PsychoPharmRef
A clinical psychopharmacology reference for psychiatrists, residents, and students — drug data, interaction checkers, rating scales, printable forms, patient handouts, and evidence-based chapters, all in one place.
Seven core clinical tasks. Open one to follow its pathway to the right tool, scale, or chapter.
1 Diagnostic assessment Screen, confirm, and characterize a psychiatric diagnosis.
2 Risk assessment Identify acute safety, medical, and treatment-emergent risk.
3 Follow-up assessment Track response and monitor safety over time.
4 Choosing appropriate therapies Select an evidence-based first-line treatment.
5 Refining therapeutic choices Optimize when the first choice falls short.
6 Managing therapeutic risks Anticipate and mitigate side effects and known hazards.
7 Personalizing care Tailor treatment to the individual patient.
PsychoPharmRef Newsletter
AI-assisted reviews of newly published psychiatric research, FDA approvals, and guideline updates — distilled into clinically actionable summaries. Free, independent, no pharma funding.
Drug Database
| Drug | Class | IBH Ref | Active Enantiomer | Half-Life (Parent) | Active Metabolites | Renal Adjust | Hepatic Adjust | Geriatric | QT Prolongation | Lipid ↑ Risk | Glucose ↑ Risk | EPS Risk | Protein Binding | Pregnancy | Breastfeeding | Route | Pre / Post-Synaptic Binding | Receptor Chart |
|---|
Diagnoses Database
Sortable, filterable reference of psychiatric diagnoses. Click any row for key characteristics, DSM-5-TR / ICD-10-CM / ICD-11 codes, approved & adjunct medications, recommended therapy, epidemiology, differentials, red flags, and rating scales.
| Diagnosis | Category | ICD-10-CM / DSM-5-TR | ICD-11 | Prevalence | Age of Onset | First-line Treatment |
|---|
P450 Interactions
CYP enzyme interactions for all medications. S = Substrate • Inhibitor strength shown in color • Ind = Inducer
| Drug | Class | CYP1A2 | CYP2B6 | CYP2C9 | CYP2C19 | CYP2D6 | CYP3A4 |
|---|
Receptor Binding Profiles
Ki values in nM (lower = higher affinity). Pie shows relative affinity (1/Ki normalized). Bar charts show pKi = −log10(Ki) per drug class.
Side-by-Side Drug Comparison
Select any two medications to compare their receptor binding profiles directly.
Class Comparisons — pKi by Receptor
Each chart shows all drugs in a class. Y-axis: pKi = −log10(Ki nM). Higher bar = stronger affinity. Switch to treemap view for an area-based hierarchy that can be easier to compare across many drugs.
Receptor Glossary
Clinical effects of receptor activation or inhibition. Expand any receptor for a full breakdown of benefits and side effects.
Psychiatry Glossary
A working clinical dictionary of psychiatry-specific language — phenomenology, diagnoses, defense mechanisms, eponyms, scales, and neuroanatomy. Search above for instant definition previews.
Pharmacokinetic Curve Comparison
Compare estimated plasma concentration curves across medications. Select a category, then choose up to 8 drugs to overlay. Peak height is scaled by primary receptor binding affinity (lower Ki = stronger binding = taller peak). The dot on each curve marks one half-life after peak concentration.
Curves use a simplified Bateman equation (single-compartment oral absorption model). Peak height is proportional to primary receptor binding affinity. Actual pharmacokinetics vary with food, genetics, formulation, drug interactions, and individual metabolism. Not for clinical dosing decisions.
Medication Price Comparison
Cash prices for common strengths from Mark Cuban Cost Plus Drugs and HealthWarehouse, with the CMS NADAC wholesale cost shown as a reference point. Each row lists the strength and quantity priced (based on usual dosing, roughly a 30-day supply).
Brand-name drugs: check the manufacturer’s savings program; retail cash prices are shown when a pharmacy stocks the product.
