Life-Threatening Effects of Antipsychotic Drugs

 
 
Academic Press
  • 1. Auflage
  • |
  • erschienen am 16. August 2016
  • |
  • 394 Seiten
 
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
E-Book | PDF mit Adobe DRM | Systemvoraussetzungen
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978-0-12-803390-6 (ISBN)
 

This book is an essential reference text for psychiatrists, pathologists and any physician treating a psychiatric patient with a life-threatening condition. It would also be useful to primary care physicians with patients taking antipsychotic medication.

Life-Threatening Effects of Antipsychotic Drugs describes in detail more than 20 life-threatening effects associated with antipsychotics, presents the best available data on their incidence and case fatality, and gives comprehensive advice on diagnosis, management and preventive strategies. In addition, the book discusses the benefit of antipsychotic medication in a range of therapeutic indications, and demonstrates the gain in life-expectancy associated with clozapine use in severe mental illness despite its serious, potentially life-threatening adverse effects.


      • Covers cardiovascular, neurological, muscular, haematological, gastrointestinal, autonomic and metabolic effects
      • Gives advice on risk factors, confounding diagnoses and measures to minimise seriousness
      • Discusses clozapine rechallenge after each of its serious adverse reactions
      • Makes suggestions for optimum management of somatic disease in those with severe mental illness, to improve life-expectancy
      • Includes data on post-mortem considerations
      • Englisch
      • San Diego
      • |
      • USA
      Elsevier Science
      • 4,90 MB
      978-0-12-803390-6 (9780128033906)
      0128033908 (0128033908)
      weitere Ausgaben werden ermittelt
      • Front Cover
      • Life-Threatening Effects of Antipsychotic Drugs
      • Copyright Page
      • Contents
      • List of Contributors
      • Foreword
      • Preface
      • Acknowledgments
      • Symbols and Conventions
      • I. Cardiovascular Adverse Effects of Antipsychotic Drugs
      • 1 Sudden Cardiac Death and Ventricular Arrhythmias
      • 1.1 Epidemiology
      • 1.2 Pathobiology
      • 1.2.1 Determinants of APD
      • 1.2.2 Amplification of Myocardial Dispersion of Repolarization
      • 1.2.3 The Initiation and Perpetuation of TdP
      • 1.2.4 Drug-Induced Prolongation of QT interval and TdP
      • 1.2.5 Antipsychotic-Induced QTc Prolongation
      • 1.3 Clinical and Laboratory Features
      • 1.4 Prevention and Management
      • References
      • 2 Myocarditis and Cardiomyopathy
      • 2.1 Definitions
      • 2.2 Epidemiology
      • 2.2.1 Causality
      • 2.2.2 Prevalence and Incidence
      • 2.2.2.1 Myocarditis
      • 2.2.2.2 Cardiomyopathy
      • 2.2.3 Risk Factors
      • 2.2.3.1 Myocarditis
      • 2.2.3.2 Cardiomyopathy
      • 2.3 Genetic Vulnerability
      • 2.4 Pathobiology
      • 2.4.1 Myocarditis
      • 2.4.2 Cardiomyopathy
      • 2.5 Clinical and Laboratory Features
      • 2.5.1 Myocarditis
      • 2.5.1.1 Laboratory and investigative features
      • 2.5.2 Cardiomyopathy
      • 2.6 Differential Diagnosis
      • 2.6.1 Myocarditis
      • 2.6.2 Cardiomyopathy
      • 2.7 Complications and Significant Sequelae
      • 2.8 Risk Stratification for Death or Permanent Disability
      • 2.9 Management
      • 2.9.1 Myocarditis
      • 2.9.1.1 Rechallenge
      • 2.9.2 Cardiomyopathy
      • 2.9.2.1 Rechallenge
      • 2.10 Prevention
      • 2.10.1 Myocarditis
      • 2.10.2 Cardiomyopathy
      • Acknowledgment
      • References
      • 3 Pulmonary Embolism
