Stahl’s Essential Psychopharmacology
Prescriber’s
Guide
With the range of psychotropic drugs expanding and the usages of existing
... [Show More] medications
diversifying, we are pleased to present this very latest edition of what has become the
indispensable formulary in psychopharmacology.
This new edition features seven new compounds as well as information about several
new formulations of existing drugs. In addition, many important new indications are
covered for existing drugs, as are updates to the profi les of the entire content and
collection, including expansion of the sections on long-acting injectable formulations of
antipsychotics.
With its easy-to-use, template-driven navigation system, The Prescriber’s Guide combines
evidence-based data with clinically informed advice to support everyone prescribing in the
fi eld of mental health.
Stephen M. Stahl is Adjunct Professor of Psychiatry at the University of California, San
Diego, and Honorary Visiting Senior Fellow in Psychiatry at the University of Cambridge,
UK. He has conducted various research projects awarded by the National Institute of
Mental Health, Veterans Affairs, and the pharmaceutical industry. Author of more than
500 articles and chapters, Dr Stahl is also the author of the bestseller Stahl’s Essential
Psychopharmacology .
SIXTH EDITION
Stahl’s Essential Psychopharmacology
Prescriber’s
Guide
SIXTH EDITION
Stephen M. Stahl
University of California at San Diego,
San Diego, California
Editorial assistant
Meghan M. Grady
With illustrations by
Nancy Muntner
University Printing House, Cambridge CB2 8BS, United Kingdom
One Liberty Plaza, 20th Floor, New York, NY 10006, USA
477 Williamstown Road, Port Melbourne, VIC 3207, Australia
4843/24, 2nd Floor, Ansari Road, Daryaganj, Delhi – 110002, India
79 Anson Road, #06-04/06, Singapore 079906
Cambridge University Press is part of the University of Cambridge.
It furthers the University’s mission by disseminating knowledge in the pursuit of
education, learning, and research at the highest international levels of excellence.
www.cambridge.org
Information on this title: www.cambridge.org/9781316618134
© Stephen M. Stahl 2005, 2006, 2009, 2011, 2014, 2017
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 2005
Revised and updated edition published 2006
Third edition published 2009
Fourth edition published 2011
Fifth edition published 2014
Sixth edition published 2017
Printed in the United Kingdom by Clays, St Ives plc
A catalog record for this publication is available from the British Library.
ISBN 978-1-316-61813-4 Paperback
ISBN 978-1-108-40488-4 Spiral
Additional resources for this publication at www.stahlonline.org
Every effort has been made in preparing this book to provide accurate and up-to-date
information that is in accord with accepted standards and practice at the time of publication.
Although case histories are drawn from actual cases, every effort has been made to disguise
the identities of the individuals involved. Nevertheless, the authors, editors, and publishers
can make no warranties that the information contained herein is totally free from error, not
least because clinical standards are constantly changing through research and regulation. The
authors, editors, and publishers therefore disclaim all liability for direct or consequential
damages resulting from the use of material contained in this book. Readers are strongly
advised to pay careful attention to information provided by the manufacturer of any drugs or
equipment that they plan to use.
Cambridge University Press has no responsibility for the persistence or accuracy of
URLs for external or third-party Internet Web sites referred to in this publication,
and does not guarantee that any content on such Web sites is, or will remain,
accurate or appropriate.
v
Contents
Introduction ix
List of icons xiii
1 acamprosate 1
2 agomelatine 5
3 alprazolam 11
4 amisulpride 17
5 amitriptyline 25
6 amoxapine 33
7 amphetamine (d) 39
8 amphetamine (d,l) 45
9 aripiprazole 53
10 armodafi nil 65
11 asenapine 71
12 atomoxetine 77
13 benztropine 83
14 blonanserin 87
15 brexpiprazole 93
16 buprenorphine 101
17 bupropion 107
18 buspirone 113
19 caprylidene 117
20 carbamazepine 121
21 cariprazine 127
22 chlordiazepoxide 133
23 chlorpromazine 139
24 citalopram 145
25 clomipramine 151
26 clonazepam 159
27 clonidine 165
28 clorazepate 171
29 clozapine 177
30 cyamemazine 187
31 desipramine 193
32 desvenlafaxine 201
33 dextromethorphan 207
34 diazepam 211
vi
35 diphenhydramine 217
36 disulfi ram 221
37 donepezil 225
38 dothiepin 231
39 doxepin 237
40 duloxetine 245
41 escitalopram 251
42 estazolam 257
43 eszopiclone 261
44 fl ibanserin 265
45 fl umazenil 269
46 fl unitrazepam 273
47 fl uoxetine 277
48 fl upenthixol 283
49 fl uphenazine 289
50 fl urazepam 297
51 fl uvoxamine 301
52 gabapentin 307
53 galantamine 313
54 guanfacine 319
55 haloperidol 323
56 hydroxyzine 331
57 iloperidone 335
58 imipramine 341
59 isocarboxazid 349
60 ketamine 357
61 lamotrigine 361
62 levetiracetam 369
63 levomilnacipran 373
64 lisdexamfetamine 379
65 lithium 385
66 lofepramine 391
67 lofl azeptate 397
68 lorazepam 403
69 lorcaserin 409
70 loxapine 413
71 lurasidone 419
72 maprotiline 427
73 memantine 435
74 mesoridazine 439
vii
75 methylfolate (l) 445
76 methylphenidate (d) 449
77 methylphenidate (d,l) 455
78 mianserin 463
79 midazolam 469
80 milnacipran 473
81 mirtazapine 479
82 moclobemide 485
83 modafi nil 491
84 molindone 497
85 nalmefene 501
86 naltrexone 505
87 naltrexone-bupropion 509
88 nefazodone 513
89 nortriptyline 519
90 olanzapine 527
91 oxazepam 537
92 oxcarbazepine 543
93 paliperidone 549
94 paroxetine 561
95 perospirone 569
96 perphenazine 573
97 phenelzine 579
98 phentermine-topiramate 585
99 pimavanserin 589
100 pimozide 593
101 pipothiazine 599
102 prazosin 605
103 pregabalin 609
104 propranolol 613
105 protriptyline 617
106 quazepam 623
107 quetiapine 627
108 ramelteon 635
109 reboxetine 639
110 risperidone 645
111 rivastigmine 655
112 selegiline 661
113 sertindole 671
114 sertraline 677
viii
115 sodium oxybate 685
116 sulpiride 689
117 suvorexant 695
118 tasimelteon 699
119 temazepam 703
120 thioridazine 707
121 thiothixene 713
122 tiagabine 719
123 tianeptine 725
124 topiramate 729
125 tranylcypromide 735
126 trazodone 741
127 triazolam 747
128 trifl uoperazine 751
129 trihexyphenidyl 757
130 triiodothyronine 761
131 trimipramine 765
132 valproate 773
133 varenicline 781
134 venlafaxine 785
135 vilazodone 791
136 vortioxetine 797
137 zaleplon 803
138 ziprasidone 807
139 zolpidem 815
140 zonisamide 819
141 zopiclone 823
142 zotepine 827
143 zuclopenthixol 833
Index by drug name 839
Index by use 855
Index by class 863
Abbreviations 866
ix
Introduction
This Guide is intended to complement Stahl’s Essential Psychopharmacology . Stahl’s
Essential Psychopharmacology emphasizes mechanisms of action and how psychotropic drugs work upon receptors and enzymes in the brain. This Guide gives practical
information on how to use these drugs in clinical practice.
It would be impossible to include all available information about any drug in a
single work, and no attempt is made here to be comprehensive. The purpose of
this Guide is instead to integrate the art of clinical practice with the science of
psychopharmacology. That means including only essential facts in order to keep
things short. Unfortunately that also means excluding less critical facts as well as
extraneous information, which may nevertheless be useful to the reader but would
make the book too long and dilute the most important information. In deciding
what to include and what to omit, the author has drawn upon common sense and
30 years of clinical experience with patients. He has also consulted with many
experienced clinicians and analyzed the evidence from controlled clinical trials
and regulatory fi lings with government agencies.
In order to meet the needs of the clinician and to facilitate future updates of this
Guide , the opinions of readers are sincerely solicited. Feedback can be emailed to
[email protected]. Specifi cally, are the best and most essential psychotropic
drugs included here? Do you fi nd any factual errors? Are there agreements or disagreements with any of the opinions expressed here? Are there suggestions for any
additional tips or pearls for future editions? Any and all suggestions and comments
are welcomed.
All of the selected drugs are presented in the same design format in order to facilitate rapid access to information. Specifi cally, each drug is broken down into fi ve sections, each designated by a unique color background: therapeutics, side effects,
dosing and use, special populations, and the art of psychopharmacology,
followed by key references.
Therapeutics covers the brand names in major countries; the class of drug; what
it is commonly prescribed and approved for by the United States Food and Drug
Administration (FDA); how the drug works; how long it takes to work; what to [Show Less]