Prices are cash pay (no insurance) for the listed strength and quantity, and change often; they may vary by pharmacy and zip code. NADAC is what pharmacies pay wholesale, not a price a patient can buy at, so it is excluded from “Best.” Because NADAC is an average of what many pharmacies pay, a low-markup seller like Cost Plus Drugs can come in below it for some generics. Cost Plus prices include its markup and $5 pharmacy fee but not shipping. Cost Plus Drugs does not sell controlled substances. Insurance copays or discount coupons may be lower. Always verify current pricing with the pharmacy before counseling patients. Inclusion of a pharmacy does not imply endorsement. Not medical or financial advice.
References & Methods
Data sources, methodology, and direct FDA labeling access.
🔍 FDA Drug@FDA Search
Search the official FDA Drug@FDA database directly at accessdata.fda.gov. Enter any medication name to open its FDA labeling page.
⚙ Methods — How Data Is Calculated
Receptor Binding Affinity (Ki Values)
Receptor binding data is expressed as the inhibition constant Ki (nM) — the concentration of drug required to occupy 50% of a receptor in a competitive binding assay. Lower Ki values indicate stronger binding affinity. All Ki values are sourced from in vitro radioligand binding studies, primarily the NIMH Psychoactive Drug Screening Program (PDSP) database, FDA-approved prescribing information, and peer-reviewed pharmacology literature.
Ki values of ≥10,000 nM are treated as negligible affinity and displayed as "—" in charts. For visualization, Ki is converted to pKi using the formula:
This transforms Ki in nanomolar units to the equivalent of −log10(Ki in molar), producing values typically between 5 and 10 where higher numbers indicate stronger binding. The pie chart displays relative affinity normalized from 1/Ki values (receptors with Ki ≥5,000 nM excluded).
Side Effect Risk Scores
Side effect risk scores estimate the likelihood that a drug will cause a given clinical side effect based on its receptor binding profile. Scores range from 0 to 100 (higher = greater predicted risk) and are calculated as follows:
- Receptor-to-side-effect mapping: Each side effect is linked to one or more receptors known to mediate it, each assigned a clinical weight (0–1.0) based on the strength of the pharmacological evidence. For example, sedation is driven primarily by H₁ antagonism (weight 1.0), with secondary contributions from α₁ (0.5) and M₁ (0.3).
- Affinity normalization: For each relevant receptor, the drug's Ki value is converted to a 0–1 affinity score using the pKi scale: normalized = max(0, (pKi − 5) / 4). This maps the range Ki=10,000 nM (pKi=5 → score 0) to Ki=1 nM (pKi=9 → score 1). Drugs with Ki ≥10,000 nM score 0.
- Weighted average: The final score is the weighted average of normalized affinity scores across all receptors in the profile, multiplied by 100: Score = (Σ weight × normalized) / Σ weight × 100.
- Risk thresholds: Scores are binned as: Very Low (<20), Low (20–39), Moderate (40–59), High (60–79), Very High (≥80).
| Side Effect | Receptor Drivers (weight) |
|---|---|
| Sedation / Drowsiness | H₁ (1.0), α₁ (0.5), M₁ (0.3) |
| Weight Gain | H₁ (1.0), 5HT₂C (0.9), M₁ (0.2) |
| Dry Mouth / Constipation | M₁ (1.0) |
| Orthostatic Hypotension | α₁ (1.0), α₂ (0.3) |
| Sexual Dysfunction | SERT (1.0), 5HT₂A (0.4) |
| EPS / Akathisia | D₂ (1.0), D₃ (0.5) |
| Metabolic Effects | 5HT₂C (1.0), H₁ (0.8), M₁ (0.2) |
| Insomnia / Activation | DAT (1.0), NET (0.9), SERT (0.3) |
| Hyperprolactinemia | D₂ (1.0) |
| Nausea / GI Upset | SERT (0.8), D₂ (0.6) |
| Cognitive Impairment | M₁ (1.0), H₁ (0.7), α₁ (0.3) |
| Cardiac / QT Effects | H₁ (0.5), α₁ (0.6) |
⚠ Important caveat: Side effect scores are derived from in vitro receptor binding data and represent a pharmacological prediction — not a clinical probability. They do not account for pharmacokinetic factors (bioavailability, CNS penetration, active metabolites), dose-dependence, individual patient variability, or clinical trial incidence data. Scores should be interpreted as a comparative tool to guide discussion, not as definitive risk estimates.
