Offering user-friendly, authoritative guidance on cutting-edge psychopharmacologic and somatic treatments for psychiatric and neurologic conditions, Massachusetts General Hospital Psychopharmacology and Neurotherapeutics, 2nd Edition, helps you put today's best approaches to work for your patients. Composed of topical chapters primarily from the third edition of Stern et al.'s Massachusetts General Hospital Comprehensive Clinical Psychiatry, this fully revised resource focuses on current psychotropic treatments, electroconvulsive therapy, and neurotherapeutics, making it an ideal quick reference for psychiatrists, psychologists, internists, and nurse practitioners.

Brings you up-to-date information on key topics in the field, including the application of anticonvulsants, anxiolytics, mood stabilizers, and psychostimulants; drug drug interactions; side effects; treatment adherence; and more.
Includes detailed coverage of antidepressants, antipsychotics, and antianxiety medications, as well as advances in caring for patients with treatment-resistant depression and new legal considerations when prescribing psychotropics.
Covers recent progress on the use of neurotherapeutic interventions, such as transcranial magnetic stimulation, vagal nerve stimulation, and deep brain stimulation.
Contains a new chapter on the pharmacotherapy of movement disorders (derived from Stern et al.'s MGH Handbook of General Hospital Psychiatry, 8th Edition).
Features a user-friendly, highly templated format with abundant boxed summaries, bulleted points, case histories, algorithms, updated references, and suggested readings.
Offers updated DSM-5-TR criteria alongside peerless, hands-on advice from members of the esteemed MGH Department of Psychiatry.
An eBook version is included with purchase. The eBook allows you to access all of the text, figures, and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Additional digital ancillary content may publish up to 6 weeks following the publication date.
Author Information
Edited by Theodore A. Stern, MD, Psychiatrist and Chief Emeritus, Avery D. Weisman Psychiatry Consultation Service, Director, Thomas P. Hackett Center for Scholarship in Psychosomatic Medicine, Massachusetts General Hospital, Boston, MA, USA, Ned H. Cassem Professor of Psychiatry in the Field, Psychosomatic Medicine/Consultation, Harvard Medical School, Boston, MA, USA; Joan A. Camprodon, MD, MPH, PHD, Chief, Division of Neuropsychiatry, Massachusetts General Hospital, Director, Laboratory for Circuit Neuroscience and Neuromodulation, Massachusetts General Hospital, Director, Transcranial Magnetic Stimulation Clinical Service, Psychiatry, Massachusetts General Hospital, Boston, MA, USA, Associate Professor of Psychiatry, Harvard Medical School, Boston, MA, USA and Maurizio Fava, MD, Psychiatrist-in-Chief, Department of Psychiatry, Vice Chair, Executive Committee on Research, Massachusetts General Hospital, Boston, MA, USA, Executive Director, Clinical Trials Network & Institute (CTNI), Massachusetts General Hospital, Boston, MA, USA, Associate Dean for Clinical & Translational Research & Slater Family Professor of Psychiatry, Harvard Medical School, Boston, MA, USA



Preface
Contributors
