adherence to treatment outcome moderators 94 long-acting injectable drugs 368 aggression, impulsive 336–346, 347; see also anger outcome mediators 99–100 anticonvulsants 338, 349 polypharmacy 109 antipsychotics 338, 339, 350 racial/ethnic differences 246 beta-blockers 340 sex differences 247 intermittent explosive disorder 340–341 therapeutic drug monitoring 130 lithium 337–338 adjustment disorders, antidepressants 283 serotonergic drugs 348 adolescents see children and adolescents aggressive dosing see high-dosing regimes ADRA2A gene 161 agitated depression 301 adrenochrome hypothesis of schizophrenia 224 agitation, anxiety disorders signs/symptoms 401 adverse drug effects 192–193, 213, 214 akathisia 202, 401 acne 193 alanine aminotransferase (ALT) biomarker 427 alopecia 193–194 alcohol abuse/dependence 426, 427–428 α receptor binding affinities in SGAs 196 acamprosate 429, 430–431, 441 bleeding 194–205 addiction 427 blood dyscrasias 195, 215 anticonvulsants 429–433 bruxism 195 antidepressants 433, 442 cardiovascular 195–197 antipsychotics 434 case vignettes 195, 209 anxiety disorders 433 cause-and-effect relationships 192 baclofen 432 definitions 198 comorbidity 33 dementia 198 definitions and terminology 428 differentiating from lack of efficacy 504–505 detection windows 440 differentiating from natural course of illness 287, 309, 310, 501 disulfiram 429, 431 discontinuation syndrome 170, 198 diversity across subpopulations 253 dopamine receptor binding affinities in SGAs 204 gabapentin 429, 431–432 dry mouth 199 hallucinogens 434 extrapyramidal side effects 202–203, 203 heritability 150

568

INDEX

moderation management 428 anticipation, addiction 426 nalfemene 431 anticonvulsants; see also specific drugs naltrexone 429–430, 441 adverse drug effects 193–194, 199, 206 novel pharmacotherapies 434 alcohol use/dependence 429–433 off-label drug uses 13 as antipsychotic adjuncts 371–372 ondansetron 432 anxiety disorders 402, 411, 420–422 placebo effects 86 borderline personality disorder 481–482 Sinclair method 431 children and adolescents 267 topiramate 431 drug discontinuation 177, 183, 187 type A vs. type B alcoholism 428 hepatically impaired patients 272 withdrawal effects, treating 428–429 impulsive aggression 338 allele, definition 151–152 lactation 272 all-or-nothing thinking, clinician 466 mechanism of action 21 alopecia, adverse drug effects 193–194 multiple pharmacodynamic effects 125 alpha agonists nomenclature/classification 23 anxiety disorders 402, 413 nonsuicidal self-injury 352 cognitive function 496 pharmacokinetic drug interactions 121 trauma/PTSD 457 pregnancy 271 alpha level corrections, false positives 54, 69 psychotropic profiles 330 alpha nicotinic acetylcholine receptors 376, 492–493 renal patients 275 alpha receptor binding affinities, antipsychotics 196 skin excoriation 351 ALT (alanine aminotransferase) biomarkers 427 strategies to optimize tolerance 219 alternative medicine 221; see also nutraceuticals suicidal ideation 206 amantadine trauma/PTSD 458, 463 adverse drug effects 216 antidepressants; see also MAOIs; SNRIs; SSRIs; tricyclic antidepressants cognitive function 488, 496 abrupt cessation issues 172–184 counteraction of iatrogenic weight gain 217 ADHD 496 hepatically impaired patients 275 adjustment disorders 283 OCD 344 adverse drug effects 193–194, 194–205, 206, 207 polypharmacy 117 alcohol abuse 433, 442 renal patients 278 antidepressant discontinuation syndromes 172–173 ambivalence, negative symptoms 389–390 as antipsychotic adjuncts 372 amino acid supplements, depression 237 anxiety disorders 302, 402, 410, 416, 417, 418 amino acids, NMDA receptors 394–395 augmentation vs. switching strategies 288–289 amisulpride 469, 490 augmentation strategies 289–291, 291–293, 325 amitriptyline bipolar disorder 309, 327 dosage conversions 184 borderline personality disorder 472, 473–474, 480 dosing recommendations 322 bupropion 286, 324 protein binding 262 children and adolescents 266 serotonin receptor binding affinities 490 choice of 284–286 therapeutic drug monitoring 141, 143 cocaine addiction 444 amoxapine 248–249, 490 cognitive function 489 amphetamine dosage conversions 176–177, 184 avoiding polypharmacy 128 dosing recommendations 319, 320, 321, 322, 323, 324 children and adolescents 269 drug discontinuation 183 cognitive function 493–494 efficacy 284 detection windows 440 efficacy pharmacogenetics 155 dosage conversions 188 geriatric psychopharmacology 248–249, 250–252, 270 drug toxicology screens, false positives 441 hepatically impaired patients 273 hepatically impaired patients 275 lactation 272 mechanism of action 21 multiple pharmacodynamic effects 126 negative symptoms 394 negative symptoms 392, 393 polypharmacy 118 nomenclature/classification 23 protein binding 262 outcome moderators 93 renal patients 278 pharmacokinetic drug interactions 120, 121 schizophrenia 375–376 pregnancy 271 stimulant use disorder 434–436 psychotic depression 300 therapeutic drug monitoring 143 renal patients 276 amygdala 334, 426; see also limbic system sex differences 247 analysis of variance (ANOVA) statistic 61–62 strategies to optimize tolerance 220 ancestry, definition 245; see also racial differences suicidal ideation 206 anger 336, 471–472, 472; see also aggression supratherapeutic dosing 286–288, 324 anhedonia 43, 106, 289, 390 switching vs. augmentation strategies 288–289 anorexia nervosa 32, 150, 236 therapeutic drug monitoring 135, 142 antepartum depression 253–254; see also reproductive psychopharmacology tolerability 285 anterior cingulate cortex (ACC), impulsivity 334–335 use of SGAs as augmentation strategy 289–291, 325 anterior insular cortex 335, 426 antihistamines; see also specific drugs anterior nuclei, thalamus 335 adverse drug effects 205 anticholinergics; see also specific drugs anxiety disorders 402, 412 adverse drug effects 198, 199 cognitive function 488 cognitive function 488 nomenclature/classification 23 FGAs 359 antihypertensives, nomenclature/classification 23 geriatric psychopharmacology 248–249, 251 anti-inflammatories, as adjuncts 372–373, 373

569

INDEX

antipsychotics; see also specific drugs gepirone 408 adverse drug effects 196, 197, 201, 205 geriatric psychopharmacology 252 alcohol use/dependence 434 HIV/AIDS patients 263 alpha receptor binding affinities 196 lactation 272 antidepressant augmentation/adjuncts 289–291, 325 maintenance vs. drug discontinuation 191 anxiety disorders 402, 411–412, 423–424 measures/assessment 415 atypical antipsychotics 356–357 mineral deficiencies 236 augmentation strategies 369, 367–370, 387, 373, 374, 370–375 mirtazapine 302, 419 bipolar depression 317 with mood disorders 301–302, 302, 317 bipolar disorder 309–310, 331, 332 nefazodone/trazodone 418 borderline personality disorder 472, 473, 474–475, 483–484 off-label drug uses 13 children and adolescents 266 outcome moderators 96 cocaine addiction 435–436 pharmacotherapy 402, 403 cognitive rigidity/inflexibility 364 placebo effects 86, 87 conversion to long-acting injectable 186 probiotics 243 dopamine receptor binding affinities 204, 362–363, 363 serotonin receptor binding affinities 407–410, 408 dopaminergic system 355–356 signs and symptoms 401, 401–402 dosage conversions 177, 185 symptoms vs. formal disorders 400–401 dose-response relationships 367 vilazodone and vortioxetine 408–410 dosing recommendations 378, 379–380, 382–385 Yerkes–Dodson law 400 drug discontinuation 183 anxiolysis, off-label drug uses 13 drug interactions 110 Apollonian alcoholism 428 efficacy of different drugs 364, 365–366 arginine supplements 237 extrapyramidal side effects 202–203, 203 aripiprazole FGAs vs. SGAs 357–378 α receptor binding affinities 196 geriatric psychopharmacology 248–249, 252 antidepressant augmentation/adjuncts 325 hepatically impaired patients 274 anxiety disorders 423–424 high-dosing regimes 365, 381 augmentation strategies 373 histamine receptor binding affinities 205, 212 bipolar disorder 331 HIV/AIDS patients 263 borderline personality disorder 472, 483–484 impulsive aggression 338, 339, 350 dopamine receptor binding affinities 204 lactation 272 dosage conversions 185, 186 long-acting injectable 368, 369, 386–387 dosing recommendations 382 mania 305–306 geriatric psychopharmacology 251–252 multiple pharmacodynamic effects 127 hepatically impaired patients 274 negative symptoms 391, 391–392, 398–399 high-dosing regimes 381 nomenclature/classification 23 histamine receptor binding affinities 205, 212 nonsuicidal self-injury 352 impulsive aggression 350 vs. placebo 366 long-acting injectable 186, 368, 369, 386–387 polypharmacy 116–117, 118, 370 multiple pharmacodynamic effects 127 pregnancy 271 negative symptoms 398–399 psychotic depression 300 protein binding 262 racial/ethnic differences 246 renal patients 277 renal patients 277 research studies 67 serotonin receptor binding affinities 212–213 serotonin receptor binding affinities 212–213, 290, 408, 490 short-acting intramuscular injection 367–368 short-acting intramuscular injection 367–368 strategies to optimize tolerance 220 therapeutic drug monitoring 143, 148 tardive dyskinesia 207–209, 208 trauma/PTSD 464 therapeutic drug monitoring 147, 148 armodafinil 143, 205 trauma/PTSD 458, 464 arousal states weight gain and obesity 213 alpha agonists 413 antisocial personality disorder see borderline, histrionic, narcissistic and antisocial biomarkers 105–106 personality disorder (cluster B) PTSD 449 anti-switch vs. anti-recurrence drugs, bipolar disorder 306–308, 307 transdiagnostic treatment 38, 41 anxiety/GAD 400–401, 414; see also panic disorder; social anxiety disorder asenapine abortive relief vs. preventative therapy 402–407 α receptor binding affinities 196 alcohol use/dependence 433 bipolar disorder 332 alpha agonists 413 borderline personality disorder 483–484 anticonvulsants 411, 420–422 dosage conversions 185 antidepressants 302, 410, 416, 417, 418, 419 dosing recommendations 382 antihistamines 412 hepatically impaired patients 274 antipsychotics 411–412, 423–424 histamine receptor binding affinities 205, 212 benzodiazepines 402, 403, 404–407, 416 negative symptoms 398–399 beta–blockers 402, 412–413 serotonin receptor binding affinities 212–213, 290, 408, 490 bupropion 418 therapeutic drug monitoring 148 buspirone 402, 403, 407–408 trauma/PTSD 464 cannabidiol 413–414 aspartate aminotransferase (AST) biomarker 427 case vignettes 405, 412 assay sensitivity, research studies 55 children and adolescents 268 assessment see measurement instruments definitions and terminology 355 association, genetic 151–152 drug discontinuation 177, 187, 191 association, negative symptoms 389–390 GABAergic system 402–403, 403 astrological post hoc analyses 103