Antipsychotic Lipid, Glucose & EPS Risk Columns
When the drug database is filtered to Antipsychotics, three additional columns appear: Lipid ↑ Risk, Glucose ↑ Risk, and EPS Risk. Unlike the receptor-affinity side-effect scores above, these are curated per-drug tiers (Very Low → Very High) drawn directly from comparative clinical trial data, because lipid and glucose effects diverge from in vitro receptor binding and are best separated using head-to-head evidence.
- Lipid ↑ and Glucose ↑: Ranked primarily from the metabolic network meta-analysis of 18 antipsychotics by Pillinger et al. (2020), which reports separate effects on lipids and fasting glucose — olanzapine and clozapine carry the greatest risk on both, while aripiprazole, brexpiprazole, cariprazine, lurasidone, ziprasidone, lumateperone and pimavanserin are most benign. Lipid and glucose are rated independently (e.g. quetiapine: higher lipid than glucose; risperidone/paliperidone raise lipids/weight without substantial fasting-glucose elevation).
- EPS Risk: Reflects extrapyramidal / movement-disorder liability from comparative data (Leucht et al. 2013; Huhn et al. 2019), tracking antipsychotic potency — high-potency first-generation agents (haloperidol, fluphenazine, pimozide) highest; clozapine, quetiapine, lumateperone and pimavanserin lowest.
⚠ Important caveat: These tiers are a comparative, class-level guide for educational use. Actual risk is dose-dependent and modified by individual patient factors, duration of exposure, and baseline metabolic status; always verify against current prescribing information and monitoring guidelines.
Pregnancy & Breastfeeding Data
Pregnancy entries show the former FDA letter category (A/B/C/D/X) for historical reference only, labeled "Former FDA Cat." The 2015 Pregnancy and Lactation Labeling Rule (PLLR) removed letter categories from prescription drug labels; current labels give a narrative risk summary instead. Use the risk badge and notes, and check current labeling, rather than the letter.
Breastfeeding classifications use Hale's Lactation Risk Categories (L1–L5):
- L1 — Safest: Extensively studied; no adverse effects in infant; not orally bioavailable in infant.
- L2 — Safer: Limited studies show no increase in adverse effects; risk to infant is remote.
- L3 — Moderately Safe: No controlled studies; risk of adverse effects possible; give only if benefit outweighs risk.
- L4 — Possibly Hazardous: Positive evidence of risk to infant; benefits may be acceptable in life-threatening situations.
- L5 — Contraindicated: Risk clearly outweighs any benefit.
Sources: FDA prescribing information, NIH LactMed database, Hale's Medications and Mothers' Milk (2023), Briggs Drugs in Pregnancy and Lactation (12th ed.).
QTc Calculator & Tisdale Risk Score
QTc values are calculated using the Bazett formula (QTc = QT / √RR) and the Fridericia formula (QTc = QT / ∛RR), where RR = 60/HR in seconds. Fridericia is recommended at heart rates <50 or >100 bpm as Bazett over-corrects at extremes.
The Tisdale Risk Score is reproduced from: Tisdale JE, et al. Circ Cardiovasc Qual Outcomes. 2013;6(4):479–487. It was validated in hospitalized patients; application in outpatient settings should be interpreted with appropriate clinical judgment.
📚 General References
- NIMH Psychoactive Drug Screening Program (PDSP) Ki Database. pdsp.unc.edu
- FDA Drug@FDA Database. accessdata.fda.gov
- NIH LactMed Database. nlm.nih.gov/lactmed
- Hale TW. Medications and Mothers' Milk. 2023 ed. Springer; 2023.
- Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation. 12th ed. Wolters Kluwer; 2021.
- Tisdale JE, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2013;6(4):479–487.
