Chapter 29.Psychopharmacology
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Excerpt
Psychopharmacology is critical to the management of all major psychiatric disorders. Since the serendipitous discovery of the psychotropic effects of antidepressants, antipsychotics, and lithium in the early 1950s, the pharmacological armamentarium and evidence for efficacy have grown dramatically, yet many of these original agents remain relevant today. Despite decades of progress, many challenges remain. Our practice of psychiatry is hampered by lack of explanatory biological specificity for the major disorders, making precise diagnosis and medication choice dependent on observation, best application of available evidence, and trial and error. Even with an appropriate diagnosis, medications have limited ability to induce remission, there is significant inter- and intra-individual difference in response, and cure is usually not possible. Further complicating treatment are psychiatric, substance use, and medical comorbidities.
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