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08

Sep

2021

Management of Complex Treatment-Resistant Psychotic Disorders

Written by: Michael Cummings

 
 

Management of Complex Treatment-Resistant Psychotic Disorders is a newly published colorful, concise reference compact paperback text for those clinicians who treat some of the most challenging patients on the planet. It was created by a California group who work as a network of psychopharmacology consultants in the California Department of State Hospitals (the Psychopharmacology Resource Network or PRN group), a circa 7000-bed forensic hospital system. It has been published as one of Stephen Stahl’s treatment guides and is available from Cambridge University Press, Amazon, and other book sellers in print and electronic formats.

The book is divided into three parts. Part one focuses on treatment strategies and includes topics such as the approach to the evaluation and treatment of positive psychotic symptoms, how and when to use medication plasma concentrations, the advantages of long-acting injectable antipsychotics, addressing treatment resistance, dealing with depression and suicidality, approach to aggression and violence, detecting and treating bipolar diathesis, treating anxiety in the context of psychosis, treatment of insomnia, evaluation and treatment of psychosis in children and adolescents, ECT and other non-pharmacological treatments, substance use disorders in schizophrenia, and treatment of behavioral disturbances in dementia.

Part two provides convenient, compact information on 85 of the most commonly employed medications, including antipsychotics, mood stabilizers, anti-Parkinson drugs, antidepressants, anxiolytics, sedatives, stimulants, cognitive enhancers, and α-2 agonists. Each medication chapter is presented in a tabular format this maintained for all of the medications. The tables in each chapter include basic information, mechanisms of action, plasma concentrations and treatment response, typical treatment response, pre-treatment workup and initial laboratory testing, monitoring, dosing and kinetics, medications to avoid in combination and warnings, and take-home pearls.

Part three is comprised of brief quick-reference appendices about optimal antipsychotic and mood stabilizer levels, correction of QT intervals, common liver inducers and inhibitors, management of constipation, liver function scoring using the Child-Pugh Scale, loading of lithium and valproate, treatment of prolactin elevation, tyramine-rich foods, medications that present a risk for serotonin syndrome, and treatment of psychomotor agitation.

Editors and contributors of Complex Treatment-Resistant Psychotic Disorders.
From left to right – Jonathan Meyer, Stephen Stahl, George Proctor, Juan Carlos Arguello, Jennifer O’Day, Michael Cummings, Joan Striebel, Ai-Li Arias, Eric Schwartz and Katherine Warburton

Management of Complex Treatment-Resistant Psychotic Disorders is well-referenced, but also is based on the decades of experience of the editors and contributors in treating severely ill psychotic patients who often suffer from comorbid conditions ranging from traumatic brain injury to complex substance use disorders. The book was written for those clinicians who work with such patients, who are frequently not addressed by treatment standards designed for less severely ill community patients. That is, this book presents in accessible form both evidence-based practice and the wisdom of practice-based evidence for treating truly complex treatment-resistant psychotic illness.

Michael A. Cummings, M.D.
Psychopharmacology Resource Network

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About the Author: Michael Cummings

Michael A. Cummings is Clinical Professor of Psychiatry at the University of California, Riverside, Associate Clinical Professor of Psychiatry at the University of California, Irvine and Senior Psychiatrist Specialist at the California Department of State Hospitals....

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