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INTRODUCTION

Chapter 8 Psychopharmacology is a combination of Chapter 15, Drug Therapy of Depression and Anxiety Disorders and Chapter 16, Pharmacology of Psychosis and Mania from Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. An understanding of the material in those chapters will be helpful in following the material presented in this chapter. In addition to the material presented here, the above chapters in the 12th Edition include:

  • A characterization of depressive and anxiety disorders

  • Table 15-2, The Potencies of Antidepressants at the Human Transporters for Norepinephrine (NET), Serotonin (SERT), and Dopamine (DAT)

  • Table 15-4, Potencies of Selected Antidepressants at Muscarinic, Histamine H1, and alpha1-Adrenergic Receptors

  • A discussion of the long-term adaptive effects of antidepressants that enhance the effectiveness of therapy

  • A discussion of the pathophysiology of psychosis

  • A discussion of the chemistry of antipsychotic agents

  • The role of dopamine and serotonin receptors in antipsychotic therapy

  • A detailed discussion of the use antipsychotic agents for nonpsychotic disorders

  • A discussion of the adverse effects of antipsychotic agents that are not predicted by monoamine receptor affinities

  • Novel treatments for psychosis and mania

LEARNING OBJECTIVES

  • Understand the mechanisms of action, therapeutic uses, and adverse effects of antidepressant drugs.

  • Know how antidepressant drugs are used to manage depression.

  • Know the mechanisms of action, therapeutic uses, and adverse effects of antipsychotic drugs and drugs used to treat mania.

  • Understand the pharmacotherapy of acute and chronic psychoses and bipolar disorder.

DRUGS INCLUDED IN THIS CHAPTER

  • Amitriptyline (ELAVIL, others)

  • Amoxapine (ASENDIN)

  • Aripiprazole (ABILIFY)

  • Asenapine (SAPHRIS, others)

  • Atomoxetine (STRATTERA)

  • Bupropion (WELLBUTRIN, ZYBAN, others)

  • Buspirone (BUSPAR)

  • Carbamazepine (TEGRETOL, others)

  • Chlorpromazine (THORAZINE, others)

  • Citalopram (CELEXA)

  • Clomipramine (ANAFRANIL)

  • Clozapine (CLOZARIL, others)

  • Desipramine (NORPRAMIN)

  • Desvenlafaxine (PRISTIQ)

  • Doxepin (ADAPIN, SINEQUAN)

  • Droperidol (INAPSIN, others)

  • Duloxetine (CYMBALTA)

  • Escitalopram (LEXAPRO)

  • Fluoxetine (PROSAC, SYMBYAX, others)

  • Fluphenazine (PROLIXIN, others)

  • Fluvoxamine (LUVOX)

  • Haloperidol (HALDOL, others)

  • Iloperidone (FANAPT)

  • Imipramine (TOFRANIL, others)

  • Isocarboxazid (MARPLAN)

  • Lamotrigine (LAMICTAL)

  • Lithium

  • Loxapine (LOXITANE)

  • Maprotiline (LUDIOMIL)

  • Mianserin (DEPNON, others)—not approved in the United States

  • Milnacipran (IXEL, others)—not approved in the United States

  • Mirtazapine (REMERON, others)

  • Molindone (MOBAN)—use discontinued

  • Nefazodone (DUTONIN, others)

  • Nortriptyline (PAMELOR)

  • Olanzapine (ZYPREXA)

  • Paliperidone (INVEGA)

  • Paroxetine (PAXIL)

  • Perphenazine (TRILAFON, others)

  • Phenelzine (NARDIL)

  • Protriptyline (VIVACTIL)

  • Quetiapine (SEROQUEL)

  • Reboxetine (EDRONAX)—not available in the United States

  • Risperidone (RESPERDAL)

  • Selegiline (EMSAM)

  • Sertindole (SERDOLECT, others)—not approved in the United States

  • Sertraline (ZOLOFT)

  • Tranylcypromine (PARNATE)

  • Trazodone (DESYREL)

  • Trifluoperazine (STELAZINE, others)

  • Trimipramine (SURMONTIL)

  • Valproic acid, divalproex sodium (DEPAKENE, DEPAKOTE, others)

  • Venlafaxine (EFFEXOR)

  • Ziprasidone (GEODON)

MECHANISMS OF ACTION OF PSYCHOPHARMACOLOGICAL AGENTS

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