- Pillinger T, McCutcheon RA, Vano L, et al. Comparative effects of 18 antipsychotics on metabolic function in patients with schizophrenia, predictors of metabolic dysregulation, and association with psychopathology: a systematic review and network meta-analysis. Lancet Psychiatry. 2020;7(1):64–77. thelancet.com
- Huhn M, Nikolakopoulou A, Schneider-Thoma J, et al. Comparative efficacy and tolerability of 32 oral antipsychotics for the acute treatment of adults with multi-episode schizophrenia: a systematic review and network meta-analysis. Lancet. 2019;394(10202):939–951.
- Leucht S, Cipriani A, Spineli L, et al. Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet. 2013;382(9896):951–962.
- Academy of Consultation-Liaison Psychiatry (ACLP). How-To Guide: QTc Prolongation. 2020.
- Woosley RL, Heise CW, Gallo T, et al. CredibleMeds / AZCERT QTDrugs List. crediblemeds.org
- Roden DM. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350:1013–1022.
- Drew BJ, et al. Prevention of Torsade de Pointes in Hospital Settings. Circulation. 2010;121:1047–1060.
QT Prolongation Risk Tool
QTc calculator, Tisdale risk scoring, drug reference lists, and monitoring guidance. For educational use — always verify with current clinical resources.
What Is QT Prolongation?
The QT interval on an ECG represents ventricular depolarization (QRS) plus repolarization (T wave). Prolongation of the QT interval reflects delayed ventricular repolarization, creating a vulnerable window during which an early depolarization can trigger a potentially fatal arrhythmia.
Because the QT interval varies with heart rate, a corrected QTc is calculated to normalize for rate. The most widely used formula is Bazett's, though Fridericia's is preferred at very high or low heart rates.
QTc Thresholds
Torsades de Pointes (TdP) & Risk Factors
Torsades de Pointes (TdP) is a polymorphic ventricular tachycardia characterized by a "twisting" QRS morphology around the isoelectric axis. It can degenerate into ventricular fibrillation and sudden cardiac death.
Patient-Level Risk Factors
- Female sex — longer baseline QTc; ~70% of TdP cases
- Age ≥65 — reduced repolarization reserve
- Hypokalemia (K+ <3.5 mEq/L) — most important electrolyte
- Hypomagnesemia — Mg²⁺ <0.8 mEq/L
- Hypocalcemia
- Bradycardia (<50 bpm) — rate-dependent TdP risk
- Heart failure — reduced repolarization reserve
- Myocardial infarction / ischemia
- Congenital long QT syndrome
- Hypothyroidism
- Hepatic impairment — increases drug exposure
- Anorexia nervosa — electrolyte depletion
Monitoring Recommendations
Before Starting a QT-Prolonging Agent
- Obtain baseline ECG with QTc measurement
- Review all concurrent medications for additive QT risk (CredibleMeds / AZCERT database)
- Measure and correct electrolytes (K⁺, Mg²⁺, Ca²⁺) before initiation
- Assess for congenital long QT syndrome risk (family/personal history of sudden death, syncope)
- Assess renal and hepatic function — affects drug clearance and exposure
During Treatment
- Repeat ECG 1–2 weeks after initiation and after dose increases
- For high-risk agents (e.g., methadone, haloperidol IV, clozapine): ECG at 1 week, 1 month, then periodically
- Monitor electrolytes regularly, especially with diuretics, vomiting, or poor oral intake
- Educate patient on symptoms: palpitations, dizziness, syncope, presyncope
Action Thresholds
▶ QTc Calculator
Enter the measured QT interval and heart rate from the ECG. QTc is calculated using both Bazett and Fridericia formulas.
▶ Tisdale QT Risk Score
Validated risk scoring tool for predicting QT prolongation in hospitalized patients (Tisdale et al., Circ Cardiovasc Qual Outcomes, 2013). Each item adds to a cumulative risk score.
Originally validated in inpatient settings. Use in outpatient context as a general guide to identify high-burden patients.
▶ Non-Psychiatric Medications with QT Risk
Commonly prescribed medications outside psychiatry that prolong the QT interval. Risk classification based on CredibleMeds / AZCERT and published literature. This does not replace the CredibleMeds database — always verify current risk status.
