Kaplan & Sadock's Pocket Handbook of Psychiatric Drug

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7th edition

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© 2011, 2006, 2001 by LIPPINCOTT WILLIAMS & WILKINS

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Library of Congress Cataloging-in-Publication Data

Names: Sadock, Benjamin J., 1933- author. | Sussman, Norman, author. | Sadock,
Virginia A., author.
Title: Kaplan & Sadock’s pocket handbook of psychiatric drug treatment / Benjamin
J. Sadock, Norman Sussman, Virginia A. Sadock.
Other titles: Kaplan and Sadock’s pocket handbook of psychiatric drug treatment |
Pocket handbook of psychiatric drug treatment
Description: Seventh edition. | Philadelphia : Wolters Kluwer, [2019] | Includes
bibliographical references and index.
Identifiers: LCCN 2017055311 | ISBN 9781496389602
Subjects: | MESH: Mental Disorders–drug therapy | Psychotropic Drugs–therapeutic
use | Handbooks
Classification: LCC RC483 | NLM WM 34 | DDC 616.89/18—dc23 LC record
available at https://lccn.loc.gov/2017055311

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 This work is no substitute for individual patient assessment based upon healthcare professionals’
examination of each patient and consideration of, among other things, age, weight, gender, current or
prior medical conditions, medication history, laboratory data and other factors unique to the patient.
The publisher does not provide medical advice or guidance and this work is merely a reference tool.
Healthcare professionals, and not the publisher, are solely responsible for the use of this work
including all medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent
professional verification of medical diagnoses, indications, appropriate pharmaceutical selections and
dosages, and treatment options should be made and healthcare professionals should consult a variety
of sources. When prescribing medication, healthcare professionals are advised to consult the product
information sheet (the manufacturer’s package insert) accompanying each drug to verify, among
other things, conditions of use, warnings and side effects and identify any changes in dosage
schedule or contraindications, particularly if the medication to be administered is new, infrequently
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 Dedicated
to our children
James and Victoria
and to our grandchildren
Celia, Emily, Oliver, and Joel
B.J.S.
V.A.S.

Dedicated
to my wife Susan
and my children
Rebecca and Zachary
N.S.
Preface
This is the seventh edition of Kaplan & Sadock’s Pocket Handbook of
Psychiatric Drug Treatment, the first of which was published almost 25
years ago. During that time, a revolution in the treatment of mental illness
occurred, sparked by the introduction of psychotropic drugs. This book has
kept up with that revolution and contains information about every drug used
in the treatment of mental illness. It has served the needs of many
professionals who provide care for the mentally ill—psychiatrists and
nonpsychiatric physicians, psychiatric residents, medical students, clinical
psychologists, psychiatric nurses, and others.

GOALS OF THIS BOOK

This book covers the entire spectrum of psychiatric drug therapy used in the
clinical practice of psychiatry. As with each new edition, every section has
been updated and revised and new sections added. Many drugs approved by
the FDA as treatments for psychiatric disorders have been found to have
benefits beyond those recognized at the time of their initial marketing, thus
expanding the range of disorders that can be treated. Some have also been
found to have unanticipated risks. These developments serve to emphasize
the importance of having updated information about drug selection and use
that reflects both research data and clinical experience. The goals of this
book are to present this information clearly and concisely.

ORGANIZATION OF THIS BOOK

Following the format of previous editions, whenever possible, we classify
drugs according to their pharmacological activity and mechanism of action
rather than using such categories as antidepressants, antipsychotics,
anxiolytics, and mood stabilizers which are overly broad. For example,
many antidepressant drugs are used to treat anxiety disorders; some
anxiolytics are used to treat depression and bipolar disorders; and drugs
from all categories are used to treat other conditions such as eating
disorders and impulse control disorders to name but two. This organization
is used in textbooks of pharmacology and we believe psychopharmacology
should follow that organization as much as possible, given the current state
of our knowledge.

HOW TO USE THIS BOOK

At the beginning of the book, the reader will find a chart (Table A) that lists
each and every drug and the chapter in which it is found. In addition, the
index lists each drug separately under its generic and brand name and the
page number on which it can be found. Each section provides a wealth of
data that includes (1) the drug’s chemical name; (2) preparation and
dosages; (3) pharmacologic actions including its pharmacokinetics and
pharmacodynamics; (4) the indications for use and clinical applications; (5)
use in children, elderly persons, and pregnant and nursing women; (6) side
effects and adverse and allergic reactions; and (7) drug–drug interactions.

NUTRITIONAL SUPPLEMENTS
We continue to include an updated chapter covering nutritional supplements
as well as herb and plant preparations with psychoactive properties because
their use is increasing. Many persons medicate themselves with these
compounds and while some may be beneficial, no standards of use have
been developed; however, many are being evaluated under the auspices of
the National Center for Complementary and Alternative Medicine
(NCCAM). Clinicians must be alert to the possibility of adverse effects of
these agents in addition to their interactions with prescribed psychotropic
medications.