570

INDEX

atomoxetine affective instability/lability 308 children and adolescents 269 antidepressants 309, 327 cognitive function 495–496 antipsychotics 305–306, 309–310, 331, 332 drug interactions 110 anti-switch vs. anti-recurrence drugs 306–308, 307 schizophrenia 375–376 case vignettes 13, 129–130, 170, 174 therapeutic drug monitoring 143 children and adolescents 266 attention deficit hyperactivity disorder see ADHD cognitive function 490–491, 499 attentional processing 485, 498 combination therapy 310–312, 328 depression 303 complex/comorbid presentations 32, 33, 33, 317, 329 diagnostic complexity/symptom overlap 27 confounding factors 51–52 impairments across psychiatric conditions 499 cyclothymic disorder 308 transdiagnostic treatment 36, 41 diagnostic complexity/symptom overlap 27 attrition/study dropout, research studies 60–61, 70 differential transdiagnostic treatment 31 atypical depression 301 drug discontinuation 170, 174, 190 atypical antipsychotics 356–357 efficacy of lithium for subsequent episodes 11 autism spectrum disorders heritability 150 heritability 150 lamotrigine 312–314, 314 negative symptoms 389–390 maintenance vs. drug discontinuation 180–181, 181, 191 probiotics 243 measurement-based care 129–130 autonomic arousal see arousal states mood stabilizers 306–308, 312–314 avoidance states, PTSD 449 off-label drug uses 13 avoidant personality disorder (cluster C) 478 outcome moderators 96, 106 overlapping features with personality disorders 467, 467 B vitamin deficiencies 224, 227–228 placebo effects 81, 81, 86, 87 baclofen, alcohol use/dependence 432 polypharmacy 108 Bacon, Sir Francis 192 premature study dropout levels 70 barbiturates 248–249, 440, 441 psychostimulants 312 Bartter–Schwartz criteria, SIADH 207 rapid cycling 314–315, 329 baseline severity relapses 255–256 law of initial value 93 research studies 62, 66 outcome moderators 93–94, 97 suicidal ideation 50 placebo effects 80–81, 81, 93 transdiagnostic treatment 31 baseline variables, research studies 55 treatment-emergent affective switch 309–310, 309, 327 Bayesian analysis, research studies 57–60 tweaking drug regimens 9 BDNF gene 167, 168 bitoperin 396 behavioral addictions 438–439, 446 bleeding, adverse drug effects 194–205 benign ethnic neutropenia (BEN) 246 blood dyscrasias, adverse drug effects 195, 215 benzodiazepines blood–brain barrier (BBB), nutraceuticals 225–226, 227–228 adverse drug effects 198, 205 body dysmorphic disorder (BDD) 465 alcohol withdrawal 428–429 Bonferroni corrections, statistical significance 69 as antipsychotic adjuncts 375 borderline, histrionic, narcissistic and antisocial personality disorder anxiety disorders 402, 403, 404–407, 416 (cluster B) 470–471, 479 borderline personality disorder 476 affective instability/lability 470–471 children and adolescents 268 anger 471–472, 472 cognitive function 488 anticonvulsants 481–482 detection windows 440 antipsychotics 474–475, 483–484 dosage conversions 187 benzodiazepines 476 drug discontinuation 177 case vignettes 477–478 drug interactions 123 coping skills 476 drug toxicology screens, false positives 441 depression/antidepressants 473, 473–474, 480 effect sizes 403 diagnostic complexity/symptom overlap 27 factors associated with long-term use 416 distress intolerance 472 geriatric psychopharmacology 248–249 memantine 476 impulsive aggression 339 methylphenidate 477 pregnancy 271 mood stabilizers 472, 473, 474 tapering drugs 407, 411, 438 omega-3 fatty acids 476 trauma/PTSD 455–456 oxytocin 477 bespoke treatment see precision medicine self-injurious behavior (SIB) 472 beta–blockers suicidal ideation 472–473 anxiety disorders 402, 412–413 yi-gan san (Chinese herbal medicine) 476 and depression 338 bottom-up cognition 101, 334 impulsive aggression 340 bound drug fractions 264 trauma/PTSD 456–457 bradycardia, adverse drug effects 195 β level corrections, type II errors 54 brain-gut interactions 229, 243 bias, cause-and-effect relationships 4 brain regions/connectivity, binge eating disorder 32, 32, 86 addiction 426 binge-intoxication 426 impulsivity/compulsivity 334–335, 334, 342 biomarkers of disease negative symptoms 389, 390 alcohol use/dependence 427 psychosis 118 diagnostic complexity/symptom overlap 26 trauma 447 outcome moderators 90–91, 98, 105–106 brain volume, trauma/PTSD 447 bipolar disorder 305; see also depression (bipolar); lithium; mania (bipolar) Bradford Hill criteria, cause-and-effect relationships 4

571

INDEX

breast cancer, drug contraindications 247 efficacy pharmacogenetics 155 brexanolone, postpartum depression 256 hepatically impaired patients 272 brexpiprazole impulsive aggression 349 α receptor binding affinities 196 indications for 316 antidepressant augmentation/adjuncts 325 pregnancy 271 anxiety disorders 423–424 protein binding 262 bipolar disorder 331 psychotropic profiles 330 dopamine receptor binding affinities 204 renal patients 275 dosage conversions 185 strategies to optimize tolerance 219 dosing recommendations 382 therapeutic drug monitoring 139, 143 geriatric psychopharmacology 251–252 trauma/PTSD 463 hepatically impaired patients 274 tweaking drug regimens 8 high-dosing regimes 381 carbohydrate deficient transferrin (CDT) biomarker 427 histamine receptor binding affinities 205, 212 Cardenas, Diane 221 impulsive aggression 350 cardiovascular adverse drug effects 195–197 negative symptoms 398–399 cariprazine protein binding 262 α receptor binding affinities 196 renal patients 277 antidepressant augmentation/adjuncts 325 serotonin receptor binding affinities 212–213, 408, 490 anxiety disorders 423–424 therapeutic drug monitoring 143 bipolar depression 328 bruxism, adverse drug effects 195 bipolar disorder 331 bulimia nervosa 32, 86, 87 dopamine receptor binding affinities 204 buprenorphine 437, 440, 445 dosage conversions 185 bupropion 286 dosing recommendations 382 adverse drug effects 205, 216 hepatically impaired patients 274 anxiety disorders 418 high-dosing regimes 381 avoiding polypharmacy 128 histamine receptor binding affinities 205, 212 behavioral addictions 446 impulsive aggression 350 children and adolescents 269 long-acting injectable 368 cocaine addiction 444 negative symptoms 398–399 dosage conversions 184 renal patients 277 dosing recommendations 324 serotonin receptor binding affinities 212–213, 408, 490 drug interactions 110, 120, 123, 124 therapeutic drug monitoring 143, 148 geriatric psychopharmacology 270 carnosine, cognitive function 492 outcome moderators 97 carry-over effects, research studies 52 protein binding 262 catatonia 301 renal patients 276 catecholamine hypothesis of mood disorders 12 supratherapeutic dosing 324 categories vs. dimensions see transdiagnostic treatment therapeutic drug monitoring 142 CATIE trial 89, 364, 365, 491 buspirone cause-and-effect relationships 3–4 adverse drug effects 216 adverse drug effects 192 anxiety disorders 402, 403, 407–408 Bradford Hill Criteria 4 children and adolescents 268 case vignette 5 depression 291 observed effects/outcomes 4–5 effect sizes 403 CBD see cannabidiol serotonin receptor binding affinities 212, 408, 407–408, 490 CDT (carbohydrate deficient transferrin) biomarker 427 therapeutic drug monitoring 143 celiac disease, patients with 261 cessation of drugs, abrupt 172, 174, 184; see also drug discontinuation CACNA1C gene, efficacy pharmacogenetics 167 changes in drug regimens see tweaking drug regimens calcium, psychiatric utility of supplements 236 chemical imbalance hypothesis 12 calcium channel blockers, adverse drug effects 199 children and adolescents 248 candidate gene studies 151–153; see also pharmacogenetics anticonvulsants 267 cannabidiol (CBD) 226–227 antidepressants 266 anxiety disorders 413–414 antipsychotics 266 definition 227 anxiolytics 268 drug toxicology screens, false positives 441 lithium 266 negative symptoms 397 psychostimulants 268, 269 opiate addiction 445 trauma outcome moderators 97 schizophrenia 375 Chinese herbal medicine 221, 476; see also nutraceuticals trauma/PTSD 459 chirality, drug 178 cannabis addiction 436 chlorpromazine carbamazepine adverse drug effects 196, 199 adverse drug effects 207, 215 dosage conversions 185 alcohol use/dependence 429 dosing 379–380 as antipsychotic adjunct 387 usefulness 358–359 anxiety disorders 420 choline, nutraceuticals 241–242 avoiding polypharmacy 128 cholinergic drugs, schizophrenia 376 bipolar mania 316 cholinergic rebound, abrupt cessation of drugs 172 borderline personality disorder 481–482 cholinergic neurotransmitter systems 16 children and adolescents 267 chromium, psychiatric utility of supplements 236 contraindications 170 chronic major depression 174, 190, 300 drug interactions 121 chronic obstructive pulmonary disease (COPD), and depression 259–260

572

INDEX

chronicity, outcome moderators 94–95 bipolar disorder 490–491 Church, George M. 149 case vignettes 491 Churchill, Sir Winston 107 clinical assessment approach 487–488 cigarette smokers, diversity across subpopulations 252 dementia 497, 499 citalopram impairments across psychiatric conditions 499 adverse drug effects 196 lithium 315–316 alcohol use/dependence 442 major cognitive domains 498 compulsive shopping/buying behavior 346 measurement instruments 486–487 dosing recommendations 319 memory 485 geriatric psychopharmacology 270 mood disorders 488–490 histamine receptor binding affinities 212 outcome mediators 101 impulsive aggression 348 practice effects 488 protein binding 262 as primary treatment target in schizophrenia 375–376 renal patients 276 procholinergics 489–490 serotonin receptor binding affinities 212–213 pseudospecificity 488–489 supratherapeutic dosing 324 PTSD 449 therapeutic drug monitoring 140, 143 pyramid model 486, 487 citicoline 397, 436 schizophrenia 491–493 classification functions, research studies 67, 67; see also nomenclature serotonin receptor 489–490, 490 Clinical Antipsychotics Treatment Intervention Effectiveness see CATIE trial subtypes of long-term memory 487 clinical assessment approach, cognitive function 487–488 therapeutic drug monitoring 144 clinical equipoise, research studies 52 cognitive rigidity/inflexibility, antipsychotics 364 Clinical Institute Withdrawal Assessment for Alcohol revised (CIWA-Ar) 427 Cohen’s d, research studies 56, 58–59 Clinical Opiate Withdrawal Scale (COWS) 427 cold cognition see top-down cognition clinically meaningful results, research 54, 56–57 collinearity 92 Clinician-Administered PTSD Scale (CAPS) 450 combination therapy see polypharmacy/combination therapy clomipramine comorbidity 32–34; see also diagnostic complexity anxiety disorders 417 ADHD 32, 33 dosage conversions 184 alcoholism 33 dosing recommendations 322 anorexia nervosa 32 drug interactions 110, 123 binge eating disorder 32, 32 serotonin receptor binding affinities 490 bipolar disorder 33, 33, 329 therapeutic drug monitoring 141, 143 bulimia nervosa 32 trichotillomania 345 genetics 33–34, 34 clonazepam, anxiety disorders 404–405 psychosis 32, 32 clonidine 269, 445, 457–458 substance use disorders 35 clozapine complementary medicine, anxiety disorders 403; see also nutraceuticals abrupt cessation issues 172–184 completely missing at random (MCAR), research studies 60 α receptor binding affinities 196 completer analyses, research studies 60, 61 antidepressant augmentation/adjuncts 325 complex combination therapy 107; see also polypharmacy/combination therapies augmentation strategies 373–374, 374 complex presentations see diagnostic complexity borderline personality disorder 483–484 compulsions, definitions 333; see also impulsivity/compulsivity dopamine receptor binding affinities 204 compulsive shopping/buying behavior 346 dosage conversions 185 COMT gene 78, 152, 160–161 dosing recommendations 383 Conan Doyle, Sir Arthur 3, 91 drug interactions 121, 122, 123 confidence intervals (CIs) 51, 258 high-dosing regimes 381 confounding by indication, defined 50; adverse drug effects 198 histamine receptor binding affinities 205, 212 confounding factors impulsive aggression 350 cause-and-effect relationships 4 negative symptoms 398–399 outcome moderators/mediators 92 polypharmacy 116–117 research studies 51–52 protein binding 262 CONSORT (CONsolidated Standards of Reporting Trials) diagrams, research racial/ethnic differences 246 studies 49, 49 renal patients 277 context processing 470 serotonin receptor binding affinities 212–213, 290, 408, 490 contingency management (CM) 426 therapeutic drug monitoring 148 controlled drinking, moderation management 428 CNTN4 gene 167 Cooper’s nomogram 134 cocaine addiction 434–436 coping skills, borderline personality disorder 476; see also resilience antidepressants 444 core mood symptoms 289 antipsychotics 435–436 corticolimbic circuitry see limbic system detection windows 440 cortico-striatal-thalamo-cortical circuitry 342 topiramate 443 course of illness Cochrane’s Q parameter 63 diagnostic complexity/symptom overlap 27, 29 codeine 155, 440 differentiating adverse effects from 287, 309, 310, 501 coefficient of variation, measurement-based care 132 longitudinal stability 30–31, 43 co-enzyme Q10 241–242 course of treatment 7–9 cognitive function 485, 497; see also attentional processing; disorganized thinking; drug maintenance vs. discontinuation 179, 180–182 executive function two week/20% rule 8 ADHD 493, 493–497 COVID-19 pandemic, trauma/PTSD 452–453 affective instability/lability 495–497 Cox proportional hazard models, research studies 65 antidepressants 489 creatine 459, 491 biomarkers 105–106 credible intervals, Bayesian analysis 58

