Author: Charles B. Nemeroff MD, PhD
Publisher: Oxford University Press
ISBN: 0199974144
Category : Medical
Languages : en
Pages : 384
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Book Description
Although there are a variety of textbooks and manuals of psychiatric disorders, few have focused on the management of treatment-resistant patients. Those that exist have largely focused on treatment-resistant depression and even these are now largely outdated. Because psychiatrists and other mental health care professionals increasingly manage patients who fail treatment from family practitioners and other non-psychiatric specialists, a single practical volume summarizing the evidence-based medicine as well as the art of managing treatment-resistant patients is a much needed volume for practitioners, psychiatry residents and other mental health workers. Most importantly, both psychopharmacological and psychotherapeutic interventions will be included, a shortcoming of many previous volumes. "Management of Treatment Resistant Major Psychiatric Disorders" contains chapters authored by leaders in the field on the management of the major treatment resistant psychiatric disorders.
Author: Yong-Ku Kim
Publisher: Springer
ISBN: 9811043582
Category : Medical
Languages : en
Pages : 416
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Book Description
This book reviews all the important aspects of treatment-resistant psychiatric disorders, covering issues such as definitions, clinical aspects, neurobiological correlates, treatment options, and predictors of treatment response. The book is divided into three sections, the first of which examines the most recent thinking on treatment resistance in psychiatry, including definition and epidemiology, paradigm shift in the study of the subjects, individual susceptibility and resilience, abnormal structural or functional connectivity, and insights from animal models. The second section then discusses treatment resistance in each of the major psychiatric disorders, with particular focus on the responsible clinical and biological factors and the available management strategies. Finally, more detailed information is presented on diverse pharmacological and non-pharmacological therapeutic interventions. The book, written by leading experts from across the world, will be of value to all who seek a better understanding of the clinical-neurobiological underpinnings and the development of management for treatment resistance in psychiatric disorders.
Author: Mantosh J. Dewan
Publisher: American Psychiatric Pub
ISBN: 1585627887
Category : Medical
Languages : en
Pages : 460
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Book Description
Why do some psychiatric patients fail to get better, even when in the care of competent clinicians? Treatment-refractory conditions are all too common in everyday clinical practice. Treatment resistance occurs across the full spectrum of psychiatric disorders, incurring enormous emotional, economic, and social costs. In the United States, treatment of depression alone costs more than $40 billion annually, and as many as 40% of patients with depression have a treatment-refractory form of the illness. This groundbreaking clinical guide starts where standard textbooks end, focusing on clinical strategies to be used after all basic treatment options, such as medication and psychotherapy, have failed. In this book expert contributors address the sequential clinical steps in treating difficult-to-treat psychiatric patients by offering a blend of evidence-based clinical recommendations, detailed case vignettes, treatment algorithms, and -- when necessary to go beyond the reach of evidence -- the clinical wisdom of leaders in the field. The chapters in this user-friendly, practical guide are organized by major disorder. Each chapter offers concrete recommendations on what to do when the usual first steps in therapy are ineffective, including evidence for biopsychosocial treatments alone versus in combination, generic versus specific therapies, and literature reviews and the latest expert wisdom. A sampling includes The management of the complex and often refractory bipolar disorder, which involves replacing or combining lithium treatment with anticonvulsants or atypical antipsychotic agents with adjuncts such as benzodiazepines, thyroid hormone, and electroconvulsive therapy, but also -- above all -- with careful attention to the therapeutic alliance. The importance of combined therapeutic modalities for patients with schizophrenia -- especially given managed care's cost-cutting strategies, which deprive many schizophrenic patients of effective treatment modalities such as family therapy or early use of an atypical antipsychotic. Combination treatments for anxiety, with medications adjusted over time as symptoms wax and wane, and early and appropriate interventions to mitigate internal and external environmental stressors. The emphasis on common sense, optimism, a sense of humor, and an iron constitution as the most important tools for clinicians wishing to work with the most severely ill patients with borderline personality disorder. The importance of individual differences in biological vulnerability, emotionality and expressiveness, cognitive schemas and beliefs, prior traumatic experience, resilience, and coping strategies for successful treatment of posttraumatic stress disorder. Packed with up-to-date information of immediate relevance, this volume will prove invaluable in both classroom and clinical practice, for everyone from beginning interns and residents to experienced psychiatric and medical practitioners and social workers.
Author: Michael Cummings
Publisher: Cambridge University Press
ISBN: 1108962122
Category : Medical
Languages : en
Pages : 545
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Book Description
This full-color, practical handbook provides a concise, evidence-based psychopharmacological approach to the management of complex treatment-resistant psychotic disorders. Part I focuses uniquely on topics and strategies relevant to treating this challenging patient population. These approaches go beyond standard guidelines while adhering to research and clinically derived data. Part II provides a concise array of information regarding those classes of medications most commonly used when treating complex treatment-resistant psychotic disorders. Each medication guide contains sections including mechanisms of action, typical treatment response, monitoring, dosing and kinetics, medications to avoid in combination/warnings, and take-home pearls. Part III offers tips in brief appendix chapters for managing common issues ranging from loading lithium and valproic acid to the treatment of acute psychomotor agitation. An essential resource for psychiatrists, forensic clinicians, psychiatric trainees, and all mental health professionals involved with, or interested in, the treatment of challenging psychotic disorders.
Author: David Mintz, M.D.
Publisher: American Psychiatric Pub
ISBN: 1615371524
Category : Medical
Languages : en
Pages : 302
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Book Description
"The troubling increase in treatment resistance in psychiatry has many culprits: the rise of biomedical psychiatry and corresponding sidelining of psychodynamic and psychosocial factors; the increased emphasis on treating the symptoms rather than the person; and a greater focus on the electronic medical record rather than the patient, all of which point to a breakdown in the person-centered prescriber-patient relationship. Psychodynamic Psychopharmacology illuminates a new path forward. It examines the psychological and interpersonal mechanisms of pharmacological treatment resistance, integrating research on evidence-based prescribing processes with psychodynamic insights and skills to enhance treatment outcomes for patients who are difficult to treat. The first part of the book explores the evidence base that guides how, rather than simply what, to prescribe. It describes precisely what psychodynamic psychopharmacology is and why its emphasis on combining the often-neglected psychosocial aspects of medication with biomedical considerations provides a more optimized approach to addressing treatment resistance. Part II delves into the psychodynamics that contribute to pharmacological treatment resistance, both when patients' ambivalence about their illness, the medication itself, or their prescriber manifests in nonadherence and when medications support a negative identity or are used as replacements for healthy capacities. Readers will gain basic skills for addressing the psychological and interpersonal dynamics that underpin both scenarios and will be better positioned to ameliorate interferences with the healthy use of medications. The final section of the book offers detailed technical recommendations for addressing pharmacological treatment resistance. It tackles issues that include countertransference-driven irrational prescribing; primitive dynamics, such as splitting and projective identification; and the overlap between psychopharmacological treatment resistance and the dynamics of treatment nonadherence and nonresponse in integrated and collaborative medical care settings. By putting the individual patient back at the center of the therapeutic equation, psychodynamic psychopharmacology, as outlined in this book, offers a model that moves beyond compliance and emphasizes instead the alliance between patient and prescriber. In doing so, it empowers patients to become more active contributors in their own recovery"--
Author: Gustavo H. Vazquez
Publisher: Academic Press
ISBN: 0128210346
Category : Medical
Languages : en
Pages : 170
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Book Description
Ketamine for Treatment-Resistant Depression: Neurobiology and Applications provides a simple, evidence-based overview for neuropsychiatrists and translational researchers on this medication, its mechanisms of actions, eligibility of patients for treatment, and the preparation and implementation of ketamine clinics. Provides efficacy research on ketamine as a treatment for depression Identifies best practices for clinical use, both long-term and acute Discusses the molecular mechanisms and neurobiology of action
Author: Eric Plakum
Publisher: National Geographic Books
ISBN: 0393706613
Category : Psychology
Languages : en
Pages : 0
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Book Description
Therapeutic hope for “treatment resistant” patients. The Austen Riggs Center is nationally recognized as the leading psychiatric hospital for treatment-resistant patients, who willingly seek help but just cannot respond to treatment. Here, leaders in treating such challenging patients offer a comprehensive psychodynamic approach for treatment and offer hope for recovery. In this book, readers are given an in-depth view into the psychodynamics systems perspective of treatment resistant disorders, with illustrations of the value of including family therapy, and developing and using a psychodynamic treatment team. Also offered is the first description published in book form of the newly-defined area of psychodynamic psychopharmacology—an approach to the use of medications that attends to the meaning of medications to the patient and clinician, as well as to their pharmacologic effects. Important clinical problems such as trauma, psychosis, suicide, family resistant, integrated treatment, and psychopharmacologic failures are covered in detail. Throughout, practical principles are reported in text boxes to help the reader apply learning from Riggs to other outpatient, residential, day treatment, and inpatient settings. The Austen Riggs Center is on the forefront of dealing with difficult-to-treat patients, and this book provides an invaluable resource for both understanding treatment resistance and implementing effective techniques to treat it in clinical practice.