      • 3.1 Epidemiology
      • 3.2 Pathobiology
      • 3.2.1 Venous Stasis as a Consequence of Obesity and Physical Inactivity
      • 3.2.2 Hypercoagulability
      • 3.2.2.1 Antipsychotic Drugs and Platelet Function
      • 3.2.2.2 Antiphospholipid Antibodies
      • 3.2.2.3 Prolactin-Mediated Hypercoagulability
      • 3.2.2.4 Obesity-Mediated Hypercoagulability
      • 3.2.3 Endothelial Injury
      • 3.3 Clinical and Laboratory Features
      • 3.3.1 Clinical Presentation
      • 3.3.2 Diagnosing Pulmonary Embolism in Psychiatric Patients
      • 3.3.2.1 Probability Assessments
      • 3.3.2.2 Laboratory Tests and Imaging Investigations
      • 3.3.2.2.1 d-Dimer
      • 3.3.2.2.2 Computed Tomographic Pulmonary Angiography
      • 3.3.2.2.3 Ventilation-Perfusion Scanning
      • 3.3.2.2.4 Venous Ultrasonography
      • 3.3.2.2.5 Echocardiography
      • 3.4 Prevention and Management
      • 3.4.1 Intravenous Unfractionated Heparin and Oral Vitamin K Antagonists
      • 3.4.2 Subcutaneous Low Molecular Weight Heparin and Oral Vitamin K Antagonists
      • 3.4.3 Oral Factor Xa Inhibitor
      • 3.4.4 Primary Prevention
      • 3.4.5 Secondary Prevention
      • References
      • 4 Orthostatic Hypotension
      • 4.1 Epidemiology
      • 4.1.1 Prevalence
      • 4.1.2 Genetic Vulnerability
      • 4.2 Pathobiology
      • 4.3 Clinical and Laboratory Features
      • 4.3.1 Autonomic Failure
      • 4.3.2 Dehydration
      • 4.3.3 Drug-Drug Interactions
      • 4.3.3.1 Use of ß-Adrenoceptor Antagonists (ß-blockers)
      • 4.3.3.2 Use of a2-Adrenoceptor Agonists
      • 4.3.3.3 Use of a1-Adrenoceptor Antagonists
      • 4.3.3.4 Use of Angiotensin-Converting Enzyme Inhibitors
      • 4.3.4 Complications and Significant Sequelae
      • 4.3.5 Risk Stratification for Death or Permanent Disability
      • 4.4 Prevention and Management
      • 4.4.1 Antipsychotic Selection
      • 4.4.2 Antipsychotic Reinitiation
      • 4.4.3 Antipsychotic Dosing Frequency
      • 4.4.4 Nonpharmacological Therapy
      • 4.4.5 Volume Expansion
      • 4.4.6 Pharmacological Therapy
      • 4.4.6.1 Fludrocortisone
      • 4.4.6.2 Desmopressin
      • 4.4.6.3 Sympathomimetic Agents
      • 4.4.7 Prevention
      • References
      • II. Hematological Complications of Treatment With Antipsychotic Drugs
      • 5 Severe Neutropenia and Agranulocytosis
      • 5.1 Epidemiology
      • 5.1.1 Drug-Induced Dyscrasias
      • 5.1.2 Epidemiology of Clozapine-Induced Neutropenia and Agranulocytosis
      • 5.2 Pathobiology
      • 5.2.1 Mechanism of Clozapine-Induced Neutropenia/Agranulocytosis
      • 5.2.1.1 Genetic Vulnerability
      • 5.3 Clinical and Laboratory Features
      • 5.3.1 Clozapine-Induced Neutropenia/Agranulocytosis
      • 5.4 Prevention and Management
      • 5.4.1 Clozapine and White Blood Count Monitoring
      • 5.4.1.1 Clozapine Rechallenge
      • 5.4.1.2 Pharmacological Interventions
      • 5.4.1.2.1 Lithium
      • 5.4.1.2.2 G-CSF and GM-CSF
      • 5.4.2 Neutropenic Risk in Clozapine-Treated Children and Adolescents
      • 5.4.3 Neutropenia/Agranulocytosis With Antipsychotics Other Than Clozapine
      • 5.4.4 Blood Dyscrasia Other Than Neutropenia Associated With Antipsychotics
      • References
      • III. Antipsychotic-Related Pathology of the Digestive System
      • 6 Gastrointestinal Hypomotility and Dysphagia
      • 6.1 Gastrointestinal hypomotility
      • 6.1.1 Introduction
      • 6.1.2 Epidemiology
      • 6.1.3 Pathobiology
      • 6.1.4 Clinical and Laboratory Features
      • 6.1.5 Imaging Studies
      • 6.1.6 Differential Diagnosis
      • 6.1.7 Complications and Significant Sequelae
