Case Studies in Psychopharmacology: The Use of Drugs in Psychiatry Second edition Case Studies in Psychopharmacology: The Use of Drugs in Psychiatry Second edition EDITED BY DAVID TAYLOR BSc MSc MRPHARMS CHIEF PHARMACIST SoUTH LONDON AND MAUDSIEY NHS TRUST DENMARKHIU LONDON SE58AZ CARoL PATON BSc DIPCUNPHARM MRPHARMS MCMHP PRINCIPAL PHARMACIST 0XLEAS NHS TRusT PINEWOOD HOUSE DARTFORD KENT DA27WG informa healthcare New York London CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2002 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20130417 International Standard Book Number-13: 978-1-84184-884-6 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. 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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword viii Contributors X 1. Rapid tranquill/zation 1 David Taylor 2. Non-refractory schizophrenia 9 Carol Paton 3. Refractory schizophrenia 21 David Taylor 4. Managing adverse effects of clozaplne 31 Shubhra Mace 5. Negative symptoms 41 Carol Paton 6. Treatment of psychosis In people with epilepsy 53 Denise McConnell 7. Treatment of psychosis in pregnancy and breastfeeding 61 Robyn McAsklll 8. Atypicals and hyperglycaemla 75 Shameem Mlr vi Contents 9. Adherence to antipsychotic medication 83 Jennie Day 10. Depression with anxiety symptoms 91 Celia Feetam 11. Sub-optimal use of antidepressants 99 John Donoghue 12. Antidepressant prophylaxis and discontinuation symptoms 107 Stephen Bazire 13. Refractory depression 115 John Whitmore 14. Treatment of depression in people with epilepsy 125 Denise McConnell 15. Treatment of depression in cardiovascular disease 1.33 Eromona Whiskey 16. Panic disorder 1.41. Celia Feetam 1. 7. Obsessive-compulsive disorder 151 Diane Booth 18. Mania Peter Pratt 19. Bipolar disorder: unlicensed treatments 171. Peter Pratt 20. Lithium prophylaxis, withdrawal and use in pregnancy 183 Stephen Bazire 21. Rapid-cycling bipolar affective disorder 191 David Taylor 22. Antidepressant-induced switching in bipolar affective disorder 199 Shameem Mir Contents vii 23. Atypical ant/psychotics in bipolar disorder 211 Petrina Douglas-Hall 24. Depression in the elderly 219 Denise Taylor 25. Psychosis in the elderly 229 Denise Taylor 26. Alzheimer's disease 239 David Taylor 27. Use of atypical ant/psychotics to treat behavioural symptoms of dementia 251 Anne Connolly 28. Self-injurious behaviour and learning disabilities 261 David Branford 29. Attention deficit hyperactivity disorder 271 Carol Paton 30. Childhood depression 283 Stuart Banham 31. Alcohol detoxification and the maintenance of abstinence 293 Carol Paton 32. Methadone initiation 307 Lucy Reeves and Janie Sheridan 33. Eating disorder - anorexia nervosa 319 Celia Feetam 34. Sleep disturbance 329 Lynn Haygarth 35. Complementary therapies 341 Sarah Beck Index 351 Foreword It is a great pleasure for me to write a foreword to the revised version of this excellent book. Once again, it comprises an unusual but very practical format. Each of the contributors, all pharmacists with a particular interest in psychopharmacology and drug treatments in psychiatry, provides a typical case history to illustrate an important area of therapeutics. The case history is followed by some focused questions which have been raised by the case history. Answers which incorporate a great deal of pharmacology and practical advice are given to these questions. Key points are then listed and each chapter finishes with a compendious list of references. Some chapters also have suggested further reading. This formula works very successfully. Although the book cannot claim to be a total account of psychopharmacology, the chapters are chosen with great care, with a particular relevance to practical issues. Difficult problems like the treatment of refractory conditions are evaluated and advice given. Other chapters deal with the side-effects of medication and the measures that could be used to counteract these problems. For example, a chapter on clozapine and its side effects should enable the practitioner to optimise his or her treatment and also to maintain compliance. Foreword ix Outside the field of psychosis a whole differences of opinion without confusing the range of conditions are discussed. The book reader completely. not only encompasses well-recognised It is hoped that this book, in its second disorders but also curs across them to deal edition, will remain an important addition to with the problems of medication and even, as the practising psychiatrist's sources of in the case of bipolar disorder, with knowledge. Furthermore, it is of interest to unlicensed treatments. This exemplifies the pharmacists, especially those specialising in 'no-nonsense' approach of the contributors. psychiatric conditions. I would hope that They have much experience of practical reading this book will help other health care problems of treatment and this is seen in the workers in the field of psychiatry, such as various chapters. nurses and social workers. General The contributors discuss each issue in a practitioners with a special interest in balanced and clear way. In many areas of drug managing psychiatric problems will also profit treatment in psychiatry, opinion is not by reading various chapters of particular unanimous. Often, consensus has not yet relevance to them. emerged, reflecting the slow accrual of relevant data. These topics are discussed in a Malcolm Lader careful way that acknowledges these London Contributors Stuart Banham BSc DipPsychPharm MRPharmS MCMHP Oxleas NHS Trust Bexley Hospital Bexley Kent DA5 2BW Stephen Bazire BPharm MRPharmS DipPsychPharm Pharmacy Services Director Norfolk Mental Health Care NHS Trust Hellesdon Hospital Notwich UK Sarah Beck BSc MRPharmS Oxleas NHS Trust Bexley Hospital Bexley Kent DA5 2BW Contributors xi Diane Booth BSc (Hons) MRPharmS Petrina Douglas-Hall BPharm MRPharmS DipPsychPharm DipPsychPharm Chief Pharmacist Pharmacist Berkshire Healthcare NHS Trust HM Prison Service Fair Mile Hospital Home Office Wallingford UK Celia Feetam BPharm (Hons) MSc MRPharmS David Branford PhD MRPharmS MCPP Clinical Psychiatric Pharmacist Director of Pharmacy UKPPG Chair Southern Derbyshire Community and Mental Senior Teaching Fellow Health Services Dept Psychiatric Pharmacy Kingsway Hospital School of Life and Health Sciences Derby Aston University UK Birmingham Anne Connolly BPharm DipClinPharm UK Medicines Information Department South London and Maudsley NHS Trust Lynn Haygarth Bpharm MRPharmS Med Maudsley Hospital Principal Pharmacist London Mental Health UK Calderdale and Huddersfield NHS Trust Jennie Day BSc MRPharmS MSc PhD St Luke's Hospital MRC Research Fellow Huddersfield Department of Clinical Psychology UK University of Liverpool Liverpool Shubhra Mace BSc (Hons) DipPharmPrac UK Senior Clinical Pharmacist Sourh London and Maudsley NHS Trust John Donoghue BSc MRPharmS MCMHP Maudsley Hospital Honorary Lecturer London School of Pharmacy and Chemistty UK Liverpool John Moores University Byrom Street Liverpool UK