DRUGS USED IN THE TREATMENT OF OBESITY

We include a chapter on drugs used to treat obesity for two reasons: Many
psychotropic drugs influence metabolism in such a way that significant
weight gain occurs as a side effect; and obesity, now classified as a disease
by the American Medical Association, occurs in conjunction with many
psychiatric disorders and psychiatrists have a role to play in its
management.

MEDICATION-INDUCED MOVEMENT DISORDERS

Movement disorders are commonly associated with the use of potent
psychotropic medications and for that reason a special chapter has been
devoted to this topic. Some movement disorders, such as neuroleptic-
induced tardive dyskinesia can be potentially disabling and others such as
neuroleptic malignant syndrome can be life threatening. Psychiatrists must
know which drugs are associated with these effects and must remain
vigilant when these drugs are prescribed. This new section will be very
helpful to clinicians in this regard.
Acknowledgments
We want to thank our assistants, especially Heidiann Grech, who worked on
this and other books of ours. We also wish to thank James Sadock, M.D.
and Victoria Sadock Gregg, M.D., both emergency physicians, for their
help. Rebecca Sussman, M.D. and Zachary Sussman were also of great help
and deserve thanks. We also extend our deepest thanks to Samoon Ahmad,
M.D., whose expertise in psychopharmacology was of invaluable help to
the authors.
Finally, we extend our thanks to Charles Marmar, M.D., Chairman of the
Department of Psychiatry at New York School of Medicine, whose support
and encouragement of all our academic accomplishments are highly
appreciated.
Contents
Preface
Acknowledgments
Table A Index to Book by Generic Name of Drug
1. General Principles of Psychopharmacology
2. α2-Adrenergic Receptor Agonists, α1-Adrenergic Receptor
Antagonists: Clonidine, Guanfacine, Prazosin, and Yohimbine
3. β-Adrenergic Receptor Antagonists
4. Anticholinergic Agents
5. Anticonvulsants
6. Antihistamines
7. Barbiturates and Similarly Acting Drugs
8. Benzodiazepines and Drugs Acting on GABA Receptors
9. Bupropion
10. Buspirone
11. Calcium Channel Inhibitors
12. Carbamazepine and Oxcarbazepine
13. Cholinesterase Inhibitors and Memantine
14. Disulfiram and Acamprosate
15. Dopamine Receptor Agonists and Precursors
16. Dopamine Receptor Antagonists (First-Generation Antipsychotics)
17. Lamotrigine
18. Lithium
19. Melatonin Agonists: Ramelteon, Melatonin, and Suvorexant
20. Mirtazapine
21. Monoamine Oxidase Inhibitors
22. Nefazodone and Trazodone
23. Opioid Receptor Agonists: Methadone and Buprenorphine
24. Opioid Receptor Antagonists: Naltrexone, Nalmefene, and Naloxone
25. Phosphodiesterase-5 Inhibitors
26. Selective Serotonin–Norepinephrine Reuptake Inhibitors
27. Selective Serotonin Reuptake Inhibitors
28. Second-Generation or Atypical Antipsychotics (Serotonin–Dopamine
Antagonists, Modulators, and Similarly Acting Drugs)
29. Sympathomimetic Drugs: Modafinil, Armodafinil, and Atomoxetine
30. Thyroid Hormones
31. Tricyclics and Tetracyclics
32. Valproate
33. Nutritional Supplements and Medical Foods
34. Weight Loss Drugs
35. Medication-Induced Movement Disorders
Index
About the Authors
Table A
Index to Book by Generic Name of Drug
 Chapter
Generic Name Brand Name Section Title Number
Acamprosate Campral Disulfiram and Acamprosate 14
Acebutolol Sectral β-Adrenergic Receptor Antagonists 3
Alprazolam Xanax Benzodiazepines and Drugs Acting on 8
GABA Receptors
Amantadine Symmetrel Dopamine Receptor Agonists and 15
Precursors
Amitriptyline Elavil, Endep Tricyclics and Tetracyclics 31
Amlodipine Lotrel, Norvasc Calcium Channel Blockers 11
Amobarbital Amytal Barbiturates and Similarly Acting Drugs 7
Amoxapine Asendin Tricyclics and Tetracyclics 31
Apomorphine Apokyn Dopamine Receptor Agonists and 15
Precursors
Aprobarbital Alurate Barbiturates and Similarly Acting Drugs 7