      • 6.1.8 Management
      • 6.1.9 Prevention
      • 6.1.10 Conclusion
      • 6.2 Dysphagia and sialorrhea
      • 6.2.1 General Considerations
      • 6.2.2 Pathobiology
      • 6.2.3 Prevention and Management
      • Acknowledgment
      • References
      • Gastrointestinal Hypomotility
      • Dysphagia and Sialorrhea
      • 7 Liver Failure
      • 7.1 Definition
      • 7.2 Search Strategy
      • 7.3 Epidemiology
      • 7.3.1 Acute Liver Failure
      • 7.3.2 Asymptomatic Antipsychotic-Induced Liver Injury and Lesser Elevations in LFT
      • 7.3.3 Genetic Vulnerability
      • 7.4 Pathobiology
      • 7.5 Clinical and Laboratory Features
      • 7.5.1 Differential Diagnosis
      • 7.5.2 Complications and Significant Sequelae
      • 7.5.3 Risk Stratification for Death or Permanent Disability
      • 7.6 Management
      • 7.7 Prevention
      • 7.8 Conclusion
      • References
      • 8 Pancreatitis
      • 8.1 Epidemiology
      • 8.2 Pathobiology
      • 8.3 Clinical and Laboratory Features
      • 8.4 Management
      • References
      • IV. Major Neurological and Neuromuscular Adverse Effects of Antipsychotic Drugs
      • 9 Seizures
      • 9.1 Epidemiology
      • 9.1.1 Seizures Occurring in Patients Receiving Therapeutic Dosages of Antipsychotic Drugs
      • 9.1.2 Seizures After Intoxications With Antipsychotic Drugs
      • 9.1.3 Genetic Vulnerability
      • 9.2 Pathobiology
      • 9.3 Clinical and Laboratory Features
      • 9.3.1 Diagnostic Relevance of the EEG
      • 9.3.2 Differential Diagnosis
      • 9.3.3 Complications and Significant Sequelae
      • 9.3.4 Risk Stratification for Death or Permanent Disability
      • 9.4 Prevention and Management
      • Acknowledgment
      • References
      • 10 Neuroleptic Malignant Syndrome
      • 10.1 Epidemiology
      • 10.1.1 Genetic Vulnerability
      • 10.1.2 Risk Factors
      • 10.1.2.1 Demographic Factors
      • 10.1.2.2 Genetic Liability
      • 10.1.2.3 Environmental Factors
      • 10.1.2.4 Pharmacological Factors
      • 10.2 Pathobiology
      • 10.2.1 Dopamine Receptor Blockade Hypothesis
      • 10.2.2 Sympathoadrenal Hyperactivity
      • 10.2.3 Musculoskeletal Fiber Toxicity Hypothesis
      • 10.2.4 Neuroimmunological Hypothesis
      • 10.3 Clinical and Laboratory Features
      • 10.3.1 Differential Diagnosis
      • 10.3.1.1 NMS and SS
      • 10.3.1.2 Catatonia and NMS
      • 10.3.2 Complications and Significant Sequelae
      • 10.3.3 Risk of Recurrence
      • 10.3.4 Risk Stratification for Death or Permanent Disability
      • 10.4 Prevention and Management
      • References
      • 11 Heat Stroke and Rhabdomyolysis
      • 11.1 Heat Stroke
      • 11.1.1 Definition
      • 11.1.2 Epidemiology
      • 11.1.3 Pathobiology
      • 11.1.4 Clinical and Laboratory Features
      • 11.1.5 Differential Diagnosis
      • 11.1.6 Complications and Significant Sequelae
      • 11.1.7 Risk Stratification for Death or Permanent Disability
      • 11.1.8 Management
      • 11.1.9 Prevention
      • 11.2 Rhabdomyolysis
      • 11.2.1 Definition
      • 11.2.2 Epidemiology
      • 11.2.3 Pathobiology
      • 11.2.4 Clinical and Laboratory Features
      • 11.2.5 Differential Diagnosis
      • 11.2.6 Complications and Significant Sequelae
      • 11.2.7 Management
      • 11.2.8 Conclusion
      • References
      • Heat Stroke
      • Rhabdomyolysis
      • V. Metabolic Complications of Antipsychotic Drug Treatment
      • 12 Type 2 Diabetes Mellitus
      • 12.1 Epidemiology
      • 12.1.1 The Increased Risk of T2DM in People With Severe Mental Illness
      • 12.1.1.1 Lifestyle and Environmental Factors