1. Psychiatric Neuroscience: Incorporating Pathophysiology into Clinical Case Formulation
OVERVIEW
PSYCHIATRIC DIAGNOSIS: BIOMARKERS AND BIOLOGICAL VALIDITY
METHODS IN PSYCHIATRIC NEUROSCIENCE
BIOLOGICAL CASE FORMULATION: NEUROSCIENTIFIC CONTENT AND PROCESS
GENES, ENVIRONMENT, AND EPIGENETICS
OVERVIEW OF THE STRUCTURE OF THE CENTRAL NERVOUS SYSTEM
CELLULAR DIVERSITY IN THE BRAIN: NEURONS AND GLIA
THE STRUCTURE OF THE SYNAPSE
A REVIEW OF CLINICALLY RELEVANT NEUROTRANSMITTER SYSTEMS
CONCLUSION
REFERENCES
2. Treatment Adherence
OVERVIEW
EPIDEMIOLOGY OF ADHERENCE
CLINICAL AND ECONOMIC IMPACT OF NON-ADHERENCE
RISK FACTORS FOR NON-ADHERENCE
ASSESSING ADHERENCE
INTEGRATING ADHERENCE INTO THE TREATMENT COURSE
PROBLEM-SOLVING BARRIERS TO ADHERENCE
FUTURE DIRECTIONS
CONCLUSION
References
3. Pharmacological Approaches to Depression and Treatment-Resistant Depression
OVERVIEW
MECHANISMS OF ACTION
CLINICAL USES OF ANTIDEPRESSANTS
CHOICE OF AN ANTIDEPRESSANT
TREATMENT-RESISTANT DEPRESSION
DEFINITION OF TREATMENT-RESISTANT DEPRESSION
STAGING MODELS OF TREATMENT-RESISTANT DEPRESSION
CLINICAL FEATURES ASSOCIATED WITH TREATMENT-RESISTANT DEPRESSION
CLINICAL APPROACH TO TREATMENT-RESISTANT DEPRESSION
COMMON TREATMENT STRATEGIES FOR TREATMENT-RESISTANT DEPRESSION
RESEARCH CHALLENGES
CONCLUSIONS
Appendix 1Massachusetts General Hospital Staging Model (MGH-S) definition of TRD Revised
REFERENCES
4. Lithium and Its Role in Psychiatry
HISTORICAL CONTEXT
PHARMACOKINETICS AND PHARMACODYNAMICS
EVIDENCE FOR LITHIUM'S EFFICACY
PRINCIPLES OF LITHIUM TREATMENT
CURRENT CONTROVERSIES AND FUTURE DIRECTIONS
REFERENCES
5. The Use of Antiepileptic Drugs in Psychiatry
OVERVIEW: HISTORICAL CONTEXT
PHARMACOKINETICS, PHARMACODYNAMICS, ADVERSE EFFECTS, AND MONITORING
OTHER ANTICONVULSANTS
CONCLUSION
REFERENCES
6. The Pharmacotherapy of Anxiety Disorders
OVERVIEW AND GENERAL PRINCIPLES
PHARMACOTHERAPY OF PANIC DISORDER AND AGORAPHOBIA
PHARMACOTHERAPY OF GENERALIZED ANXIETYDISORDER
PHARMACOTHERAPY OF SOCIAL ANXIETY DISORDER
CONCLUSIONS AND FUTURE DIRECTIONS
REFERENCES
7. Pharmacotherapy of Attention-Deficit Hyperactivity Disorder Across the Life Span
OVERVIEW
STIMULANTS
ATOMOXETINE
ALTERNATIVE (NOT APPROVED BY THE FOOD AND DRUG ADMINISTRATION) TREATMENTS FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER
SUGGESTED MANAGEMENT STRATEGIES ACROSSTHE LIFE SPAN
CONCLUSION
REFERENCES
8. Natural Medications in Psychiatry
OVERVIEW
EFFICACY AND SAFETY
MOOD DISORDERS
ANXIETY AND INSOMNIA
PREMENSTRUAL AND MENOPAUSAL SYMPTOMS
COGNITION AND DEMENTIA
CONCLUSION
REFERENCES
9. Antipsychotic Drugs
INTRODUCTION
HISTORY
GENERAL CLINICAL CONSIDERATIONS
DRUG SELECTION
FIRST-GENERATION ( TYPICAL ) ANTIPSYCHOTICS
EXTRAPYRAMIDAL SYMPTOMS AND TARDIVE DYSKINESIA
NEUROLEPTIC MALIGNANT SYNDROME
SECOND-GENERATION ( ATYPICAL ) AND THIRD-GENERATION ANTIPSYCHOTICS
THIRD-GENERATION AND NEWEST ANTIPSYCHOTICS
DRUG INTERACTIONS WITH ANTIPSYCHOTIC AGENTS
ONGOING CHALLENGES
REFERENCES
10. Patients with Abnormal Movements
OVERVIEW
IDIOPATHIC MOVEMENT DISORDERS
TREMORS
DRUG-INDUCED MOVEMENT DISORDERS
FUNCTIONAL MOVEMENT DISORDERS
REFERENCES
11. Pathophysiology, Psychiatric Co-morbidity, and Treatment of Pain
OVERVIEW
EPIDEMIOLOGY
PATHOPHYSIOLOGY OF PAIN TRANSMISSION
CORTICAL SUBSTRATES FOR PAIN AND AFFECT
