SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
OBJECTIVE: To review the current status of psychopharmacology education for medical students, residents, and practitioners in psychiatry and other specialties. METHODS: A search of the MEDLINE and PsychInfo data bases was conducted using four keywords: pharmacology, psychopharmacology, teaching, and student. Additional references were obtained from citations in these articles. Published material was supplemented with the experience of the author and others involved in psychopharmacology teaching. RESULTS: The majority of psychopharmacology education is provided by faculty from disciplines that include psychiatry, primary care medicine, basic science, and pharmacy. The pharmaceutical industry supports a substantial amount of continuing medical education (CME) by psychiatrists, pharmacists, and other medical practitioners, while much of the information that office practitioners receive and an increasing amount of material provided to residents comes from pharmaceutical representatives. The most important attributes of the effective psychopharmacology educator are knowledge, enthusiasm, honesty, an ability to encourage critical thinking, and genuine interest in the student. However, the primary criteria for participation in psychopharmacology education are faculty who are most available and willing in the academic medical center and those who engage in paid CME activities. CONCLUSIONS: Educators with clinical experience should play a core role in helping students to integrate research with actual clinical practice and should be able to teach students how to evaluate new research in psychopharmacology, especially if it is industry sponsored.
'Cosmetic psychopharmacology' is a term coined by Peter Kramer in his 1993 best-seller, Listening to Prozac. It has come to refer to the use of psychoactive substances to effect changes in function for conditions that are either normal or subclinical variants. In this paper, I ask: What distinguishes an existential ailment from clinical depression, or either of those from normal depressed mood, melancholic temperament, dysthymia or other depressive disorders? Can we reliably distinguish one from the other? Are the boundaries of illness and disorder really so distinct? If not, how can we know that treatment of 'depression' with Prozac in any given instance constitutes a cosmetic as opposed to, say, a medical or clinical use of psychopharmacology - a distinction that seems to turn on our ability to clearly differentiate the clinical from the cosmetic. If we cannot reliably distinguish between such conditions, can we even have a cosmetic psychopharmacology that is not a form of malpractice, broadly speaking? What if we unplugged Prozac from all the amplitude and hype that resulted in Listening to Prozac becoming an instant best-seller and simply asked whether or not we can clearly distinguish an appropriate cosmetic use of Prozac for 'depression' from an inappropriate cosmetic use of Prozac, and both of those from Prozac's appropriate clinical, that is, non-cosmetic uses? If we cannot make these distinctions, perhaps it is too early to say there can be such a thing as a cosmetic psychopharmacology.
Pediatric psychopharmacology is taught at the Duke University Hospital Child and Adolescent Psychiatry Residency Training Program within the context of an evidence-based medicine model. The basic goal of the course is to develop competence in the psychopharmacologic management of psychiatric problems of children and adolescents as part of a biopsychosocial/developmental model of care. Associated with this over-arching goal is the demonstration of specific attitudes, knowledge, and skills. This article discusses the educational model with examples and each of these goals in depth.
Following a brief discussion of the epidemiology, underlying neuropathological mechanisms, neuropsychological symptoms and present treatment strategies of AIDS-associated dementia (AAD), parallels are drawn between the longer standing research on drugs for the treatment of other cognitive disorders, particularly senile dementia, and ongoing efforts to develop psychopharmacological approaches for the treatment of the cognitive impairments in AAD. Important aspects of hypotheses designed to guide such a research are indicated with the help of a speculative, paradigmatic hypothesis concerning the role of cortical cholinergic inputs in AAD. Furthermore, aspects of validity of animal models, and cognition as a crucial intervening variable in the effects of potential treatments, are evaluated.
This article reviews psychopharmacology in organ transplant patients, with particular attention to the changes in the metabolism and elimination of drugs during organ insufficiency and drug interactions in the immunosuppressed state. The side effects of psychotropic drugs need to be distinguished from those of immunosuppressants. Antidepressants, including tricyclics, heterocyclics, MAOIs, stimulants, and newer agents, are discussed. Use of neuroleptics for delirium, mania, and other organic disorders is described. Lithium may be more difficult to use in the immediate postoperative period. Anxiolytics, including benzodiazepines and buspirone, are useful depending on the underlying medical problem.
A revision of the British Association for Psychopharmacology guidelines for treating depressive disorders with antidepressants was undertaken in order to specify the scope and target of the guidelines and to update the recommendations based explicitly on the available evidence. A consensus meeting, involving experts in depressive disorders and their treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from participants and interested parties. A literature review is given which identifies the quality of evidence followed by recommendations, the strength of which are based on the level of evidence. The guidelines cover the nature and detection of depressive disorders, acute treatment with antidepressant drugs, choice of drug versus alternative treatment, practical issues in prescribing, management when initial treatment fails, continuation treatment, maintenance treatment to prevent recurrence and stopping treatment.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Since the neural impulses in the brain are transmitted from one neuron to the next by various chemical mediators such as noradrenaline, dopamine, serotonin, acetylcholine, etc., the use of drugs acting specifically on one or more of these mediators should illucidate the chemical substrates of behavior. However, recent data indicating an extensive interaction between the various neurotransmitters on a cellular and even synaptic level, suggests that interpreting the behavioral effects of drugs in term of only one neurotransmitter is a potentially misleading oversimplification. Perhaps, rather than the action of a single neurotransmitter, it is the balance between neurotransmitter systems that determines behavior. Because of its rich innervation by noradrenaline, dopamine, serotonin and acetylcholine synapses, the amygdala is ideally suited for monitoring the balance between these neurotransmitters and altering maladaptive behavior based on fluctuations in neurotransmitter balance.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.