573

INDEX

crime scene investigation (CSI) psychiatry 5–6, 26 outcome moderators 96, 106 crossover designs, research studies 52, 53 and physical illness 258–260, 259, 263 cross-tapering 170–171; see also tapering drug regimes placebo effects 86, 87 curvilinear dose-response curves 132 premature study dropout levels 70 cyclothymic disorder 308 premenstrual/premenstrual dysphoric disorder 256–257 CYP gene family 161, 165 probiotics 243 cytochrome P450 system psychedelic drugs 304 drug interactions 100 psychotic 300 efficacy pharmacogenetics 155 relapse-prevention post ECT 304, 326 nutraceuticals 231 sex differences 247 pharmacokinetic pharmacogenetics 154, 155 serotonergic system 291 pharmacokinetics 263 transdiagnostic treatment 31, 41 therapeutic drug monitoring 143 descriptive statistics, research studies 61 desipramine D-cycloserine, cognitive function 492 alcohol use/dependence 442 D-serine, trauma/PTSD 459 anxiety disorders 417 D vitamin deficiencies 223–224 cocaine addiction 435, 444 case vignettes 223 dosage conversions 184 depression 223–224, 232 dosing recommendations 322 physiological role 233 protein binding 262 schizophrenia 223 therapeutic drug monitoring 141, 143 treating low serum levels 224 desvenlafaxine dasotraline, ADHD 496 dosing recommendations 320 data mining, research studies 63 geriatric psychopharmacology 250 Davidson Trauma Scale 451 protein binding 262 davunetide (novel neuropeptide) 368 renal patients 276 deficit states see negative symptoms supratherapeutic dosing 324 delirium 31–32, 401 therapeutic drug monitoring 136–137, 141 delusional parasitosis, pimozide 359 deutetrabenazine dementia protein binding 262 adverse drug effects 198 tardive dyskinesia 208 agitation and aggression 260–261 therapeutic drug monitoring 143 anxiety disorders signs/symptoms 401 dextroamphetamine cognitive function 497 half-life of drugs 178 differential transdiagnostic treatment 31–32 OCD 344 therapeutic drug monitoring 144 therapeutic drug monitoring 143 demographic factors, adherence to treatment 100 dextromethorphan 143, 248 dependent personality disorder (cluster C) 478 DHEA (dehydroepiandosterone) dependent (outcome) variables, research studies 55 cognitive function 492 deprescribing see drug discontinuation negative symptoms 396 depression, bipolar 308–309, 310 psychotropic relevance of 238 antidepressants 309, 327 diagnostic complexity 6; see also comorbidity; differential diagnosis; form fruste antipsychotics 317 conditions; transdiagnostic treatment evidence-based medicine 310, 311, 328 bipolar disorder 329 lamotrigine 312–314, 313 evidence-based medicine 7 treatment flow diagram 310 heritability of psychiatric disorders 150–151 depression/MDD; see also antidepressants; postpartum depression; treatment- overlapping symptoms domains 41 resistant depression PTSD 449–450 agitated 301 and symptom overlap 26–27 amino acid supplements 237 diagnostic criteria, research studies 48 with anxiety disorders 301–302, 302, 401 diagnostic errors 30, 466; see also differential diagnosis; form fruste conditions attentional processing 303 diazepam 143, 187 atypical 301 dietary restrictions, MAOIs 296 and beta-blockers 338 Dietary Supplement Health and Education Act (DSHEA) 222 borderline personality disorder 473–474 dietary supplements, definition 222; see also nutraceuticals children and adolescents 266 differential diagnosis; see also diagnostic complexity chronic/persistent 300 affective instability/lability vs. bipolar disorder 31 cognitive function 499 cognitive disorganization 31–32 D vitamin deficiency 223–224, 232 diagnostic complexity/symptom overlap 27, 41 drug discontinuation 174, 190 negative symptoms vs. depression 31 drug maintenance vs. discontinuation 181, 191 diffusion tensor imaging (DTI) 91 geriatric psychopharmacology 250–252, 270 digit symbol substitution test (DSST) 487, 487, 488–489 heritability 150 dimensions vs. categories see transdiagnostic treatment indications for pharmacotherapy 283 Dionysian alcoholism 428 inflammatory-state 303 diphenhydramine 143, 255 L-methylfolate 228 discontinuation syndrome 172, 198; see also drug discontinuation maintenance phase 304–305 disorganized thinking 31–32, 41 mineral deficiencies 236 dispositional optimism, placebo effects 77 noradrenergic symptom cluster 302 dissociation, trauma/PTSD 459–460 nutraceuticals 241–242 dissociative identity disorder (DID) 460 off-label drug uses 13 distress, and trauma 448–449 one-carbon donor molecules 227, 227–228 distress intolerance

574

INDEX

borderline personality disorder 472 art of deprescribing 114–115, 178–179 post-traumatic 39 axioms 178–179 and recovery 10 benzodiazepines 177, 187, 407 transdiagnostic treatment 38–39 case vignettes 170, 174–175, 175–176 withdrawal effects 438 chirality 178 disulfiram 146, 429, 431 conversion to LAI antipsychotics 186 divalproex cross-tapering vs. switching to another drug 170–171 adverse drug effects 215 exponential half-life elimination 176 alcohol use/dependence 429 half-life of drugs 178 as antipsychotic adjunct 387 lack of efficacy 169–170 anxiety disorders 420 vs. maintenance 179, 180–182, 181, 191 bipolar mania 316 MAOIs 173 borderline personality disorder 481–482 placebo effects 84 children and adolescents 267 polypharmacy 114–115 contraindications 170 prior to starting ECT 173–174 hepatically impaired patients 272 psychostimulants 177–178, 188, 189 impulsive aggression 338, 349 randomized controlled trials 190 indications for 316 situations requiring 170, 183 polycystic ovarian syndrome 257 switching serotonergic agents 175 pregnancy 271 drug interactions; see also pharmacokinetic interactions protein binding 262 outcome mediators 99–100 psychotropic profiles 330 pharmacodynamic 123 renal patients 275 polypharmacy 108–125, 120, 121, 122 research studies 66 therapeutic drug monitoring 130 strategies to optimize tolerance 219 drug intolerance see adverse drug effects therapeutic drug monitoring 139 drug level monitoring see therapeutic drug monitoring trauma/PTSD 463 drug response, heritability 150 tweaking drug regimens 8 drug treatments, general information 3, 15, 500 diversity across subpopulations 244–245, 265; see also children and avoiding changes where possible 175, 503 adolescents; geriatric psychopharmacology; physical illness; reproductive backup plans 502–503 psychopharmacology case vignettes 5, 13, 505 alcohol use 253 cause-and-effect relationships 3–4, 4 cigarette smokers 252 caution in use of high-dosing regimes 506 racial/ethnic differences 245–247 changing one variable at a time 500 sex differences 247–248 course of treatment 7–8 donepezil 278, 488, 489–490, 499 defining goals of treatment 14–15 dopamine receptor binding affinities 362–363, 363 defining recovery 10 antipsychotics 204, 363 differentiating effects from lack of efficacy 504–505 anxiety disorders 423–424 differentiating effects from natural course of illness 287, 309, 310, 501 bipolar disorder 331, 332 dose-response relationships 9–10 dosing recommendations 382 efficacy for subsequent episodes 11 polypharmacy 117–118 gyroscope analogy 10 dopaminergic system 17 humility in practice 507 addiction 426 learning from past experience 503–504 drug interactions 110 mechanism of action 11–12, 21 negative symptoms 389, 393–394 nomenclature/classification 13–14, 23 psychosis 355, 355–356, 360, 361–362 objective measures of symptom severity 500–501 and serotonergic system 356–357, 391, 391 observed effects/outcomes 4–5 DORAs (dual orexin receptor antagonists) 21 “on- label/off-label” uses 12–13 dorsolateral prefrontal cortex (DLPFC) 334–335 patient individuality 7–8 dose-response relationships 9–10; see also high-dosing regimes pharmaco-archaeology 504 placebo effects 77 phases of drug development 22 lurasidone 367 recognising need to move beyond pharmacological solutions 507 therapeutic drug monitoring 132 retracing steps if problems arise 503 doxepin risk-benefit analysis of aggressive pharmacology 506–507 dosage conversions 184 role of placebo/nocebo effects 505 dosing recommendations 322 sliding scale approach 505 hepatically impaired patients 274 treatment rationale 502 protein binding 262 tweaking drug regimens 8–9 therapeutic drug monitoring 143 two week/20% rule 8 DRD4 gene 167, 168 wise use of technology 506 dronabinol, addiction 436 dry drunk 426 dropout rates, research studies 60–61, 70 dry mouth, adverse drug effects 199 drug discontinuation 169, 182; see also tapering drug regimes; withdrawal effects DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), transdiagnostic abrupt cessation advantages 174 treatment 36 abrupt cessation issues 172, 184 duloxetine ain’t broke don’t fix 175, 503 anxiety disorders 302, 407, 419 alcohol withdrawal 428–429 cigarette smokers 252 anticonvulsants 177, 187 dosing recommendations 320 antidepressant discontinuation syndromes 172–173 geriatric psychopharmacology 250, 270 antidepressant dosage equivalents 176–177, 184 impulsive aggression 348 antipsychotic dosage equivalents 177, 185 renal patients 276

575

INDEX

duloxetine (cont.) failed trials, research studies 66 serotonin receptor binding affinities 212–213 false discovery statistic 69 therapeutic drug monitoring 141, 143 false negatives, research studies 54, 74, 103 duration of untreated illness (DUI) outcome moderators 95–96 false positives, research studies 54 dysthymic disorder 300 familiality, definition 150; see also pharmacogenetics dystonia, acute 203 family history, diagnostic complexity 27 family-wise error rate (FWER) 55 early response to treatment, outcome mediators 101–102 fast-on/fast-off hypothesis, atypical antipsychotics 356 EBM see evidence-based medicine fat-soluble vitamins 232, 233 ecological fallacy, definition 81 fear, vs. anxiety disorders 355 Ecstasy 440, 459 fight-or-flight response 354; see also hot cognition ECT (electroconvulsive therapy) 173–174, 304, 326, 375 FINISH mnemonic, antidepressant discontinuation 172–173 Edison, Thomas 485 first order kinetics, dose-response curves 132 EEG (electroencephalography) 105–106 five-factor model of personality 35–36, 45 effect sizes, research studies 53, 56 fixed-dose research studies 64, 177 efficacy, and drug discontinuation 169–170 fixed effects, meta-analyses 63 efficacy pharmacogenetics 153, 155–158, 167 fixed tapering dose regimen (FTDR), alcohol 429 efficacy vs. effectiveness, research studies 65, 89 flexible dose research studies 64 Einstein, Albert 129 fluoxetine elderly patients see geriatric psychopharmacology adverse drug effects 196 electroconvulsive therapy see ECT alcohol use/dependence 442 emotional lability see affective instability/lability anxiety disorders 302, 416, 419 emotional processing, outcome mediators 101 borderline personality disorder 480 endophenotypes, definition 152 cigarette smokers 252 end-organ monitoring 137, 146 dosing recommendations 319 enduring response to treatment, outcome mediators 101–102 drug interactions 121 enriched study designs 66–67, 103 geriatric psychopharmacology 270 epidemiology, absolute risk reduction 156 histamine receptor binding affinities 212 errors see diagnostic errors impulsive aggression 348 escitalopram multiple pharmacodynamic effects 126 anxiety disorders 302, 407, 416, 419 outcome moderators 96 dosage conversions 184 protein binding 262 dosing recommendations 319 renal patients 276 efficacy pharmacogenetics 156 schizotypal personality disorder 470 geriatric psychopharmacology 270 serotonin receptor binding affinities 212–213 histamine receptor binding affinities 212 skin excoriation 351 inflammatory-state depression 303 therapeutic drug monitoring 140, 143 protein binding 262 fluphenazine renal patients 276 conversion to long-acting injectable 186 serotonin receptor binding affinities 212–213, 408 dosage conversions 185 skin excoriation 351 dosing 379–380 supratherapeutic dosing 324 therapeutic drug monitoring 147 therapeutic drug monitoring 140, 143 fluvoxamine estrogen, negative symptoms 396 alcohol use/dependence 442 eszopiclone behavioral addictions 446 drug-drug interactions 123 borderline personality disorder 480 hepatically impaired patients 274 cigarette smokers 252 protein binding 262 dosage conversions 184 renal impairment 278 dosing recommendations 319 therapeutic drug monitoring 143 drug interactions 110, 123 ethnicity, definition 245; see also racial differences impulsive aggression 348 euphoria, transdiagnostic treatment 41 multiple pharmacodynamic effects 126 evidence-based medicine (EBM) 6–7; see also randomized controlled trials; research protein binding 262 studies and statistical analysis renal patients 276 bipolar depression 310, 311, 328 serotonin receptor binding affinities 212–213 vs. compassionate care/pragmatic solutions 500 skin excoriation 351 levels of evidence 7 therapeutic drug monitoring 140, 143 nutraceuticals 221–222, 225 fMRI (functional magnetic resonance imaging) 91, 105–106 polypharmacy 108, 111 folic acid, nutraceuticals 228 research studies 48 food, medications best absorbed with/without 131 exaggerated incentive salience 426 form fruste conditions 5, 25, 29–30 executive function 37, 41, 486, 494–495; see also cognitive function formal thought disorder (FTD) 31–32 expectation bias, placebo effects 76 fornix, impulsivity/compulsivity 335 exponential dose-response curves 132 4 As (affect, association, ambivalence and autism), negative symptoms 389–390 exponential half-life elimination 176 fraction excreted unchanged (Fe) 264 expressed emotion (EE), outcome mediators 101 frequentist statistics, research studies 57 extensive metabolizers (EMs) 154 funnel plots, meta-analyses 64, 71 external locus of control, placebo effects 77 externalizing vs. internalizing dichotomy, transdiagnostic treatment 30, 43 g factor (general cognitive ability) 487; see also cognitive function extraction ratio 264 GABAergic system extrapyramidal side effects (EPS) 202–203, 203; see also tardive dyskinesia adverse drug effects 205 FGAs vs. SGAs 357–378 anxiety disorders 402–403, 403, 411 racial/ethnic differences 246 neurotransmitter systems 19

