Kaplan & Sadock's Synopsis of Psychiatry Quotes

“Psychotropic drugs have also been organized according to structure (e.g., tricyclic), mechanism (e.g., monoamine, oxidase inhibitor [MAOI]), history (first generation, traditional), uniqueness (e.g., atypical), or indication (e.g., antidepressant). A further problem is that many drugs used to treat medical and neurological conditions are routinely used to treat psychiatric disorders.”
― Benjamin J. Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“selective serotonin reuptake inhibitor (SSRI) and serotonin–norepinephrine reuptake inhibitors (SNRIs) are now used as primary treatments, with benzodiazepines used as adjuncts. Benzodiazepine abuse is rare, usually found in patients who abuse multiple prescription and recreational drugs.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The complex interplay of the emotions, however, is far beyond the understanding of functional neuroanatomists. Where, for example, are the representations of the id, ego, and and the superego? Through what pathway are ethical and moral judgments shepherded? What processes allow beauty to be in the eye of the beholder? These philosophical questions represent a true frontier of human discovery.”
― Benjamin Sadock, Kaplan And Sadocks Synopsis Of Psychiatry 11Ed

“The issues of antidepressant-associated suicide has become front-page news, the result of an analysis suggesting a link between medication use and suicidal ideation among children, adolescents, a link between medication use and suicidal ideation among children, adolescents, and adults up to age 24 in short term (4 to 16 weeks), placebo-controlled trials of nine newer antidepressant drugs. The data from trials involving more than 4.4(K) patients suggested that the average risk of suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants was 4 percent, twice the placebo risk of 2 percent. No suicides occured in these trials. The analysis also showed no increase in suicide risk among the 25 to 65 age group. Antidepressants reduced suicidality among those over age 65. Following public hearings on the subject, in October 2004, the FDA requested the addition of “black box” warnings—the most serious warning placed on the labeling of a prescription medication—to all antidepressant drugs, old and new.”
― Benjamin James Sadock, Kaplan & Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Medications used to treat psychiatric disorders are commonly referred to as psychotropic drugs. These drugs are commonly described by their major clinical application, for example, antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, cognitive enhancers, and stimulants. A problem with this approach is that these drugs have multiple indicators. For example, selective serotonin reuptake inhibitors (SSRls) are both antidepressants and anxiolytics, and the serotonin-dopamine antagonists (SDAs) are both anxiolytics and mood stabilizers.”
― Benjamin J. Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Alprazolam is available in an extended-release form, which reduces the frequency of dosing.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“An estimated length of therapy should be decided at the beginning of therapy, and the need for continued therapy should be reevaluated at least monthly because of the problems associated with long-term use.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Antacids and food”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“antacids may reduce the GI absorption of benzodiazepines.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The plasma concentrations of triazolam and alprazolam are increased to potentially toxic concentrations by nefazodone (Serzone) and fluvoxamine (Luvox).”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The SSRIs may prolong and exacerbate the severity of zolpidem-induced hallucinations. Deaths have been reported when parental lorazepam is given with parental olanzapine.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“may decrease the plasma concentrations of benzodiazepines, and smoking may increase the metabolism of benzodiazepines.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The manufacturer of nefazodone recommends that the dosage of triazolam be lowered by 75 percent and the dosage of alprazolam be lowered by 50 percent when given concomitantly with nefazodone.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“and should be avoided.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The combination of benzodiazepines and clozapine (Clozaril) has been reported to cause delirium”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The dosage range of carbamazepine used to facilitate withdrawal is 400 to 500 mg a day. Some clinicians report particular difficulty in tapering and discontinuing alprazolam, especially in persons who have been receiving high dosages for long periods. There have been reports of successful discontinuation of alprazolam by switching to clonazepam, which is then gradually withdrawn.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“taper alone.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“be tapered slowly (25 percent a week); otherwise, recurrence or rebound of symptoms is likely.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Alprazolam seems to be particularly associated with an immediate and severe withdrawal syndrome and should be tapered gradually.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“which may include depression, paranoia, delirium, and seizures.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Benzodiazepine withdrawal syndrome consists of anxiety, nervousness, diaphoresis, restlessness, irritability, fatigue, lightheadedness, tremor, insomnia, and weakness (Table 29.9-2). Abrupt discontinuation of benzodiazepines, particularly those with short half-lives, is associated with severe withdrawal symptoms,”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Zolpidem and zaleplon are secreted in breast milk and are therefore contraindicated for use by nursing mothers. The dosage of zolpidem and zaleplon should be reduced in elderly persons and persons with hepatic impairment.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“the use of benzodiazepines in the third trimester can precipitate a withdrawal syndrome in newborns. The drugs are secreted in the breast milk in sufficient concentrations to affect newborns. Benzodiazepines may cause dyspnea, bradycardia, and drowsiness in nursing babies.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“persons with a history of substance abuse, cognitive disorders, renal disease, hepatic disease, porphyria, central nervous system (CNS) depression, or myasthenia gravis.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“Triazolam has received significant attention in the media because of an alleged association with serious aggressive behavioral manifestations. Therefore, the manufacturer recommends that the drug be used for no more than 10 days for treatment of insomnia and that physicians carefully evaluate the emergence of any abnormal thinking or behavioral changes in persons treated with triazolam, giving appropriate consideration to all potential causes. Triazolam was banned in Great Britain in 1991.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“High-potency benzodiazepines, especially triazolam, can cause anterograde amnesia. A paradoxical increase in aggression has been reported in persons with preexisting brain damage.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“The most serious adverse effects of the benzodiazepines occur when other sedative substances, such as alcohol, are taken concurrently. These combinations can result in marked drowsiness, disinhibition, or even respiratory depression. Infrequently, benzodiazepine receptor agonists cause mild cognitive deficits that may impair job performance. Persons taking benzodiazepine receptor agonists should be advised to exercise additional caution when driving or operating dangerous machinery.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“additional flumazenil is unlikely to have an effect. Sedation can return in 1 to 3 percent of persons treated with flumazenil. It can be prevented or treated by giving repeated dosages of flumazenil at 20-minute intervals. For repeat treatment, no more than 1 mg (given as 0.5 mg a minute) should be given at any one time, and no more than 3 mg should be given in any 1 hour.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“With flumazenil treatment, the tricyclic-induced seizures or cardiac arrhythmias may appear and result in a fatal outcome. Flumazenil does not reverse the effects of ethanol, barbiturates, or opioids.”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry

“associated with the use of flumazenil is the precipitation of seizures, which is especially likely to occur in persons with seizure disorders, those who are physically dependent on benzodiazepines, and those who have ingested large quantities of benzodiazepines. Flumazenil”
― Benjamin James Sadock, Kaplan and Sadock's Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry