Key Points Complementary and alternative medical therapies are made up of a diverse spectrum of practices (including natural medications) that often overlap with more traditional medical practice. The use of natural medications is growing considerably in the US and around…
Key Points Background A systematic approach to side effects of medications should include consideration of the nature, severity, and timing of symptoms to facilitate optimal management of such side effects. History Many medications (e.g., nefazodone) previously used in psychiatric disorders,…
Key Points Drug–drug interactions refer to alterations in drug levels or drug effects (or both) related to the administration of two or more prescribed, recreational, or over-the-counter agents in close temporal proximity. Although some drug–drug interactions involving psychotropic medications are…
Key Points Attention-deficit/hyperactivity disorder (ADHD) is a common disorder in children, adolescents, and adults. While the phenotype of ADHD changes across the life span, ADHD persists in many children, adolescents, and adults. Formulations of stimulant and non-stimulant medications are Food…
Key Points A “kindling hypothesis” of mood instability led to the search for anticonvulsant medications that might improve the course of illness in bipolar disorder (BPD). Divalproex sodium (valproate) and carbamazepine (in extended-release form) are effective in the treatment of…
Key Points Lithium remains a first-line treatment for all phases of bipolar disorder, including mania, depression, and prevention of recurrence. While not examined in a controlled trial, abundant evidence supports a role for lithium in decreasing the risk of suicide.…
Key Points Somatic therapies are a group of device-based techniques that modulate disease-relevant structures of the nervous system via surgical ablation or electrical stimulation with the goal of therapeutically modifying pathological patterns of brain activity and circuit connectivity. Ablative limbic…
Key Points Remission rates of 70%–90% have been reported in clinical trials of electroconvulsive therapy (ECT) and ECT is currently the most promising prospect for addressing the unmet worldwide need for effective treatment of individuals suffering from depression. The symptoms…
Key Points Background Treatment-resistant depression (TRD) refers to an inadequate response to at least one antidepressant given in sufficient doses and for an appropriate duration. History Despite the recent advances in treatment of depression, only 30%–40% of patients achieve remission…
Key Points The immediate mechanism of action of modern antidepressants (“immediate effects”) involves influencing the function of one or more monoamine neurotransmitter systems (serotonin, norepinephrine [noradrenaline], or dopamine). Influencing monoaminergic function has been shown to result in several changes in…