Clinical Psychopharmacology Prakash B

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Clinical Psychopharmacology Prakash B. Behere • Anweshak Das Aniruddh P. Behere

Clinical Psychopharmacology An Update Prakash B. Behere Anweshak Das Department of Psychiatry Consultant Psychiatrist D Y Patil Medical College & D. Y. Patil Psychiatric Clinic Education Society (Deemed University) Guwahati Kolhapur Assam Maharashtra India India

Aniruddh P. Behere Pediatric Behavior Health Helen Devos Childrens’s Hospital Michigan State University College of Human Medicine Grand Rapids, Michigan USA

ISBN 978-981-13-2091-0 ISBN 978-981-13-2092-7 (eBook) https://doi.org/10.1007/978-981-13-2092-7

Library of Congress Control Number: 2018957629

© Springer Nature Singapore Pte Ltd. 2019 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore Dedicated to My Wife Mrs. Manikyamba Prakash Behere This book is the outcome of her inspiration. —Prakash B. Behere Foreword

It is a pleasure to write the foreword for Dr. Prakash Behere’s latest book entitled Clinical Psychopharmacology: An Update. Dr. Behere was my postgraduate stu- dent at the Postgraduate Institute of Medical Education and Research, Chandigarh, during my early days as a postgraduate teacher. We have had interaction several times since. I regard him as a very talented individual whose work in the area of mental health, especially in the use of medications to treat different forms of mental disorders has been exceptional and has vast clinical experience in treating the mentally ill. He has vast clinical experience in treating the mentally ill. The purpose of this book is to highlight what the specific medicines offer in terms of benefits, side effects, and risks. It provides practical information on how to use various psychotropic drugs in clinical practice, emphasizing the mechanisms of action of these drugs upon the receptors and enzymes in the brain. Prof. Behere has worked to ensure that all the information in this book concern- ing drug dosages, schedules, routes of administration, indications and contraindica- tions, etc., is accurate at the time of publication. The book consists of 11 chapters in all and the 10th chapter covers special populations which include the elderly, children, adolescents, nursing and pregnant women. Prof. Behere presents a balanced and an even approach in his writing which allows the reader to consider the current range of views about modern psychotropic medications. The publication of this book is a major event in the field of psychopharmacology and represents a unique contribution to all mental health professionals. It has 11 chapters and interestingly at the end of every chapter there is a block covering summary of that chapter. I believe it is a book every medical practitioner would benefit from having access to and will add to the treasure of existing books in psychopharmacology. Finally, I am happy to write the Foreword for this book.

Naren N. Wig Postgraduate Institute of Medical Education and Research Chandigarh, India

vii Preface

This is an effort to provide an up-to-date, easy to use, and a portable source of drug information for mental health professionals. This guide is intended to complement Essential Psychopharmacology and Textbook of Psychopharmacology. It provides practical information on how to use various psychotropic drugs in clinical practice, emphasizing the mechanisms of action of these drugs upon the receptors and enzymes in the brain. Earlier we have written a book entitled Handbook of Clinical Psychopharmacology in 2010, which was our initial attempt to write in psychopharmacology. As this earlier book became very popular among postgraduates in psychiatry, we penned this book. It consists of 11 chapters—10 chapters cover various classes of drugs, and the 10th chapter covers special populations which include the elderly, children, adolescents, pregnant and nursing women. All the selected drugs are presented in the same design format in order to facilitate rapid access to information. Specifically, each drug is individually divided into sections—class of the drug, history and introduc- tion, classification, pharmacological action, doses, drug interactions, indications, side effects, and special population. Only the essential facts about each drug have been included in order to make the content concise and to avoid dilution of important information. At the end of chapters, there is a block giving summary of the chapter. This book is intended to be genuinely helpful for practitioners of psychopharmacology by providing them with facts and relevant details of all the important psychotropic drugs. Every effort has been made to provide accurate and up-to-date information in accordance with the accepted standards and practice at the time of publication.