576

INDEX

polypharmacy 118, 118 schizotypal personality disorder 470 psychotropic relevance of supplements 237 tics 210 gabapentin trauma/PTSD 457–458 adverse drug effects 205 gut flora 229, 243 alcohol use/dependence 429, 431–432 gyroscope analogy, resilience 10 anxiety disorders 411, 422 avoiding polypharmacy 128 H2 blockers, geriatric psychopharmacology 248 borderline personality disorder 481–482 hair pulling 345 children and adolescents 267 half-life of drugs 176, 178, 385 drug discontinuation 177, 187 hallucinogens 434, 438 drug interactions 110 haloperidol hepatically impaired patients 272 conversion to long-acting injectable 186 high-risk subgroups 248 dosage conversions 185 OCD 344 schizotypal personality disorder 470 off-label uses 13 serotonin receptor binding affinities 490 pregnancy 271 therapeutic drug monitoring 143, 147 protein binding 262 halotype, definition 151–152 psychotropic profiles 330 Hardy–Weinberg equilibrium (HWE), definition 151–152 renal patients 264, 275 Hawthorne effect 75, 76 stimulant use disorder 435 Hedges’ g, research studies 56, 58–59 strategies to optimize tolerance 219 hedonic capacity 101; see also anhedonia trauma/PTSD 463 hedonistic behavior, transdiagnostic treatment 41 GAD (general anxiety disorder) see anxiety/GAD Hemingway, Ernest 281 galantamine 16 hepatically impaired patients 261 cognitive function 376, 489–490, 492 adverse drug effects 199–200 effect sizes 499 anticonvulsants 272 hepatically impaired patients 275 antidepressants 273 renal patients 278 antipsychotics 274 gambling, pathological 446 other medications 275 gaslighting 353, 354 psychostimulants 275 gastric bypass, patients with 261 safety pharmacogenetics 164 gastrointestinal disorders, patients with 261 sedatives 274 gastrointestinal upsets, adverse drug effects 199 Heraclitus 333 gatekeeping procedures, research studies 55 herbal medicines 221, 239, 240, 476; see also nutraceuticals gender dysphoria, diversity across subpopulations 247–248 heritability; see also pharmacogenetics general anxiety disorder see anxiety/GAD definition 150 general cognitive ability 487; see also cognitive function drug response 150, 153 generalized estimating equations (GEE) 60, 61 psychiatric disorders 150, 150–153 genetics see pharmacogenetics heroin, detection windows 440 Genome-Based Therapeutic Drugs for Depression (GENDEP) project 157 heterogeneity, meta-analyses 63 genome-wide association studies (GWAS) 152–153; see also pharmacogenetics heterozygote, definition 151–152 Genomics Used to Improve DEpression Decisions (GUIDED) trial, high sensitivity C-reactive protein (hs-CRP) biomarkers 105–106 pharmacogenetics 156–157 high-dosing regimes 10 genotype, definition 151–152 antidepressants 286–288 gepirone, anxiety disorders 408 antipsychotics 365, 381 geriatric psychopharmacology 248 caution in use of 506 adjunctive strategies 251–252 risk-benefit analysis 506–507 antipsychotics 252 hippocampus 334, 447; see also limbic system anxiolytics 252 Hippocrates 221 depression/antidepressants 250–252, 270 histamine system 20 other safety considerations 249–250 adverse drug effects 212 sleep aids 249 antipsychotics 205 specific drugs/conditions 248–249 historical perspectives, nutraceuticals 221 Gingko biloba, effect on cognitive function 497 histrionic personality disorder see borderline, histrionic, narcissistic and antisocial glaucoma, patients with 261–262 personality disorder (cluster B) glutamate supplements 237 hit and run drugs, therapeutic drug monitoring 131 glutamate receptors 297, 360, 361, 362 HIV/AIDS, patients with 262–263 glutamatergic system; see also NMDA receptors HLA gene family 161, 168 negative symptoms 394–395, 395, 396 hoarding behavior, compulsive 346 neurotransmitter systems 19 Holm–Bonferroni corrections 69 polypharmacy 118, 118 Hommel-based gatekeeping 55 psychosis 359–362, 371–372 homotypic comorbidity 30 glutamyl transferase (GGT) biomarker 427 homozygote, definition 151–152 glycine, cognitive function 492 hope induction, placebo effects 76 goals of treatment, defining 14–15 hot cognition 101, 334 GR1A gene family, commercially available tests 168 HTR2A gene 160 grandiosity, transdiagnostic treatment 41 human growth hormone (hGH), supplements 238 GRIN2B gene, efficacy pharmacogenetics 167 humility, principles of psychopharmacology 507 guanfacine 23, 24, 413 Hunter’s triad, serotonin syndrome 205 cognitive function 496 hydralazine 165, 199 efficacy pharmacy 167, 269 hydrocone 155, 440 safety considerations 268 hydrocortisone, trauma/PTSD 458–459

577

INDEX

hydromorphone, detection windows 440 inflammatory biomarkers, outcome moderators 98 hydroxyzine 23 inflammatory-state anxiety disorders 402, 403, 412 depression 303 bruxism 195 psychosis 372–373, 373 cognitive function 488 insight loss, psychosis 38 safety considerations 268 insomnia see sleep aids hyperarousal see arousal states insula (anterior insular cortex) 335, 426 hyperhidrosis, adverse drug effects 200 intent-to-treat (ITT) samples, research studies 60 Hypericum perforatum (St. John’s wort) 231, 240 interaction effect, analysis of variance 61 hyperparathyroidism, adverse drug effects 200, 200 interleukin-6 (IL-6) biomarkers 105–106 hyperprolactinemia, adverse drug effects 200–201, 201, 247, 357–378 intermittent explosive disorder (IED) 340–341; see also aggression hypersalivation, adverse drug effects 206 (impulsive) hypersensitivity reactions, discontinuation of drugs 170 internalizing vs. externalizing dichotomy, transdiagnostic treatment 30, 43 hypertension, abrupt drug cessation 172 internet use disorder 439; see also behavioral addictions hypotension, orthostatic 195–196 interpersonal factors, outcome mediators/moderators 98, 101 hypothalamus, impulsivity/compulsivity 334 intramuscular injection (IM), antipsychotics 367–368 hypotheses, research studies 49, 91, 103 intrinsic clearance 264 intrusive thoughts, PTSD 449 Icarus pharmacology 118–119, 506; see also high-dosing regimes ionotropic glutamate receptors 297 illness course see course of illness iron supplements 236 illness severity see baseline severity irritability 41, 336; see also impulsivity/compulsivity illness subtype outcome moderators/mediators 98–99, 103 irritable bowel syndrome 261 iloperidone isocarboxazid 24, 142, 321 α receptor binding affinities 196 isotretinoin, suicidal ideation 206–207 bipolar disorder 332 izoniazid 165, 199, 234 dopamine receptor binding affinities 204 dosage conversions 185 Jadad Scale, research studies 53 dosing recommendations 364–383 hepatically impaired patients 274 Kava kava (Piper methysticum) 231, 240 high-dosing regimes 381 ketamine histamine receptor binding affinities 205, 212 detection windows 440 impulsive aggression 350 mechanism of action 11, 21 negative symptoms 398–399 NMDA receptors 360 protein binding 262 randomized controlled trials 326 renal patients 277 trauma/PTSD 458 serotonin receptor binding affinities 290, 408 treatment-resistant depression 296–300, 299, 326 therapeutic drug monitoring 136, 143, 148 Ketter’s hypothesis 312 imipramine kidney damage 197–198; see also renal patients alcohol use/dependence 442 kindling paradigm 95 anxiety disorders 417 kleptomania 346 dosage conversions 184 Kruskal–Wallis test, research studies 61–62 dosing recommendations 322 geriatric psychopharmacology 270 L-arginine 237 outcome moderators 96 L-carnosine 492 protein binding 262 L-methylfolate 228 serotonin receptor binding affinities 490 L-theanine 237, 396 therapeutic drug monitoring 141, 143 laboratory drug monitoring see therapeutic drug monitoring Impact of Events Scale (IES) 451 lactation 255, 272; see also reproductive psychopharmacology impulsivity/compulsivity 333–334, 336–346, 347; see also aggression LAIs see long-acting injectable antipsychotics (impulsive); OCD Laing, R. D. 389 in affective and psychotic disorders 336 lamotrigine brain regions/networks 334–335 abrupt cessation issues 172–184 case vignettes 340 antidepressant augmentation/adjuncts 292 corticolimbic loop 334 as antipsychotic adjunct 371 cortico-striatal-thalamo-cortical dysfunction 342 anxiety disorders 420 definitions and terminology 333, 335 bipolar depression 312–314, 313, 314, 328 nonsuicidal self-injury 345, 352 bipolar disorder 307, 312–314, 314 obsessive-compulsive phenomena 341–344, 351 borderline personality disorder 481–482 other disorders of 345–346 children and adolescents 267 salience network 335 cognitive function 490 serotonergic drugs 337, 342–344, 348 drug interactions 121 skin excoriation 344–345, 351 hepatically impaired patients 272 somatic marker hypothesis 335 impulsive aggression 349 top-down/bottom-up cognition 334 OCD 344 transdiagnostic treatment 37, 41 off-label uses 13 trichotillomania 345 placebo effects 81, 81 working memory 335 pregnancy 271 independent variables, research studies 55 psychotropic profiles 330 indication bias, adverse drug effects 198 renal patients 275 indications for pharmacotherapy 6 skin excoriation 351 individuality, response to medication 7–8; see also precision medicine strategies to optimize tolerance 219 inferential statistics, research studies 61 therapeutic drug monitoring 134–135, 139

