Practical Psychopharmacology: Translating Findings From Evidence-Based Trials into Real-World Clinical Practice

Despite the lack of guidance available for practitioners, extensive polypharmacy has become the primary method of treating patients with severe and chronic mood, anxiety, psychotic or behavioral disorders. This ground-breaking new book provides an overview of psychopharmacology knowledge and decision-making strategies, integrating findings from evidence-based trials with real-world clinical presentations. It adopts the approach and mind-set of a clinical investigator and reveals how prescribers can practice 'bespoke psychopharmacology', tailoring care to the individualized needs of patients. Practitioners at all levels of expertise will enhance their ability to devise rationale-based treatments, targeting manifestations of dysfunctional neural circuitry and dimensions of psychopathology that cut across conventional psychiatric diagnoses. Presented in a user-friendly, practical, full-colour layout and incorporating summary tables, bullet points, and illustrative case vignettes, it is an invaluable guide for all healthcare professionals prescribing psychotropic medications, including psychiatry specialists, primary care physicians, and advanced practice registered nurses.

Table of Contents:
Part I. General Principles: 1. Core concepts of good psychopharmacology; 2. Targets of treatment: categories versus dimensions of psychopathology; 3. Interpreting and using the literature: integrating evidence-based trials with real-world practice; 4. Placebo and nocebo effects; 5. Tailoring the fit: moderators and mediators of treatment outcome; 6. Complex regimens and rationale-based combination drug therapies; 7. Laboratory values and psychiatric symptoms: what to measure, what not to measure, and what to do with the results; 8. Pharmacogenetics: when relevant, when not; 9. Cross-tapering and the logistics of drug discontinuation; 10. Managing major adverse drug effects: when to avoid, switch, or treat through; 11. Novel drug therapeutics: nutraceuticals, steroids, probiotics, and other dietary supplements; 12. Human diversity and considerations in special populations; Part II. Targets of Pharmacotherapy: 13. Disordered mood and affect; 14. Disorders of impulsivity, compulsivity, and aggression; 15. Psychosis; 16. Deficit states and negative symptoms; 17. Anxiety; 18. Addiction and the reward pathway; 19. Trauma and posttraumatic stress disorder; 20. Personality disorders; 21. Cognition; 22. Putting it all together; References; Index.

Review :
'Psychopharmacology textbooks are typically either scholarly, endlessly long and inaccessible to clinicians, or clinician-friendly but with inadequate documentation for readers who want more detailed information. Somehow, Goldberg and Stahl's Practical Psychopharmacology combines the best of these two styles. It is astonishingly comprehensive with many Tables citing every relevant study while simultaneously providing the deep practical wisdom and experience of the two authors, both of whom are world class clinician-scholars. Practical Psychopharmacology also provides a sophisticated yet accessible review of the biological underpinnings of both psychopathology and medication effects. It does not just inform; it teaches the reader how to think about medications. This book will set the standard in our field for the foreseeable future.' Michael Gitlin, Distinguished Professor of Clinical Psychiatry, Director, Adult Division of Psychiatry, Director, Mood Disorders Clinic, Geffen School of Medicine at UCLA 'The translation of clinical research findings into practice is fraught. The methodology of many trials is imperfect, complex, and opaque and hard to generalise to real world patients. Many critical questions are poorly answered by the extant evidence. The basic neuroscience is extraordinarily complex. This book is a Rosetta stone for translating this evidence into practice in providing a critical bridge for practising clinicians in distilling and interpreting the evidence into clear and coherent pragmatic management and prescribing recommendations. Written by two of the world's premier authorities, it is infused with a rare synergy of clinical wisdom and neuroscience expertise and is an essential resource for any practising prescriber of psychotropic agents.' Michael Berk, NHMRC Senior Principal Research Fellow; Alfred Deakin Professor of Psychiatry, School of Medicine, Deakin University and Barwon Health; Director, IMPACT, the Institute for Mental and Physical Health and Clinical Translation 'Drs. Goldberg and Stahl have reminded us that they are scientific artisans by creating a pragmatic, patient-centered set of guiding principles in clinical psychopharmacology. The emergence of newer psychopharmacologic treatments and expansion of indications for previously available agents has provided hope for identifying therapeutic avenues for patients to improve their general wellbeing, but also can feel daunting, overwhelming, and a source of entropy. Consequently, it is not uncommon for clinicians at point of care to be genuinely perplexed as to which treatments and capabilities are 'promising rather than prime-time'. The authors have deftly synthesized the scientific literature and have produced a book that is comprehensive, concise, and an invaluable source of decision support at the point of care for multidisciplinary practitioners who provide care to persons with mental disorders.' Roger S. McIntyre, Professor of Psychiatry and Pharmacology and Head, Mood Disorders Psychopharmacology Unit, University of Toronto, Canada