Aripiprazole Abilify Serotonin–Dopamine Antagonists 28
Armodafinil Nuvigil Stimulant Drugs and Atomoxetine 29
Asenapine Saphris Serotonin–Dopamine Antagonists 28
Atenolol Tenormin β-Adrenergic Receptor Antagonists 3
Atomoxetine Strattera Stimulant Drugs and Atomoxetine 29
Barbital Veronal Barbiturates and Similarly Acting Drugs 7
Benzphetamine Didrex Stimulant Drugs and Atomoxetine 29
Benztropine Cogentin Anticholinergic Agents 4
Biperiden Akineton Anticholinergic Agents 4
Bromocriptine Parlodel Dopamine Receptor Agonists and 15
Precursors
Buprenorphine Buprenex Opioid Receptor Agonists 23
Bupropion Wellbutrin, Zyban Bupropion 9
Buspirone BuSpar Buspirone 10
Carbamazepine Tegretol, Equetro Carbamazepine and Oxcarbazepine 12
Carbidopa Lodosyn Dopamine Receptor Agonists and 15
Precursors
Cetirizine Zyrtec Antihistamines 6
Chloral hydrate Noctec Barbiturates and Similarly Acting Drugs 7
Chlordiazepoxide Librium Benzodiazepines and Drugs Acting on 8
GABA Receptors
Thorazine Dopamine Receptor Antagonists 16
Chlorpromazinea
Chlorprothixene Taractan Dopamine Receptor Antagonists 16
Citalopram Celexa Selective Serotonin Reuptake Inhibitors 27
Clomipramine Anafranil Tricyclics and Tetracyclics 31
Clonazepam Klonopin Benzodiazepines and Drugs Acting on 8
GABA Receptors
Clonidine Catapres α2-Adrenergic Receptor Agonists and α1- 2
Adrenergic Receptor Antagonists
Clorazepate Tranxene Benzodiazepines and Drugs Acting on 8
GABA Receptors
Clozapine Clozaril Serotonin–Dopamine Antagonists 28
Cyproheptadine Periactin Antihistamines 6
Desipramine Norpramin, Tricyclics and Tetracyclics 31
Pertofrane
 Chapter
Generic Name Brand Name Section Title Number
Dexmethylphenidate Focalin Stimulant Drugs and Atomoxetine 29
Dextroamphetamine Dexedrine, Dextrostat Stimulant Drugs and Atomoxetine 29
Dextroamphetamine- Adderall Stimulant Drugs and Atomoxetine 29
Amphetamine
Diazepam Valium Benzodiazepines and Drugs Acting on 8
GABA Receptors
Diethylpropion Tenuate Stimulant Drugs and Atomoxetine 29
Disulfiram Antabuse Disulfiram and Acamprosate 14
Diphenhydramine Benadryl Antihistamines 6
Divalproex Depakote Valproate 32
Donepezil Aricept Cholinesterase Inhibitors and Memantine 13
Doxepin Adapin, Sinequan Tricyclics and Tetracyclics 31
Droperidol Inapsine Dopamine Receptor Antagonists 16
Duloxetine Cymbalta Selective Serotonin–Norepinephrine 26
Reuptake Inhibitors
Escitalopram Lexapro Selective Serotonin Reuptake Inhibitors 27
Estazolam ProSom Benzodiazepines and Drugs Acting on 8
GABA Receptors
Eszopiclone Lunesta Benzodiazepines and Drugs Acting on 8
GABA Receptors
Ethopropazine Parsidol Anticholinergics Agents 4
Fexofenadine Allegra Antihistamines 6
Flumazenil Romazicon Benzodiazepines and Drugs Acting on 8
GABA Receptors
Fluoxetine Prozac, Sarafem Selective Serotonin Reuptake Inhibitors 27
Fluphenazine Prolixin, Permitil Dopamine Receptor Antagonists 16
Flurazepam Dalmane Benzodiazepines and Drugs Acting on 8
GABA Receptors
Fluvoxamine Luvox Selective Serotonin Reuptake Inhibitors 27
Gabapentin Neurontin Anticonvulsants 5
Galantamine Reminyl Cholinesterase Inhibitors and Memantine 13
g-Hydroxybutyrate GHB, Xyrem Benzodiazepines and Drugs Acting on 8
GABA Receptors
Guanfacine Tenex, Intuniv α2-Adrenergic Receptor Agonists and α1- 2
Adrenergic Receptor Antagonists
Haloperidol Haldol Dopamine Receptor Antagonists 16
Hydromorphone Dilaudid Opioid Receptor Agonists 23
Hydroxyzine Atarax, Vistaril Antihistamines 6
Iloperidone Fanapt Serotonin–Dopamine Antagonists 28
Imipramine Tofranil Tricyclics and Tetracyclics 31
Irbesartan Avapro Lithium 18
Isocarboxazid Marplan Monoamine Oxidase Inhibitors 21
Isradipine DynaCirc Calcium Channel Inhibitors 11
Labetalol Normodyne, Trandate β-Adrenergic Receptor Antagonists 3
Lamotrigine Lamictal Lamotrigine 17
Levetiracetam Keppra Anticonvulsants 5
Levodopa Larodopa Dopamine Receptor Agonists and 15
Precursors