578

INDEX

trauma/PTSD 463 LSD (lysergic acid diethylamide) 434, 440, 441 tweaking drug regimens 8 lumateperone last observation carried forward (LOCF) 60, 61 α receptor binding affinities 196 lavender, herbal medicines 240 bipolar depression 328 law of initial value 93 bipolar disorder 332 leukopenia, adverse drug effects 215 dosing recommendations 383 levetiracetam 421, 463 hepatically impaired patients 274 levomilnacipran high-dosing regimes 381 dosing recommendations 320 histamine receptor binding affinities 205 geriatric psychopharmacology 250 protein binding 262 protein binding 262 psychosis 363 renal patients 276 renal patients 277 therapeutic drug monitoring 141, 143 lupus erythematosus, adverse drug effects 198–199, 199 levothyroxine, outcome moderators 96 lurasidone life events, stressful 10, 448 α receptor binding affinities 196 likeability, pharmacotherapy 406 antidepressant augmentation/adjuncts 325 likelihood-based models, research studies 60 anxiety disorders 423–424 limbic system; see also amygdala, hippocampus bipolar depression 328 impulsivity/compulsivity 334–335 bipolar disorder 332 negative symptoms 389, 390 cognitive function 489, 490–491 psychosis 118, 354–356 dosage conversions 185 linear dose-response curves 132 dose-response relationships 367 linear pharmacokinetics 131–132 dosing recommendations 384 linear regression models 62 high-dosing regimes 381 Linehan, Marsha 465 histamine receptor binding affinities 205, 212 linkage disequilibrium (LD), definition 152 off-label uses 13 lisdexamfetamine 111, 494 renal patients 277 literature of psychopharmacology see research studies serotonin receptor binding affinities 212–213, 290, 408, 490 lithium 200, 315 therapeutic drug monitoring 143 abrupt cessation issues 184 luteal phase dosing 256, 257 adverse drug effects 193, 197–198, 199, 200 as antidepressant adjunct 291 magnesium supplements 236 as antipsychotic adjunct 387 main effect, analysis of variance 61 anti-switch vs. anti-recurrence drugs 307 maintenance medication 180–182, 191 avoiding polypharmacy 128 bipolar disorder 181 behavioral addictions 446 depression 304–305 case vignettes 5, 174 schizophrenia 376, 388 children and adolescents 266 major depressive disorder see depression/MDD cognitive effects 315–316 major depressive disorder with mixed features (MDD-MF) 13, 317–318 confounding factors 51–52 mammillary bodies 334 drug discontinuation 174, 183, 190 manganese supplements 236 drug interactions 111, 123, 124 mania, bipolar 305–306; see also lithium efficacy for subsequent episodes 11 anxiety disorders signs/symptoms 401 geriatric psychopharmacology 250 carbamazepine 316 HIV/AIDS patients 263 divalproex 316 impulsive aggression 337–338 other anticonvulsants 316, 330 increased WBC production 215 MAO-A gene 78 indications for 315 MAOIs (monoamine oxidase inhibitors) low-dose 316 abrupt cessation issues 172–184 maintenance vs. discontinuation 180–181, 181 anxiety disorders 418 mechanism of action 21 borderline personality disorder 473–474 multiple pharmacodynamic effects 125 dietary restrictions 296 number of episodes 95 dosing recommendations 321 outcome moderators 98 drug discontinuation 173 practical considerations 330 drug interactions 112–113, 124 pregnancy 271 hepatically impaired patients 273 relapse-prevention post ECT 326 outcome moderators 106 renal patients 264, 275 renal patients 276 strategies to optimize tolerance 219 strategies to optimize tolerance 220 therapeutic drug monitoring 131, 134, 139 therapeutic drug monitoring 142 tweaking drug regimens 8 treatment-resistant depression 294, 295, 295–296 lithium orotate 225 maprotiline 24, 490 liver problems see hepatically impaired patients marijuana, detection windows 440 LOCF (last observation carried forward) 60, 61 Maslow’s hierarchy of needs 452 locus, definition 152 maxims of psychopharmacology see drug treatments logical fallacy phenomenon 4 MBC see measurement-based care long-acting injectable (LAI) antipsychotics 67, 186, 368, 369, 386–387 MC4 gene 168 longitudinal stability 30–31, 43; see also course of illness MDD-MF see major depressive disorder with mixed features long-term memory, subtypes 487 MDMA (3,4-methylenedioxymethamphetamine) 440, 459 lorcaserin 211 medication, stopping see drug discontinuation lorazepam, dosage conversions 187 measurement-based care (MBC) 129–130, 138 low-dose lithium 316 case vignettes 129–130 loxapine 185, 379–380, 490 definitions 130–131

579

INDEX

measurement-based care (MBC) (cont.) multiple pharmacodynamic effects 126 experimental measures 137–138 OCD 344 objective measures of symptom severity 500–501 protein binding 262 secondary outcomes 137, 144 renal patients 276 serum drug monitoring see therapeutic drug monitoring serotonin receptor binding affinities 212–213, 408, 490 measurement instruments sex differences 247 addiction 427 supratherapeutic dosing 324 anxiety disorders 415 therapeutic drug monitoring 142, 143 cognitive function 486–487 missing at random (MAR), research studies 60 negative symptoms in schizophrenia 390 mixed effect models, meta-analyses 63 PTSD 450–451 mixed models for repeated measures (MMRM) 60, 61 mechanism of drug action 11–12, 21; see also neurotransmitter systems MMSE (Mini-Mental Status Exam) 486 Medawar, Peter 73 moclobemide mediators of treatment outcomes see outcome moderators/mediators dosage conversions 184 medically unexplained physical symptoms (MUPS) 258 dosing recommendations 321 melatonin geriatric psychopharmacology 270 neurotransmitter systems 20 therapeutic drug monitoring 142, 143 psychotropic relevance of supplements 238 modafinil memantine avoiding polypharmacy 128 alcohol use/dependence 434 children and adolescents 269 borderline personality disorder 476 cognitive function 492, 494–495 cognitive function 492, 496, 499 to counter sedation 205 OCD 344 drug interactions 111, 124 schizophrenia 376 hepatically impaired patients 275 memory 485, 487; see also working memory off-label uses 13 mesocortical circuitry see limbic system protein binding 262 meta-analyses 63–64 renal patients 278 funnel plots 64 schizophrenia 376 network 63–64 moderation management, controlled drinking 428 pitfalls 71 moderator analyses, research studies 62–63 metabolic dysregulation, drug effects 210–213, 213 moderators of treatment outcomes see outcome moderators/mediators metabotropic glutamate receptors 297, 360, 361, 362 monoamine oxidase inhibitors see MAOIs methadone Montreal Cognitive Assessment (MoCA) 486 adverse drug effects 196 mood disorders 281–283, 318; see also bipolar disorder; depression; major detection windows 440 depressive disorder with mixed features drug toxicology screens, false positives 441 adjustment disorders 283 opiate addiction 437, 445 with anxiety disorders 301–302, 302, 317 therapeutic drug monitoring 143 catatonia 301 methamphetamine use disorder 436 cognitive function 488–490 methylenedioxymethamphetamine see MDMA cyclothymic disorder 308 methylphenidate dimensions of 282 borderline personality disorder 477 emotional lability/affective instability 308 children and adolescents 269 impulsivity/compulsivity 336 cognitive function 493–494 PTSD 449 dosage conversions 189 mood stabilizers drug interactions 111 as antipsychotic adjuncts 370–371, 387 geriatric psychopharmacology 251–252 anti-switch vs. anti-recurrence drugs 306–308 half-life of drugs 178 borderline personality disorder 472, 473, 474 hepatically impaired patients 275 mood swings long-acting formulations 494 see affective instability/lability protein binding 262 morphine, detection windows 440 renal patients 278 MTHFR gene 162, 168 schizophrenia 375–376 multiple diagnoses, cause-and-effect relationships 5 methylfolate supplements 228 multiple imputation methods, research studies 60 microbiome, brain-gut interactions 229, 243 multiple regression models 62 mineral deficiencies 225, 236; see also nutraceuticals multivariate analyses, research studies 61 Mini-Mental Status Exam (MMSE) 486 muscarinic procholinergics 293 minocycline 199, 303, 396 myocardial infarction, and depression 258 mirtazapine myocarditis, adverse drug effects 195 adverse drug effects 216 alcohol use/dependence 442 nabilone 436 antidepressant adjuncts 292 N-acetyl-cysteine (NAC) anxiety disorders 302, 419 addiction 436 cigarette smokers 252 behavioral addictions 446 cognitive function 488 cognitive function 492 dosage conversions 184 nutraceuticals 241–242 dosing recommendations 323 skin excoriation 351 drug interactions 111, 123 trauma/PTSD 459 geriatric psychopharmacology 270 nadolol 340 hepatically impaired patients 273 nalfemene 431, 446 histamine receptor binding affinities 212 naltrexone impulsive aggression 348 addiction 426

580

INDEX

alcohol use/dependence 429, 441 NMDA receptors behavioral addictions 446 alcohol use/dependence 434 dysphoria 430 cognitive function 492 kleptomania 346 drugs targeting 376, 394–395; see also ketamine opiate addiction 445 negative symptoms 394–395 Sinclair method 431 psychosis 359–362 narcissistic personality disorder see borderline, histrionic, narcissistic and antisocial nocebo effect 76, 77–78, 82–84, 87, 192, 193, 505 personality disorder (cluster B) nomenclature NaSSAs (noradrenergic and specific serotonergic antidepressants) 372 case vignettes 13 NAT2 gene 165 drug treatments 13–14, 23 natural course of illness see course of illness neuroscience-based 14, 24 naturalistic designs, research studies 50 nominal p-values, statistical significance 55 necessary clinical adjustments (NCAs) 9; see also tweaking drug regimens nomograms, therapeutic drug monitoring 133–134, 134 needs hierarchy, Maslow’s 452 nonadherence to treatment see adherence to treatment nefazodone noninferiority, research studies 55, 56 anxiety disorders 302, 418 nonlinear pharmacokinetics 131–132 dosage conversions 184 non-nucleoside reverse transcriptase inhibitors 263 dosing recommendations 323 nonparametric tests, research studies 50–51, 69 protein binding 262 nonsuicidal self-injury (NSSI) 345, 352 serotonin receptor binding affinities 408 borderline personality disorder 472 therapeutic drug monitoring 142, 143 transdiagnostic treatment 41 negative affect, addiction 426 noradrenergic symptom clusters, depression 302 negative predictive value (NPV), research studies 67 noradrenergic system 19 negative symptoms in schizophrenia 389, 397 norepinephrine reuptake inhibitors see SNRIs 4 As of 389–390 normal distribution, research studies 50, 50 amphetamine 394 nortriptyline antidepressants 392, 393 anxiety disorders 417 antipsychotics 391–392, 398–399 cognitive function 488–489 cannabidiol 397 dosage conversions 184 citicoline 397 dosing recommendations 322 corticolimbic circuitry 389, 390 geriatric psychopharmacology 251, 270 dehydroepiandosterone 396 inflammatory-state depression 303 dopaminergic system 389, 391, 391, 393–394 lactation 255 estrogen 396 protein binding 262 measures/assessment 390 relapse-prevention post ECT 326 NMDA receptors 394–395, 395 therapeutic drug monitoring 141, 143 other medications targeting glutamatergic system 396 not otherwise specified (NOS) diagnosis 29 oxytocin 396 novelty seeking, placebo effects 77 pregnenolone with L-theanine 396 NSSI see nonsuicidal self-injury pro-dopaminergic drugs 393–394 nucleus acumbens, impulsivity/compulsivity 335 serotonergic system 391, 391, 397 number needed to treat (NNT) 57 testosterone 397 number of episodes, outcome moderators 95 transdiagnostic treatment 31 nutraceuticals 221–222, 229, 230; see also vitamin deficiencies negative trials, research studies 66 adaptogens 228, 243 nephrogenic diabetes insipidus (NDI) 202 anxiety disorders 403 network meta-analyses 63–64 blood–brain barrier 225–226, 227–228 neurobiological perspectives cannabidiol 226–227 pharmacogenetic test results 158 case vignettes 229 placebo effects 78 definitions 227, 229 transdiagnostic treatment 35–36 dietary supplements definition 222 neuroimaging biomarkers 105–106 evidence-based medicine 221–222, 225 neuroleptic malignant syndrome (NMS) 202 herbal medicines 239, 240 neuroscience-based drug nomenclature (NbN) 14, 24 historical perspectives 221 neuroticism, placebo effects 77 L-methylfolate 228 neurotoxicity/neuroprotection, FGAs vs. SGAs 357–378 mineral deficiencies 225, 236 neurotransmitter systems negative symptoms 396, 397 cholinergic system 16 neurotransmitters 237 dopaminergic system 17 one-carbon donor molecules 227–228 GABA/glutamate System 19 other compounds 241–242 histamine system 20 probiotics 229, 229, 243 mechanism of drug action 11–12 racial/ethnic differences 246 melatonin and orexin systems 20 repletion/replenishment concept 223 noradrenergic system 19 safety concerns 222–223, 231 placebo effects 78 serotonin synthesis 226 psychotropic relevance of supplements 237 sleep aids 228 serotonergic system 18 steroid supplements 238 Newtonian laws of psychopharmacology 9, 82, 180 niacin deficiency, schizophrenia 224 obesity see weight gain and obesity nicotinic acetylcholine receptors 376, 492–493 objective measures of symptom severity 500–501; see also measurement-based Nietzsche, Fredrich 47, 447 care NIMH Collaborative Depression Study 180 observational designs, research studies 6, 50 NIMH Research Domain Criteria (RDoC) 35, 44 observed cases, research studies 60, 61