▶ Psychiatric Medications with QT Risk
Medications in the database flagged for QT prolongation. Click any drug name to open its full detail modal.
▶ References
- Tisdale JE, et al. Development and validation of a risk score to predict QT interval prolongation in hospitalized patients. Circ Cardiovasc Qual Outcomes. 2013;6(4):479–487.
- Tisdale JE, et al. Drug-Induced QT Interval Prolongation and Torsades de Pointes: Role of the Pharmacist in Risk Assessment, Prevention and Management. Can Pharm J (Ott). 2016;149(3):139–152.
- Academy of Consultation-Liaison Psychiatry (ACLP). How-To Guide: QTc Prolongation. 2020. Available at: aclponline.org.
- Woosley RL, Heise CW, Gallo T, et al. CredibleMeds / AZCERT. Available at: crediblemeds.org. [QTDrugs List — updated continuously]
- Nachimuthu S, Assar MD, Schussler JM. Drug-induced QT interval prolongation: mechanisms and clinical management. Ther Adv Drug Saf. 2012;3(5):241–253.
- Roden DM. Drug-Induced Prolongation of the QT Interval. N Engl J Med. 2004;350:1013–1022.
- Drew BJ, et al. Prevention of Torsade de Pointes in Hospital Settings: A Scientific Statement From the American Heart Association and the American College of Cardiology Foundation. Circulation. 2010;121:1047–1060.
Refill Calendar
Tools for tracking controlled and restricted medication fills — days between dates, usage analysis, and refill date projection.
📅 Days Between Two Dates
Calculate the exact number of days between any two dates.
⚙ Usage Calculator
Estimate average daily use, monthly consumption, and percentage over- or underuse compared to the prescribed regimen.
▶ Forward Refill Dates
Enter a fill date and days supply to project the next 6 refill dates.
◀ Reverse Refill Tracker
Enter the most recent fill date and expected days between fills to estimate when the previous 6 fills should have occurred.
🔄 Medication Sync
Align two medications to a common refill date using a one-time short fill. Enter each medication's last fill date, days supply, quantity dispensed, and daily dose.
Cognitive Domains
Cognitive domains, standardized screening instruments, and clinical interpretation.
Loading…
Classic Neuropsychiatric Circuits
Parallel cortico–basal ganglia–thalamo–cortical loops and limbic circuits.
🧠 Classic Neuropsychiatric Circuits
Several circuits are repeatedly referenced in neuropsychiatry because they link brain anatomy to cognition, behavior, and psychiatric symptoms. Most originate from Alexander, DeLong & Strick's landmark 1986 description of parallel cortico–basal ganglia–thalamo–cortical loops, each specialized for a distinct functional domain.
All four loops share the same basic architecture: Cortex → Striatum → Globus Pallidus/SNr → Thalamus → Cortex. What differs is which cortical region anchors the loop and therefore which function is modulated. This framework underlies DBS target selection, neuropsychiatric differential diagnosis, and neuroimaging interpretation.
- Executive function & cognitive control
- Working memory (maintenance + manipulation)
- Planning and goal-directed behavior
- Cognitive flexibility / set-shifting
- Problem solving
- Impulse control and behavioral inhibition
- Social judgment and contextual behavior
- Reward evaluation and value-based decision making
- Emotional regulation via prefrontal modulation
- Motivation and initiation of behavior
- Effort allocation toward goals
- Emotional processing and salience detection
- Error monitoring and response conflict
- Emotional processing and subjective emotional experience
- Episodic memory encoding and consolidation
- Integration of emotional context with memory
- Spatial navigation (hippocampal component)
- Fear acquisition and extinction learning
- Threat detection and emotional salience
- Contextual modulation of fear (vmPFC)
- Conditioned fear responses
- Reward processing and hedonic response
- Motivation and incentive salience
- Reinforcement learning (prediction error signal)
- Drug-induced euphoria and craving
- Executive function and working memory (D1 receptors on PFC)
- Motivation and effort-based decision making
- Cognitive aspects of goal-directed behavior
- Modulates DLPFC and ACC loop activity
- Initiation and scaling of voluntary movement
- Selection of appropriate motor programs
- Suppression of competing/unwanted movements
- Template architecture for all parallel BG loops
⚡ Quick Clinical Heuristic — Symptom to Circuit
When a patient presents with a neuropsychiatric symptom cluster, this mapping provides a starting point for circuit-level localization. Symptoms rarely reflect a single circuit; overlap is the rule.