Kolhapur, India Prakash B. Behere Guwahati, India Anweshak Das Grand Rapids, MI Aniruddh P. Behere

ix Contents

1 Antidepressants �� 1 1.1 Tricyclic and Tetracyclic Antidepressants �� 1 1.2 Specific Serotonin Reuptake Inhibitors �� 4 1.2.1 Fluoxetine �� 4 1.2.2 Sertraline �� 7 1.2.3 Fluvoxamine �� 9 1.2.4 Paroxetine and Paroxetine CR �� 11 1.2.5 Citalopram and Escitalopram �� 13 1.3 Monoamine Oxidase Inhibitors �� 15 1.4 Selective Serotonin Norepinephrine Reuptake Inhibitors �� 18 1.4.1 Venlafaxine and Desvenlafaxine �� 18 1.4.2 Duloxetine �� 20 1.4.3 Milnacipran �� 22 1.5 Norepinephrine Dopamine Reuptake Inhibitors �� 23 1.5.1 Bupropion �� 23 1.6 Serotonin Adrenaline Reuptake Inhibitors �� 25 1.6.1 Trazodone �� 25 1.6.2 Nefazodone �� 27 1.7 Noradrenaline and Specific Serotonergic Agents �� 28 1.7.1 Mirtazapine �� 28 1.8 Newer Antidepressants �� 30 1.8.1 Agomelatine �� 30 1.8.2 Opipramol �� 32 1.8.3 Dapoxetine �� 33 1.8.4 Vilazodone �� 35 1.9 Important Tables Related to Antidepressants �� 36 1.10 Points to Remember �� 38 2 Antipsychotics �� 39 2.1 Typical Antipsychotics �� 39 2.1.1 Chlorpromazine �� 42 2.1.2 Haloperidol �� 43 2.1.3 Sulpiride and Levosulpiride �� 44 2.1.4 Loxapine �� 46

xi xii Contents

2.2 Atypical Antipsychotics �� 48 2.2.1 Olanzapine �� 48 2.2.2 Risperidone �� 51 2.2.3 Quetiapine �� 54 2.2.4 Ziprasidone �� 56 2.2.5 Clozapine �� 59 2.2.6 Amisulpride �� 63 2.2.7 Aripiprazole �� 66 2.2.8 Paliperidone �� 68 2.2.9 Zotepine �� 70 2.2.10 Asenapine �� 72 2.2.11 Iloperidone �� 74 2.3 Newer Atypical Antipsychotic �� 75 2.3.1 Blonanserin �� 75 2.3.2 Lurasidone �� 78 2.4 Depot Antipsychotics �� 80 2.5 Description of Drugs �� 81 2.5.1 Flupenthixol Decanoate �� 81 2.5.2 Fluphenazine Decanoate �� 81 2.5.3 Haloperidol Decanoate �� 82 2.5.4 Pipothiazine Palmitate �� 82 2.5.5 Zuclopenthixol Decanoate �� 83 2.5.6 Risperidone Long-Acting Injection (RLAI) �� 83 2.5.7 Olanzapine Pamoate Long-Acting Injection (OPLAI) �� 84 2.5.8 Aripiprazole Long Acting �� 85 2.6 Important Tables Related to Antipyschotics �� 85 2.7 Points to Remember �� 87 Further Reading �� 87 3 Anxiolytics and Hypnotics �� 89 3.1 Benzodiazepines �� 89 3.2 Newer Benzodiazepine �� 92 3.3 Non-Benzodiazepines �� 93 3.4 Beta Blockers �� 95 3.5 Points to Remember �� 98 4 Mood Stabilizers �� 99 4.1 Lithium �� 99 4.2 Carbamazepine �� 105 4.3 Valproate �� 108 4.4 Gabapentin �� 110 4.5 Topiramate �� 112 4.6 Lamotrigine �� 114 4.7 Points to Remember �� 116 Contents xiii

5 Antiepileptics �� 117 5.1 Phenytoin �� 117 5.2 Oxcarbazepine �� 119 5.3 Tiagabine �� 121 5.4 Zonisamide �� 122 5.5 Levetiracetam �� 124 5.6 Phenobarbitone �� 125 5.7 Carbamazepine �� 127 5.8 Valproic Acid and Divalproex Sodium �� 127 5.9 Gabapentin �� 127 5.10 Topiramate �� 127 5.11 Newer Anticonvulsant �� 127 5.12 Points to Remember �� 130 6 Sympathomimetics and Dopamine Receptor Agonists (Psycho Stimulants) �� 131 6.1 Amphetamines �� 131 6.2 Modafinil �� 133 6.3 Methylphenidate (d), Methylphenidate (d,l) �� 135 6.4 Atomoxetine �� 136 6.5 Guanfacine �� 138 6.6 Points to Remember �� 139 7 Drugs Used in Dementia �� 141 7.1 Cholinesterase Inhibitors �� 141 7.1.1 Tacrine �� 141 7.1.2 Donepezil �� 142 7.1.3 Rivastigmine �� 144 7.1.4 Galantamine �� 145 7.2 Noncholinesterase Inhibitors �� 147 7.2.1 Memantine �� 147 7.3 Newer Agents: Huperzine �� 148 7.4 Points to Remember �� 150 8 Antiparkinsonism: Drug Induced �� 151 9 Drugs Used in Substance Dependence �� 153 9.1 Clonidine �� 153 9.2 Disulfiram �� 155 9.3 Naltrexone �� 158 9.4 Varenicline �� 159 9.5 Baclofen �� 160 9.6 Acamprosate �� 163 9.7 Bupropion �� 164 9.8 Buprenorphine �� 164 9.9 Naloxone �� 165 9.10 Points to Remember �� 166 xiv Contents