INTERACTIONS BETWEEN PAIN AND PSYCHOPATHOLOGY
PAIN TERMINOLOGY
ASSESSMENT OF PAIN
CORE PSYCHOPATHOLOGY AND PAIN-RELATED PSYCHOLOGICAL SYMPTOMS
PAIN AND CO-MORBID PSYCHIATRIC CONDITIONS
GENERAL PRINCIPALS OF MULTI-MODAL ANALGESIA
TREATMENT OF PAIN BEHAVIOR AND THE USE OF MULTI-DISCIPLINARY PAIN CLINICS
REHABILITATION
CONCLUSIONS
REFERENCES
12. Psychiatric Illness During Pregnancy and the Post-partum Period
OVERVIEW
PRECONCEPTION CONSIDERATIONS
SCREENING AND DIAGNOSIS OF DEPRESSION AND ANXIETY DURING PREGNANCY
TREATMENT OF DEPRESSION DURING PREGNANCY: CLINICAL GUIDELINES
ELECTROCONVULSIVE THERAPY DURING PREGNANCY
MOOD STABILIZERS DURING PREGNANCY
TREATMENT OF BIPOLAR DURING PREGNANCY: CLINICAL GUIDELINES
PSYCHOTIC DISORDERS DURING PREGNANCY
ANXIETY DISORDERS DURING PREGNANCY
ATTENTION-DEFICIT HYPERACTIVITY DISORDER AND PREGNANCY
CANNABIS USE DURING PREGNANCY
POST-PARTUM MOOD AND ANXIETY DISORDERS: DIAGNOSIS AND TREATMENT
PREVENTION OF POST-PARTUM PSYCHIATRIC DISORDERS
BREAST-FEEDING AND PSYCHOTROPIC DRUG USE
REFERENCES
13. Side Effects of Psychotropic Medications
OVERVIEW
ANTIDEPRESSANTS
Tricyclic Antidepressants
Monoamine Oxidase Inhibitors
Other Antidepressants
MOOD STABILIZERS
ANTIPSYCHOTICS
ANTI-ANXIETY AND SLEEP AGENTS
OTHER AGENTS USED IN THE TREATMENT OF PSYCHIATRIC CONDITIONS
Guanfacine
REFERENCES
14. Drug Drug Interactions in Psychopharmacology
OVERVIEW
CLASSIFICATION
PHARMACOKINETICS
ANTIPSYCHOTICS
MOOD STABILIZERS
ANTIDEPRESSANTS
BENZODIAZEPINES
PSYCHOSTIMULANTS AND MODAFINIL
REFERENCES
15. Pharmacotherapy of Neurocognitive Disorders and Dementia
OVERVIEW
EPIDEMIOLOGY OF DEMENTIA
THE ROLE OF AGE OF ONSET
EVALUATION OF A PATIENT WITH SUSPECTED COGNITIVE IMPAIRMENT
ALZHEIMER DISEASE
LEWY BODY DEMENTIA
FRONTOTEMPORAL DEMENTIAS
VASCULAR DEMENTIA
CORTICOBASAL DEGENERATION
PROGRESSIVE SUPRANUCLEAR PALSY
NORMAL-PRESSURE HYDROCEPHALUS
RAPIDLY PROGRESSING DEMENTIAS: PRION DISEASES WITH CREUTZFELDT JAKOB DISEASE AS AN EXAMPLE
CONCLUSIONS
REFERENCES
16. Pharmacotherapy of Substance Use Disorders
OVERVIEW
ALCOHOL USE DISORDER AND RELATED CONDITIONS
COCAINE USE DISORDER AND ASSOCIATED CONDITIONS
AMPHETAMINE USE DISORDER
CLUB DRUGS
OPIOID USE DISORDER AND ASSOCIATED CONDITIONS
BENZODIAZEPINES AND BARBITURATES
REFERENCES
17. Pharmacotherapy of Sexual Disorders and Sexual Dysfunction
OVERVIEW
EPIDEMIOLOGY AND RISK FACTORS
PATHOPHYSIOLOGY
CLINICAL FEATURES AND DIAGNOSIS
DIFFERENTIAL DIAGNOSIS OF SEXUAL DISORDERS
TREATMENT
OUTLOOK
REFERENCES
18. Device Neuromodulation and Brain Stimulation Therapies
OVERVIEW
TRANSCRANIAL MAGNETIC STIMULATION
ELECTROCONVULSIVE THERAPY
VAGUS NERVE STIMULATION
DEEP BRAIN STIMULATION
ABLATIVE LIMBIC SYSTEM SURGERY
Conclusion
REFERENCES
19. Legal Considerations for Mental Health Providers
OVERVIEW
BASIC CONCEPTS
INFORMED CONSENT
TREATMENT REFUSAL
CONSENT TO PARTICIPATE IN RESEARCH
CIVIL COMMITMENT
THE MEDICAL LIABILITY CLIMATE
MALPRACTICE LIABILITY
LIABILITY AND MANAGED CARE
SELECTED AREAS OF LIABILITY RISK IN PSYCHIATRY
BOUNDARY VIOLATIONS
REDUCING MALPRACTICE RISK
CRIMINAL COMPETENCIES
COMPETENCY TO PLEAD, DECLINE COUNSEL, AND REPRESENT ONESELF
COMPETENCY TO BE EXECUTED
CRIMINAL RESPONSIBILITY
EVALUATIONS OF CRIMINAL RESPONSIBILITY
CONCLUSION
REFERENCES
Index