Author: Charles B. Nemeroff
Publisher: OUP USA
ISBN: 0199739986
Category : Medical
Languages : en
Pages : 379
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Book Description
A sizable percentage of patients with major psychiatric disorders do not respond to the first or second treatments they receive. This book summarizes the latest evidence from clinical studies concerning the treatment of patients with treatment-resistant psychiatric disorders. Both pharmacological and psychotherapeutic interventions are included, as well as somatic non-pharmacological treatments. The chapter authors represent the leaders in their respective fields.
Author: Siegfried Kasper
Publisher: John Wiley & Sons
ISBN: 1118556739
Category : Medical
Languages : en
Pages : 229
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Book Description
Treatment-resistant Depress Successful management of patients with treatment-resistant depression requires a thorough understanding of the biological basis for both the depression and its failure to respond to standard treatments. This book clearly and succinctly summarizes the latest scientific research and its applications in clinical practice. A first step is a clear definition of what constitutes treatment-resistant depression so that clinical trials and other studies are using common criteria, enabling comparison and meta-analysis of their outcomes. The opening chapter reviews definitions and predictors of treatment-resistant depression originating from different fields and discusses their usefulness in clinical practice and clinical research. The next chapter proposes a new definition, adapting terminology from medicine. Biological classification requires identification of genetic risk factors and gene variants have been identified as accounting for 50% of the variance in the clinical outcomes of antidepressant treatments. Chapter 3 describes several genes already associated with treatment-resistant depression and, while further work is needed to translate findings into clinical recommendations, suggests that genetic prediction of treatment resistance could become a widespread clinical reality within a few years. Most patients with treatment-resistant depression will be treated pharmacologically, so three chapters review the latest evidence for pharmacological best practice in switching strategies for antidepressants, the role of antipsychotics and augmentation strategies to complement lithium. There are two major alternatives to pharmacotherapy: neuromodulation and psychotherapy. The brain intervention chapter summarizes clinical research and experience with electroconvulsive therapy, transcranial magnetic stimulation, vagus nerve stimulation, deep brain stimulation and magnetic seizure therapy. The final chapter reviews the literature pertaining to the effectiveness of various forms of psychotherapy in patients who have not responded to antidepressant pharmacotherapy, explaining that patients who have not responded to one or two trials of antidepressant medication have a 30%-50% chance of responding to a focused psychotherapy. It proposes indications for psychotherapy in treatment-resistant depression and summarizes general therapeutic principles. Essential reading for all psychiatrists managing patients with this distressing disorder.
Author: Bernhard Baune
Publisher: Academic Press
ISBN: 0128131772
Category : Medical
Languages : en
Pages : 604
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Book Description
Personalized Psychiatry presents the first book to explore this novel field of biological psychiatry that covers both basic science research and its translational applications. The book conceptualizes personalized psychiatry and provides state-of-the-art knowledge on biological and neuroscience methodologies, all while integrating clinical phenomenology relevant to personalized psychiatry and discussing important principles and potential models. It is essential reading for advanced students and neuroscience and psychiatry researchers who are investigating the prevention and treatment of mental disorders. Combines neurobiology with basic science methodologies in genomics, epigenomics and transcriptomics Demonstrates how the statistical modeling of interacting biological and clinical information could transform the future of psychiatry Addresses fundamental questions and requirements for personalized psychiatry from a basic research and translational perspective