581

INDEX

observed effects, cause-and-effect relationships 4–5 changing one variable at a time 500 observer effect 75 childhood trauma 97 obsessions; see also impulsivity/compulsivity; OCD chronicity 94–95 anxiety disorders signs/symptoms 401 cognitive function/emotional processing 101 definitions 333 confounding factors 92 vs. psychosis 38 definitions 90 Obsessive-Compulsive Drinking Scale 427 diffusion tensor imaging 91 obsessive-compulsive personality disorder (cluster C) 478 drug interactions 99–100 OCD (obsessive-compulsive disorder) 341–344; see also impulsivity/compulsivity duration of untreated illness 95–96 with bipolar disorder 317 early and enduring response to treatment 101–102 placebo effects 87 efficacy vs. effectiveness 89 predictors/risk factors for postpartum depression 254 expressed emotion 101 skin excoriation 344–345, 351 genetics 98 odds ratios (ORs), research studies 51 hedonic capacity 101 olanzapine illness severity 93–94 α receptor binding affinities 196 illness subtype 98–99 antidepressant augmentation/adjuncts 325 inflammatory biomarkers 98 anxiety disorders 423–424 number of episodes 95 behavioral addictions 446 past treatment responses 97–98 bipolar disorder 332 patient preferences 98 borderline personality disorder 483–484 post hoc analyses 103 cigarette smokers 252 pregnancy 101 conversion to long-acting injectable 186 psychosocial factors 98 dopamine receptor binding affinities 204 racial/ethnic differences 96 dosage conversions 185 resilience 97 dosing recommendations 384 sex differences 96 hepatically impaired patients 274 for specific conditions 106 high-dosing regimes 381 suicidal ideation 96 histamine receptor binding affinities 205, 212 substance misuse 101 impulsive aggression 350 tweaking drug regimens 102–103 long-acting injectable (LAI) 386–387 Wilder’s law 93 negative symptoms 398–399 outcome variables, research studies 55 protein binding 262 outcomes, primary/secondary 64–65, 72 renal patients 277 overdose, toxicity states 170 serotonin receptor binding affinities 212–213, 290, 408, 490 oversimplifications, chemical imbalance hypothesis 12 sex differences 247 oxcarbazepine short-acting intramuscular injection 367–368 alcohol use/dependence 429 therapeutic drug monitoring 143, 148 borderline personality disorder 481–482 trauma/PTSD 464 children and adolescents 267 olanzapine/fluoxetine combination (OFC) 295 hepatically impaired patients 272 old age/older adults see geriatric psychopharmacology impulsive aggression 349 omega-3 fatty acids 241–242, 476 psychotropic profiles 330 omnibus test, research studies 51 renal patients 275 “on-label/off-label” drug treatments 12–13 trauma/PTSD 463 ondansetron 397, 426, 432 oxytocin one in ten rule, regression models 62 borderline personality disorder 477 one-size-fits-all approach, efficacy vs. effectiveness 89 negative symptoms 396 one-carbon donor molecules 227–228 schizophrenia 376 one-tailed tests, research studies 55–56 trauma/PTSD 458 open-label placebos 82 opiates paliperidone addiction 437, 445 α receptor binding affinities 196 drug toxicology screens, false positives 441 antidepressant augmentation/adjuncts 325 metabolism 437 bipolar disorder 332 opioid antagonists borderline personality disorder 483–484 nonsuicidal self-injury/self-injurious behavior 352 conversion to long-acting injectable 186 skin excoriation 351 dosage conversions 185 optimism, dispositional 77 dosing recommendations 384 oral loading strategies, therapeutic drug monitoring 133–134 hepatically impaired patients 274 orbitofrontal cortex (OFC) 335 high-dosing regimes 381 orexin neurotransmitter system 20 histamine receptor binding affinities 212 orthostatic hypotension, adverse drug effects 195–196 impulsive aggression 350 Osler, Sir William 89 long-acting injectable 386–387 osmotic-release oral delivery system (OROS) formulation, methylphenidate 494 negative symptoms 398–399 outcome measures see measurement instruments protein binding 262 outcome moderators/mediators 89, 99, 104 renal patients 264, 277 adherence to treatment 99–100 serotonin receptor binding affinities 212–213, 290, 490 age factors/age at onset 94 panic attacks 412 baseline anxiety disorders 97 panic disorder; see also anxiety/GAD bespoke treatment 90, 93 anxiety disorders signs/symptoms 401 biomarkers as moderators 90–91, 105–106 buspirone 408 case vignettes 99 heritability 150

582

INDEX

maintenance of pharmacotherapy 181–182 efficacy 153, 155–158, 167 MAOIs 418 GENDEP project 157 outcome moderators 96, 99 genome-wide association studies 152–153 placebo effects 86, 87 GUIDED trial 156–157 research studies 61 heritability of drug response 150, 153 PANSS Negative Symptom Factor 390 heritability of psychiatric disorders 150–153 Papez circuit 354; see also limbic system neurobiological perspectives 158 parachutes analogy 222 outcome moderators 98 paradoxical injunction, placebo effects 77–78 placebo effects 78 paralimbic structures, impulsivity/compulsivity 335 results interpretation 158, 159, 159–162 parallel designs, research studies 52 safety pharmacogenetics 153, 164, 166 parametric tests, research studies 50–51, 69 schizophrenia 158 paranoia pharmacogenomics, definition 149 anxiety disorders signs/symptoms 401 pharmacokinetic pharmacogenetics 154 transdiagnostic treatment 41 cytochrome P450 metabolism 154, 155 paranoid personality disorder 468–470 enzymes in phase I/phase II hepatic metabolism 164 Parkinsonism, adverse drug effects 202 interpretation of test results 161 Parkinson’s disease 248, 264 pharmacokinetics 122 paroxetine antidepressant combinations 120 alcohol use/dependence 442 antidepressant/anticonvulsant combinations 121 anxiety disorders 302, 416, 419 cytochrome P450 system 263 behavioral addictions 446 linear and nonlinear pharmacokinetics 131–132 cognitive function 488 non-nucleoside reverse transcriptase inhibitors 263 dosing recommendations 319 outcome mediators 99–100 geriatric psychopharmacology 250, 270 protease inhibitors 263 histamine receptor binding affinities 212 therapeutic drug monitoring 135–137 lactation 255 pharmacotherapy see drug treatments personality features 465 phases of treatment see course of treatment renal patients 276 phencyclidine 440, 441 serotonin receptor binding affinities 212–213, 408 physical illness, psychological sequelae therapeutic drug monitoring 140, 143 chronic obstructive pulmonary disease 259–260 trauma/PTSD 452–453 dementia 260–261 parsimonious drug regimens 115–116, 125, 126, 127, 128 drug protein binding 262 Passiflora incarnata, herbal medicines 240 gastrointestinal disorder 261 past treatment responses, outcome moderators 97–98 glaucoma 261–262 pathological gambling 446 HIV/AIDS 262–263 patient individuality, response to medication 7–8; see also precision medicine myocardial infarction 258 patient preferences, outcome moderators/mediators 98 Parkinson’s disease 264 Pearson, Karl 47 post-stroke depression 258, 258–259 peer review, research studies 47 psychosis due to 374 perceptual distortions see psychosis renal patients 263–264 per protocol analyses, research studies 60, 61 sleep apnea 264–265 perphenazine 358 pimavanserin anxiety disorders 411 adverse drug effects 196 dosage conversions 185 antidepressant augmentation/adjuncts 325 dosing 379–380 dosing recommendations 384 therapeutic drug monitoring 147 hepatically impaired patients 274 persistent depressive disorder 174, 190, 300 protein binding 262 personality renal patients 277 correlates, placebo effects 77–78 serotonin receptor binding affinities 290 structural components, transdiagnostic treatment 36 therapeutic drug monitoring 143 personality disorders 465–467, 479; see also borderline, histrionic, narcissistic and pimozide 359, 378, 490 antisocial personality disorder (cluster B) Piper methysticum, herbal medicines 231, 240 cluster A 468–470, 479 placebo-controlled trials 66 cluster C 478, 479 placebo effects 8, 73–74, 85 case vignettes 469, 477–478 active vs. inactive 82 classification 467–468 antipsychotics 366 overlapping features with other conditions 466, 467 bipolar depression 311, 314 pharmacotherapy 468–470 case vignettes 77–78 personalized medicine see precision medicine cause-and-effect relationships 3 PET (positron emission tomography) 105–106 dosing frequency 77 pharmaco-archaeology 504 drug discontinuation effects 84 pharmacodynamic drug interactions 123 early and enduring response to treatment 102 pharmacodynamic pharmacogenetics 154, 155, 159 illness severity 80–81, 81, 93, 93 pharmacogenetics 149, 162–163; see also SNPs neurobiological correlates 78 and see specific genes nocebo effect 76, 77–78, 82–84, 87 candidate gene studies 151–153 open-label placebos 82 commercially available tests 165, 168 patient-specific response characteristics 75–76, 76 comorbidity 33–34, 34 persistence/transience 81–82 controversies 150, 151, 155, 156, 157 pharmacogenetic correlates 78 cytochrome P450 metabolism 154, 155 prevalence across disorders 80–81, 86 definitions 149, 150, 151–152, 158, 159, 161 principles of practical psychopharmacology 505

583

INDEX

placebo effects (cont.) renal patients 264, 275 psychological and personality correlates 77–78 strategies to optimize tolerance 219 regression to the mean 74–75 tapering drugs 411 response rates 78–79 trauma/PTSD 463 study designs to minimise 84, 85, 88 pregnancy; see also reproductive psychopharmacology trial duration 79–80 drug contraindications 170 plasma drug level monitoring 130–131; see also therapeutic drug outcome mediators 101 monitoring pharmacotherapy during 254–255, 271 pleiomorphic heterogeneity 34 opiates 255 PMDD see premenstrual dysphoric disorder pregnenolone Poe, Edgar Allan 425 addiction 436 polycystic ovarian syndrome 257 cognitive function 492 polypharmacy/combination therapies 107, 119 negative symptoms 396 adherence to treatment 109 psychotropic relevance of supplements 238 aggressive dosing 118–119 premenstrual dysphoric disorder (PMDD) 256 antipsychotics 116–117, 118, 370 preoccupation, addiction 426 bipolar disorder 310–312, 328 primary outcomes, research studies 64–65, 72 complex dopamine model 110 principles of practical psychopharmacology see drug treatments (general continual review of regimens 114 information) definition 107 prior probability, Bayesian analysis 59 discontinuation of individual components 114–115 probiotics 227, 229, 243 dopamine agonism/antagonism 117–118 problem-solving impairments 499 drug interactions 108–125, 120, 121, 122, 123 processing speed impairments 499 drug-related problems 108 procholinergics see acetylcholinesterase inhibitors extensive regimens 107–108 pro-dopaminergic drugs, negative symptoms 393–394; see also psychostimulants GABEergic system 118 progesterone supplements 238 MAOIs plus TCAs 112–113, 124 proof-of-concept studies 6 parsimonious regimens 115–116, 125, 126, 127, 128 propranolol 128, 340 serotonin agonists 113 prospective research studies 50 serotonin syndrome 111–112 protease inhibitors, pharmacokinetics 263 therapeutic drug monitoring 135–137 protein binding, psychotropic medications 262 unusual combinations 110–111 protopathic bias 198 Pomaglumetad 362 pseudobulbar affect (PBA) 249 poor metabolizers (PMs) 154 pseudospecificity population stratification 152 cognitive function 488–489 positive predictive value (PPV) 67, 67 research studies 63 post hoc analyses pseudotranssexualism 248 outcome moderators/mediators 103 psilocybin, substance use disorders 438 research studies 51, 62–63 psychedelic drugs, depression 304 post hoc ergo propter hoc phenomenon 4 psychological correlates, placebo effects 77–78 post-acute withdrawal syndrome (PAWS) 437 psychopharmacology, practical see drug treatments posterior probabilities, Bayesian analysis 57 psychosis 353–356, 377; see also schizophrenia postpartum depression 253–254, 254, 255, 256; see also reproductive case vignettes 374 psychopharmacology children and adolescents 266 post-stroke depression 258–259 cognitive rigidity/inflexibility 364 post-traumatic distress intolerance 39 comorbidity 32 post-traumatic stress disorder see trauma and PTSD delusional parasitosis 359 power, statistical 53–55 differential transdiagnostic treatment 31–32 practical psychopharmacology see drug treatments dimensional model 38 practice effects, cognitive function 488 dopaminergic system 355–356, 360, 361–363, 363 pramipexole due to physical illness 374 cognitive function 491 fear vs. anxiety disorders 355 polypharmacy 118 gaslighting 353, 354 protein binding 262 glutamatergic system/NMDA receptors 359–362, 371–372 treatment-resistant depression 295 impulsive aggression 338, 350 prebiotics 227 impulsivity/compulsivity 336 precision medicine; see also diversity across subpopulations limbic system 118, 354–356 outcome moderators/mediators 90, 93 vs. obsessions 38 pharmacogenetics 149–150, 155 placebo effects 366 response to medication 7–8 top-down/bottom-up cognition 353–354 predictors of treatment outcome 90; see also outcome moderators/mediators transdiagnostic treatment 37–38, 41 Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 63 treatment goals 353 prefrontal cortex, addiction 426 treatment-resistant 373–374, 374, 377 pregabalin psychosocial factors, outcome mediators/moderators 98, 101 alcohol use/dependence 429 psychostimulants; see also amphetamine; methylphenidate anxiety disorders 403, 407, 422 adverse drug effects 193–194 children and adolescents 267 affective instability/lability 495–497 drug discontinuation 177, 187 antidepressant augmentation/adjuncts 293 drug interactions 110 bipolar disorder 312 hepatically impaired patients 272 borderline personality disorder 477 off-label uses 13 children and adolescents 268, 269 protein binding 262 cognitive function 493–494