10 Psychotropic Drug Use in Special Patient Group �� 167 10.1 Drug Choice in Pregnancy �� 167 10.2 Drug Choice in Breastfeeding �� 168 10.3 Drug Choice in Renal Impairment �� 169 10.4 Drug Choice in Hepatic Impairment �� 170 10.5 Drug Choice in Elderly People �� 170 10.6 Drug Choices in Hyperglycemia/Diabetes �� 171 10.7 Drug Choices in Weight Gain �� 172 10.8 Psychotropic Drugs: Side Effects and Teratogenic Risks �� 173 11 Upcoming Medicines �� 175 11.1 Cariprazine �� 175 11.2 Brexpiprazole �� 175 11.3 Vortioxetine �� 175 11.4 Levomilnacipran �� 176 11.5 Flibanserin �� 176 11.6 Adzenys XR-ODT �� 176 11.7 Prucalopride �� 176

References �� 179 About the Authors

Prakash B. Behere is Vice-Chancellor and Professor of Psychiatry at D.Y. Patil University, Kolhapur, Maharashtra; graduated from the Government Medical College, Jabalpur; and obtained his M.D. in Psychiatry from PGIMER, Chandigarh. He has previously served as Director of Research and Development and Professor/ Head of the Department of Psychiatry at Jawaharlal Nehru Medical College, Wardha; as Director and Professor/Head of the Department of Psychiatry at MGIMS, Sewagram, Maharashtra; and as a Reader at Banaras Hindu University, Varanasi. Having also worked as a Consultant (Locum) Child and Adolescent Psychiatrist at Raigmore Hospital, Inverness, Scotland, he has authored 180 journal publications and 51 book chapters, served as editor for eight books, and completed numerous WHO and ICMR projects. He is the recipient of the Dr. B.C. Roy National Award for Socio-Medical Relief and the Marfatia Award. He is a fellow of the National Academy of Medical Sciences and International Institute of Psychological Medicine. His many awards include the Dr. V.N. Bagadia Lifetime Achievement Award, Dr. D.L.N. Murthy Rao Oration Award, PPA Oration Award of the Indian Association of Child and Adolescent Mental Health, and the N.N. De Oration Award of the Indian Association of Society Psychiatrists.

Anweshak Das Graduated from Jawaharlal Nehru Medical College, Wardha, in 2010 and obtained his M.D. in Psychiatry from the same institution in 2015. He is the recipient of the Chancellors Gold Medal in M.D. Psychiatry Award from his university. He has authored six publications and ten book chapters and has served as an associate editor for one book. Currently he is a practicing Consultant Psychiatrist in Guwahati, Assam.

Aniruddh P. Behere completed his residency in Psychiatry at the SIU School of Medicine in Springfield, IL, USA, in 2011 and subsequently went on to do a fellowship in Child and Adolescent Psychiatry, graduating from the same institution in 2013. He was awarded the Helen Beiser Award during his residency training and recognized for academic excellence upon the completion of his fellowship. He is board certified in both Adult and Child & Adolescent Psychiatry. He is currently working at Helen Devos Children’s hospital, Grand Rapids, Michigan, with a

xv xvi About the Authors focus on medically complex children. He has a keen interest in clinical research and has presented research papers at national meetings, published numerous papers in peer-reviewed journals, and has written book chapters pertaining to mental health. He has also participated in various community education activities promoting mental health in children. His areas of interest include cross-cultural psychiatry, complementary and alternative medicine, psychopharmacology, and exploring ways to use technology to facilitate the diagnosis and treatment of psychiatric disorders.