      • 12.1.1.2 Biological Effects of the Mental Illness
      • 12.1.1.3 Antipsychotic Medication Use
      • 12.1.1.4 Genetic Vulnerability
      • 12.1.1.5 Gene-Environment Interactions
      • 12.2 Pathobiology
      • 12.3 Clinical and Laboratory Features
      • 12.3.1 Categories of Increased Risk for Diabetes (Prediabetes)
      • 12.3.1.1 At-Risk Groups
      • 12.3.1.2 Differential Diagnosis
      • 12.3.1.3 Complications, Significant Sequelae, and Risk Stratification for Death or Permanent Disability
      • 12.4 Prevention and Management
      • 12.4.1 Screening for T2DM in People Taking Antipsychotics
      • 12.4.2 Screening in People With Normal Baseline Tests
      • 12.4.3 Screening in People With Risk Factors
      • 12.4.4 Lifestyle Modification
      • 12.4.5 Pharmacological Interventions
      • 12.5 Conclusion
      • References
      • VI. Other Life-Threatening Effects of Antipsychotic Drugs
      • 13 Interstitial Nephritis and Interstitial Lung Disease
      • 13.1 Interstitial Nephritis
      • 13.1.1 Definition
      • 13.1.2 Epidemiology
      • 13.1.3 Pathobiology
      • 13.1.4 Clinical and Laboratory Features
      • 13.1.5 Differential Diagnosis
      • 13.1.6 Management
      • 13.1.7 Prevention
      • 13.2 Interstitial Lung Disease
      • 13.2.1 Definition
      • 13.2.2 Epidemiology
      • 13.2.3 Conclusion
      • References
      • Interstitial Nephritis
      • Interstitial Lung Disease
      • VII. Clinical and Forensic Challenges in the Use of Antipsychotic Drugs
      • 14 The Benefits of Antipsychotic Drugs: Symptom Control and Improved Quality of Life
      • 14.1 Therapeutic Objectives in Schizophrenia
      • 14.2 Pharmacology of Antipsychotic Drugs
      • 14.3 Symptom Reduction in Schizophrenia
      • 14.4 Relapse Prevention and Antipsychotic Maintenance Treatment
      • 14.5 Improving Quality of Life in Patients With Schizophrenia
      • 14.6 Antipsychotic Drugs in Treating Other Psychiatric Disorders
      • References
      • 15 Antipsychotic-Related Mortality: Risk and Strategy for Improved Clinical Management
      • 15.1 Reduced Life-expectancy with Severe Mental Illness (SMI)
      • 15.1.1 Cardiovascular Disease Mortality
      • 15.1.2 Sudden Cardiac Death
      • 15.1.3 QTc-Prolongation
      • 15.1.3.1 Screening for QTc-Prolongation
      • 15.1.4 Brugada Syndrome
      • 15.2 Suicide Reduced with Clozapine
      • 15.3 An Obstacle to Clozapine Prescribing: Agranulocytosis
      • 15.4 Diabetic Ketoacidosis: Poor Outcomes With Severe Mental Illness (SMI)
      • 15.5 Strategy for Improved Outcomes
      • 15.5.1 Poor Care of Somatic Illness in Severe Mental Illness (SMI)
      • 15.5.2 Assertive Care for Mental Illness
      • 15.5.3 Difficulties for Medical Practitioners
      • 15.5.4 Assertive Care for Somatic Illness
      • 15.5.5 Conclusion: Increase Clozapine Prescribing
      • References
      • Further Reading
      • 16 Forensic Investigation of Antipsychotic-Related Deaths
      • 16.1 Introduction
      • 16.2 Clinical and Pathological Correlations
      • 16.3 Toxicological Assessments
      • 16.3.1 Postmortem Toxicology
      • 16.3.2 Accuracy of a Diagnosis of Poisoning
      • 16.3.3 Postmortem Biochemistry
      • 16.4 System-Specific Forensic Considerations
      • 16.4.1 Antipsychotics and Sudden Unexpected Death
      • 16.4.2 Diabetes-Related Deaths
      • 16.4.3 Seizure-Related Deaths
      • 16.4.4 Other Potential Causes of Unexpected Death
      • 16.5 Conclusions
      • References
      • Guide to the Interpretation of the Results of Some Chemical Pathology Tests
      • Index
      • Back Cover

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