584

INDEX

dosage conversions 188, 189 redundancy of treatment effects 4, 15, 107, 123, 171, 288, 502–503 drug discontinuation 177–178, 183 regression models, research studies 62 drug interactions 110, 111, 124 regression to the mean 74–75 executive function 494–495 rejection sensitivity 92 geriatric psychopharmacology 251–252 relapses hepatically impaired patients 275 course of treatment 180–182 lactation 272 post ECT 304, 326 long-acting formulations 494 schizophrenia 388 negative symptoms 393–394 reliability of diagnosis 27–28, 42 pharmacological tolerance 495 relief-seeking, addiction 425 pregnancy 271 renal patients 263–264 renal patients 278 adverse drug effects 197–198 stimulant use disorder 434–436 anticonvulsants and lithium 275 therapeutic drug monitoring 142 antidepressants 276 psychotherapy, borderline personality disorder 476 antipsychotics 277 psychotic depression 300 definitions and terminology 264 PTSD (post-traumatic stress disorder) see trauma and PTSD other medications 278 PTSD Checklist (PCL) 451 psychostimulants 278 pyramid model, cognitive function 486, 487 sedatives 278 repeated measures, analysis of variance 61 QTc interval prolongation 196, 196–197, 258 repletion/replenishment concept, nutraceuticals 223 antipsychotics 365 reproductive psychopharmacology 253–254 pimozide 378 brexanolone 256 quantitative measures see measurement-based care divalproex and polycystic ovarian syndrome 257 quercetin, nutraceuticals 241–242 opiates 255 quetiapine pharmacotherapy during lactation 255, 272 α receptor binding affinities 196 pharmacotherapy during pregnancy 254–255, 271 antidepressant augmentation/adjuncts 325 postpartum depression 253–254, 254, 255, 256 anxiety disorders 302, 423–424 predictors/risk factors for depression 254 bipolar depression 328 premenstrual dysphoric disorder 256–257 bipolar disorder 332 relapses of existing mood disorders 255–256 borderline personality disorder 483–484 research studies and statistical analysis 47–48, 68 dopamine receptor binding affinities 204 α/β level corrections 54, 69 dosage conversions 185 analysis of variance 61–62 dosing recommendations 385 attrition and study dropout 60–61, 70 geriatric psychopharmacology 251–252 Bayesian analysis 57–60 half-life 385 classification functions 67 hepatically impaired patients 274 clinically meaningful results 54, 56–57 high-dosing regimes 381 Cohen’s d/Hedge’s g 56, 58–59 histamine receptor binding affinities 205, 212 confounding factors 51–52 multiple pharmacodynamic effects 127 CONSORT diagrams 49, 49 negative symptoms 398–399 effect sizes 53, 56 off-label uses 13 efficacy vs. effectiveness 65 renal patients 277 enriched designs 66–67 research studies 62 evidence-based medicine 48 serotonin receptor binding affinities 212–213, 290, 408, 490 flexible vs. fixed-dose studies 64 therapeutic drug monitoring 143, 148 funnel plots 64 trauma/PTSD 464 Jadad Scale 53 meta-analyses 63–64, 71 racial differences moderator analyses 62–63 antipsychotics 246 noninferiority/superiority/sensitivity 55, 56 definitions 245 normal distribution 50, 50 diversity across subpopulations 245–247 number needed to treat 57 outcome moderators 96 observational vs. naturalistic designs 50 rage attacks 41, 336; see also aggression (impulsive) odds ratios/confidence intervals 51 raloxefine 238, 492 one-tailed/two-tailed tests 55–56 ramelteon 249, 274 parallel vs. crossover designs 52, 53 random effects, meta-analyses 63 parametric vs. nonparametric tests 50–51, 69 randomization, research studies 51–52 placebo effects 78–84, 85, 88 randomized controlled trials (RCTs) 6–7; see also evidence-based medicine placebo-controlled trials/active comparators 66 drug discontinuation 190 post hoc analyses 51, 62–63 ketamine 326 primary/secondary outcomes 64–65, 72 racial/ethnic differences 245 prospective vs. retrospective designs 50 rapid cycling, bipolar disorder 314–315, 329 pseudospecificity 63 rapid initial dose escalation (RIDE) strategy 365 randomization 51–52 rapid neuroleptization 365 receiver operating characteristic curves 68 rating scales see measurement instruments regression models 62 reality-testing, psychosis 353–354 sample size 54 reasoning impairments 499 sensitivity and specificity 67 rebound hypertension, abrupt drug cessation 172 single-group open trials 52–53 receiver operating characteristic (ROC) curves 68 statistical significance and power 53–55 recovery, and life stresses 10 study design 49–50

585

INDEX

research studies and statistical analysis (cont.) placebo effects 86, 87 study group/study population 48, 49 probiotics 243 time until event analyses 65 schizotypal personality disorder 468–470, 491 type I error/false positives 54 scopolamine, antidepressant augmentation 293 type II error/false negatives 54 Screen for Cognitive Impairment for Psychiatry (SCIP) 486 univariate/multivariate analyses 61 secondary outcomes, research studies 64–65 resilience sedation, adverse drug effects 205 borderline personality disorder 476 sedatives; see also benzodiazepines; Z-drugs gyroscope analogy 10 hepatically impaired patients 274 outcome moderators 97 pregnancy 271 transdiagnostic treatment 38–39 renal patients 278 trauma/PTSD 447, 452 seizures retrospective research designs 50 abrupt cessation of drugs 172 reverse causality 198 adverse drug effects 205 reward pathway disorders 335, 425–427 selective serotonin reuptake inhibitors see SSRIs reward-seeking 425; see also addiction selenium supplements 236 risk-benefit analysis, aggressive pharmacology 506–507 self-efficacy, placebo effects 77 risky behaviors, transdiagnostic treatment 41 self-injurious behavior (SIB) see nonsuicidal self-injury risperidone sensitivity, research studies 67 adverse drug effects 201 SEP-363856 investigational drug 357 antidepressant augmentation/adjuncts 325 sequential parallel comparison design studies 85, 88 anxiety disorders 423–424 serotonergic drugs; see also SNRIs; SSRIs bipolar disorder 332 adverse drug effects 199 conversion to long-acting injectable 186 borderline personality disorder 480 dopamine receptor binding affinities 204 histamine receptor binding affinities 212 dosage conversions 185 impulsive aggression 337, 348 dosing recommendations 385 impulsivity/compulsivity 342–344 drug interactions 111 serotonin receptor binding affinities 212–213 hepatically impaired patients 274 switching serotonergic agents 175 histamine receptor binding affinities 205, 212 serotonergic system 18; see also 5HT gene family impulsive aggression 350 anxiety disorders 355 long-acting injectable 386–387 atypical antipsychotics 356–357 multiple pharmacodynamic effects 127 serotonin synthesis 226 negative symptoms 398–399 serotonin receptor renal patients 277 adverse drug effects 212–213 schizotypal personality disorder 469 antipsychotic adjuncts 372 serotonin receptor binding affinities 212–213, 290, 490 anxiety disorders 407–410, 408 therapeutic drug monitoring 143, 148 cognitive function 489–490 trauma/PTSD 464 depression 291 ROC see receiver operating characteristic curves and dopaminergic system 356–357, 391 rumination 333, 401 negative symptoms 397 OCD 344 SAD (seasonal affective disorder), placebo effects 87 polypharmacy 113, 113 s-adenosylmethionine (SAMe) 96, 227–228 psychotropic relevance of supplements 237 safety concerns, nutraceuticals 222–223, 231 SGAs 290 safety pharmacogenetics 153, 166 serotonin syndrome 111–112, 205 cytochrome P450 metabolism 154, 155 sertraline enzymes in phase I/phase II hepatic metabolism 164 adverse drug effects 195 St. John’s wort, herbal treatments 231, 240 alcohol use/dependence 442 salience network, impulsivity/compulsivity 335 anxiety disorders 302, 416, 419 saturation kinetics 131–132 behavioral addictions 446 Sayers, Dorothy L. 25 cocaine addiction 444 Schedule for the Assessment of Negative Symptoms (SANS) 390 cognitive function 488–489 schizoid personality disorder 468–470 dosage conversions 184 schizophrenia; see also negative symptoms dosing recommendations 319 adrenochrome hypothesis 224 drug interactions 121 augmentation strategies 372, 372–373, 375 efficacy pharmacogenetics 156 benzodiazepines 375 geriatric psychopharmacology 250, 270 cannabidiol 375 histamine receptor binding affinities 212 case vignettes 175–176 impulsive aggression 348 cognition as primary target 375–376 lactation 255 cognitive function 491–493, 499 multiple pharmacodynamic effects 126 D vitamin deficiency 223 outcome moderators 96, 99 diagnostic complexity/symptom overlap 27 postpartum depression 255 drug discontinuation 175–176 protein binding 262 drug interactions 111 renal patients 276 efficacy of different drugs 365–366 serotonin receptor binding affinities 212–213, 408 electroconvulsive therapy 375 skin excoriation 351 heritability 150 supratherapeutic dosing 324 maintenance vs. discontinuation of therapy 191, 376, therapeutic drug monitoring 140 388 trauma/PTSD 452–453 outcome moderators 106 serum drug level monitoring, definition 130–131; see also therapeutic drug pharmacogenetics 158 monitoring

586

INDEX

Seuss, Dr. 244 outcome moderators 96, 98 severity of illness see baseline severity placebo effects 76 sex differences research studies 61 diversity across subpopulations 247–248 strategies to optimize tolerance 220 outcome moderators 96 therapeutic drug monitoring 140 PTSD 450 trauma/PTSD 452–455, 462 sexual dysfunction, adverse drug effects 206, 216 trichotillomania 345 Shakespeare, William 400 stability over time 30–31, 43; see also course of illness SIADH, adverse drug effects 207 standard mean difference (SMD), effect size 56, 58–59 sialorrhea, adverse drug effects 206 STAR*D MDD trials 97, 288–289, 292, 293–294, 301, 336 SIB (self-injurious behavior) see nonsuicidal self-injury State-Trait Anxiety Inventory (STAI) 451 sigmoidal dose-response curves 132 statins, as antipsychotic adjuncts 373 Sinclair method, alcohol use/dependence 431 statistical power 53–55 single-group open trials 52–53 statistical significance 53–55 single-nucleotide polymorphisms see SNPs statistical tests 50–51, 69 skin excoriation 344–345, 351 statistics, measurement-based care 132–133; see also research studies and SLC gene family 159–160, 167, 168 statistical analysis sleep aids stellate ganglion block, trauma/PTSD 459 geriatric psychopharmacology 249 steroidal drugs/supplements 238, 396 nutraceuticals 228 stimulants see psychostimulants transdiagnostic treatment 41 stopping psychotropic medication see drug discontinuation sleep apnea, patients with 264–265 stratification. confounding factors 52 sliding scale approach to psychopharmacology 505 stress; see also distress intolerance SMD see standard mean difference life events 448 SNPs (single-nucleotide polymorphisms) 151–153, 152; see also and recovery 10 pharmacogenetics and trauma 448–449 biomarkers 105–106 stroke, post-stroke depression 258–259 commercially available tests 165, 168 Stroop effect, pharmacogenetics 159 comorbidity 34 structural components of personality, transdiagnostic treatment 36 definition 152 study design see research studies and statistical analysis efficacy pharmacogenetics 167 Study to Predict Optimised Treatment in Depression (iSPOT-D) 91 SNRIs (serotonin–norepinephrine reuptake inhibitors); see also specific drugs subpopulations see diversity across subpopulations anxiety disorders 417, 419 substance misuse; see also addiction avoiding polypharmacy 128 detection windows 440 dosing recommendations 320 outcome mediators 101 drug interactions 110, 123 transdiagnostic treatment 35 geriatric psychopharmacology 250 subtherapeutic doses, polypharmacy 108 hepatically impaired patients 273 suicidal ideation mechanism of action 21 adverse drug effects 206–207 multiple pharmacodynamic effects 126 borderline personality disorder 472–473 strategies to optimize tolerance 220 outcome moderators 96 therapeutic drug monitoring 141 racial/ethnic differences 246 social anxiety disorder; see also anxiety/GAD research studies 50 buspirone 408 transdiagnostic treatment 39–40, 41 drug discontinuation 190 superiority, research studies 55 MAOIs 418 supratherapeutic dosing see high-dosing regimes placebo effects 80, 86 surface under the cumulative ranking curve (SUCRA), meta-analyses 63–64 social cognition 498 suvorexant impairments across psychiatric conditions 499 hepatically impaired patients 274 transdiagnostic treatment 37 protein binding 262 sodium benzoate 376, 492 sleep aids 249 somatic marker hypothesis 335 therapeutic drug monitoring 143 somatic symptom disorder 258 sweating, adverse drug effects 200 somatosensory amplification 83 symptom-based treatment approaches 28 somnolence, adverse drug effects 205 symptom overlap 26–27, 41 special populations see diversity across subpopulations symptom subcomponents, categorical disorders 34–35 specificity, research studies 67 symptom triggered regimen (STR), alcohol withdrawal 429 spectrum diagnoses, transdiagnostic treatment 29–30 syndrome of inappropriate antidiuretic hormone secretion (SIADH), adverse drug SSRIs (selective serotonin reuptake inhibitors); see also specific drugs effects 207 abrupt cessation issues 172–184 synergistic effects, polypharmacy 108, 130 adverse drug effects 195, 199 Syrus, Publilius 169 anxiety disorders 403, 416, 419 Szasz, Thomas 353 bipolar disorder 311 cause-and-effect relationships 3 tachyphylaxis 11, 131 dosing recommendations 319 tamoxifen 122, 155 drug interactions 110, 120, 123 tapering drug regimes see also drug discontinuation effect sizes 403 alcohol withdrawal 428–429 hepatically impaired patients 273 benzodiazepines 407 impulsive aggression 348 cross-tapering vs. switching to another drug 170–171 impulsivity/compulsivity 336 tardive dyskinesia 207–209, 208 mechanism of action 21 case vignettes 209 multiple pharmacodynamic effects 126 FGAs vs. SGAs 357–378 nonsuicidal self-injury/self-injurious behavior 352 VMAT2 inhibition/dopamine supersensitivity 208

587

INDEX

taurine supplements 237 trauma/PTSD 463 TDM see therapeutic drug monitoring toxicity states 130, 170 TEAS see treatment-emergent affective switch TPH1 gene 78, 167 temazepam, dosage conversions 187 TPH2 gene, commercially available tests 168 teratogenic risks of pharmacotherapy 254 tramadol, drug interactions 112 testosterone transdiagnostic treatment 25–26, 40 negative symptoms 397 affective instability/lability 31, 36, 41 supplements 238 arousal states 38, 41 theanine 237, 396 attentional processing 36, 41 theory of mind, transdiagnostic treatment 37 bipolar disorder 31 therapeutic alliance, role in placebo effect 74–75, 83 case vignettes 26 therapeutic drug monitoring (TDM) 129, 130–131, 138, 139; see also cognitive disorganization differential treatment 31–32 measurement-based care comorbidity 32–34, 34, 35 antidepressants 135, 142 core transdiagnostic treatment 28–29 antipsychotics 147, 148 diagnostic complexity/symptom overlap 26–27, 41 case vignettes 136 distress intolerance 38–39 CYP450 inducers and inhibitors 143 executive function 37, 41 definition 131 externalizing vs. internalizing dichotomy 30, 43 dose-response curves 132 first/subsequent episode correlations 30–31, 43 end-organ monitoring 137, 146 five-factor model of personality 35–36, 45 lamotrigine 134–135 form fruste conditions/spectrum diagnoses 29–30 linear and nonlinear pharmacokinetics 131–132 homotypic comorbidity 30 nomograms 133–134, 134 impulse control 37, 41 oral loading strategies 133–134 negative symptoms vs. depression treatment 31 other antidepressants 142 neuroscience-based 35–36 polypharmacy 135–137 NIMH Research Domain Criteria 35, 44 psychostimulants 142 psychosis 37–38 secondary outcomes 137, 144 reliability/validity 27–28, 42 SNRIs 141 social cognition/theory of mind 37 SSRIs 140 stability over time/longitudinal stability 30–31 tricyclic antidepressants 141 structural components of personality perspective 36 useful statistics 132–133 substance use disorders 35 therapeutic index, pharmacokinetics 132 suicidal ideation 39–40, 41 therapeutic range, pharmacokinetics 132 symptom subcomponents 34–35 therapeutic window, pharmacokinetics 131–132 symptom-based treatment approaches 28 thiopurine methyltransferase, SNPs 165 Tridimensional Personality Questionnaire 36, 46 thioridazine 196, 379–380 transgender individuals 247–248 thiothixene 379–380, 469, 470 trauma and PTSD 447–448, 460, 461 thrombocytopenia, adverse drug effects 215 acute stress disorder 452 thyroid hormone, antidepressant augmentation 292–293 alpha agonists 457 tiagabine 421, 435, 463 anticonvulsants 458, 463 tics, adverse drug effects 210, 496 antipsychotics 458, 464 timecourse of illness benzodiazepines 455–456 see course of illness beta-blockers 456–457 time until event analyses, research studies 65 case vignettes 449 TNF (tumor necrosis factor) biomarkers 105–106 as categorical construct 449–450 top-down (cold) cognition 101, 334 cognitive therapy 452 corticolimbic loop 334 combination therapy 462 psychosis 353–354 COVID-19 pandemic 452–453 topiramate diagnostic complexity/symptom overlap 27 alcohol use/dependence 431 dissociative illnesses 459–460 as antipsychotic adjunct 371–372 ketamine 458 anxiety disorders 420 life events 448 avoiding polypharmacy 128 Maslow’s hierarchy of needs 452 behavioral addictions 446 measures/assessment 450–451 borderline personality disorder 481–482 novel pharmacotherapies 458–459 children and adolescents 267 and personality disorders 466 cocaine addiction 443 pharmacotherapy 454 cognitive function 488 placebo effects 86, 87 counteraction of iatrogenic weight gain 217 PTSD construct 449–450 hepatically impaired patients 272 resilience 447, 452 impulsive aggression 338, 349 SSRIs 452–455, 462 OCD 344 stellate ganglion block 459 off-label uses 13 stress, distress and trauma 448–449 pregnancy 271 trauma/PTSD 447 protein binding 262 trazodone psychotropic profiles 330 adverse drug effects 196, 216 renal patients 264, 275 anxiety disorders 418 skin excoriation 351 cigarette smokers 252 stimulant use disorder 435 cognitive function 488 strategies to optimize tolerance 219 dosage conversions 184

588

INDEX

drug interactions 111, 123 venlafaxine geriatric psychopharmacology 270 anxiety disorders 302, 403, 407, 419 histamine receptor binding affinities 212 dosage conversions 184 postpartum depression 255 dosing recommendations 320 protein binding 262 geriatric psychopharmacology 270 therapeutic drug monitoring 143 outcome moderators 97 treatment adherence see adherence to treatment protein binding 262 treatment course see course of treatment relapse-prevention post ECT 326 treatment outcomes see outcome moderators/mediators renal patients 276 treatment-emergent affective switch (TEAS), bipolar disorder 309–310, 309, 327 supratherapeutic dosing 324 treatment-resistant conditions therapeutic drug monitoring 141, 143 and accuracy of transdiagnostic treatment 30 ventral striatum 426 diagnostic errors 466 ventral tegmentum 335 GUIDED trial 156–157 ventrolateral prefrontal cortex (VLPFC) 335 therapeutic drug monitoring 130 ventromedial prefrontal cortex (VMPFC) 335 treatment-resistant depression 293–294 verbal fluency, major cognitive domains 498 ketamine 296–300, 299, 326 verbal learning impairments 499 MAOIs 294, 295, 295–296 vilazodone olanzapine/fluoxetine combination 295 anxiety disorders 408–410 pramipexole 295 dosing recommendations 323 staging model 294 geriatric psychopharmacology 250 tree-structured gatekeeping procedures 55 protein binding 262 tremor, adverse drug effects 210 renal patients 276 triazolam, dosage conversions 187 serotonin receptor binding affinities 408–410 trichotillomania 345 therapeutic drug monitoring 142, 143 tricyclic antidepressants; see also specific drugs visual learning impairments 499 adverse drug effects 196, 205 vitamin deficiencies; see also B vitamin deficiencies; D vitamin deficiencies anxiety disorders 417 adrenochrome hypothesis of schizophrenia 224 bipolar depression 308–309 case vignettes 223 cognitive function 488 dosing recommendations 235 dosing recommendations 322 fat-soluble vitamins 232, 233 drug interactions 110, 112–113 psychiatric disorders 232, 234 efficacy for subsequent episodes 11 water-soluble vitamins 234, 235 hepatically impaired patients 273 VNTR (variable number of tandem repeat) 152 irritable bowel syndrome 261 Voltaire (François-Marie Arouet) 73, 500 multiple pharmacodynamic effects 126 volume of distribution 264 racial/ethnic differences 246 vortioxetine renal patients 276 adverse drug effects 199 strategies to optimize tolerance 220 anxiety disorders 408–410 therapeutic drug monitoring 141 cognitive function 488–489 Tridimensional Personality Questionnaire (TPQ) 36, 46 dosing recommendations 323 trifluoperazine, anxiety disorders 411 geriatric psychopharmacology 250 triptans, drug interactions 111 hepatically impaired patients 273 tryptophan, nutraceuticals 241–242 protein binding 262 tumor necrosis factor (TNF) biomarkers 105–106 serotonin receptor binding affinities 408–410, 490 tweaking drug regimens 8–9 therapeutic drug monitoring 142, 143 ain’t broke don’t fix 175, 503 bipolar disorder 9 water-soluble vitamins 234 necessary clinical adjustments, bipolar disorder 9 weight gain and obesity Newtonian psychopharmacology 9 adverse drug effects 210–213, 213 one variable at a time 500 pharmacological strategies 217, 218 outcome moderators/mediators 102–103 Wilder’s law 93 twin studies, heritability of psychiatric disorders 151 Withania somnifera, cognitive function 491 two week/20% rule, course of treatment 8 withdrawal effects; see also drug discontinuation two-tailed tests, research studies 55–56 abrupt cessation of drugs 172 type A vs. type B alcoholism 428 addiction 426 type I errors, research studies 54 alcohol use/dependence 428–429 type II errors, research studies 54, 74, 103 withdrawal syndromes 172 within-group effect sizes, research studies 53 161 UGT gene family , 165 working memory 335, 498, 499 ultra-rapid metabolizers (URMs) 154 unbound drug fractions 264 xenobiotics 161 univariate analyses, research studies 61 xerostomia, adverse drug effects 199 valbenazine protein binding 262 Yerkes–Dodson law, anxiety disorders 400 tardive dyskinesia 208 yi-gan san (Chinese herbal medicine) 476 216 therapeutic drug monitoring 143, 143 yohimbe, adverse drug effects 408 Valeriana officinalis, herbal medicines 231, 240 yohimbine, serotonin receptor binding affinities validity of diagnosis 27–28, 42 valproic acid, HIV/AIDS patients 263 Z-drugs 403, 488; see also zolpidem variable number of tandem repeat (VNTR) 152 zero order kinetics 131–132

589

INDEX

zinc supplements 236 histamine receptor binding affinities 205, 212 ziprasidone negative symptoms 398–399 α receptor binding affinities 196 renal patients 277 antidepressant augmentation/adjuncts 325 serotonin receptor binding affinities 212–213, 290, 408, 490 anxiety disorders 423–424 short-acting intramuscular injection 367–368 bipolar disorder 332 therapeutic drug monitoring 143, 148 borderline personality disorder 483–484 trauma/PTSD 464 dopamine receptor binding affinities 204 zolpidem dosage conversions 185 hepatically impaired patients 274 dosing recommendations 385 protein binding 262 hepatically impaired patients 274 sex differences 247 high-dosing regimes 381 therapeutic drug monitoring 143

590