| Symptom / Presentation | Primary Circuit | Key Neurotransmitter | Example Conditions |
|---|---|---|---|
| Executive dysfunction, poor planning | DLPFC Circuit | Dopamine (D1, PFC) | Schizophrenia, ADHD, MDD, FTD |
| Impulsivity, disinhibition, compulsions | Orbitofrontal Circuit | Serotonin, Dopamine | OCD, Tourette, FTD, SUD |
| Apathy, amotivation, anhedonia | Anterior Cingulate Circuit | Dopamine (mesolimbic) | MDD, Parkinson, TBI |
| Anxiety, fear, hypervigilance | Amygdala–PFC Circuit | GABA, Serotonin, NE | PTSD, GAD, Panic Disorder |
| Positive psychotic symptoms (hallucinations, delusions) | Mesolimbic Circuit | Dopamine (↑D2, NAc) | Schizophrenia, mania, stimulant psychosis |
| Negative / cognitive symptoms | Mesocortical Circuit | Dopamine (↓D1, PFC) | Schizophrenia, ADHD, MDD |
| Memory impairment | Papez Circuit | ACh, Glutamate | Alzheimer, Korsakoff, TBI |
| Movement disorder (rigidity, chorea, tics) | Motor BG Circuit | Dopamine (putamen) | Parkinson, Huntington, Tourette, TD |
Brain Regions in Neuropsychiatric Disorders
Neuroanatomical correlates of major psychiatric and neurological diagnoses.
🧠 Brain Regions in Neuropsychiatric Disorders
Each major neuropsychiatric condition is associated with dysfunction in a characteristic set of brain regions. Region involvement is based on convergent evidence from structural MRI, functional neuroimaging, lesion studies, and postmortem data. Colors indicate brain region category.
Hyperactivation of the amygdala drives exaggerated fear responses and intrusive memories. The vmPFC normally suppresses amygdala activation during extinction — this inhibition is impaired in PTSD. Hippocampal volume reduction contributes to impaired contextual fear memory, resulting in generalized (context-independent) fear responses.
Unlike PTSD (cue-dependent fear), GAD involves sustained, diffuse apprehension mediated by the bed nucleus of the stria terminalis (BNST) — a structure implicated in anticipatory anxiety. The insula processes interoceptive signals contributing to somatic anxiety symptoms. Prefrontal hypoactivation impairs top-down regulation of the threat network.
OCD is characterized by hyperactivation of the orbitofrontal–caudate–thalamic loop. Normally the OFC evaluates action outcomes and the caudate gates habitual behaviors — in OCD this loop becomes "stuck," generating repetitive, compulsive thoughts and behaviors. Neuroimaging consistently shows increased activity in the OFC and caudate at rest, normalizing with successful treatment (SSRIs or CBT).
Tourette syndrome involves hyperactivation of cortico-striatal sensorimotor loops, generating premonitory urges and tics. Striatal overactivity releases suppressed motor programs, producing involuntary vocalizations and movements. High comorbidity with OCD (same orbitofrontal loop) and ADHD (same frontostriatal network) reflects shared circuit overlap.
Mayberg's limbic-cortical model describes MDD as hyperactivity of the subgenual ACC (sgACC/Area 25) driving sustained negative affect, while the dorsal PFC is hypoactive (impairing cognitive regulation). Hippocampal volume loss — partially reversible with antidepressants and exercise — reflects glucocorticoid toxicity from chronic stress. Nucleus accumbens hypoactivation underlies anhedonia. The sgACC is the primary target of deep brain stimulation for treatment-resistant depression.
Bipolar disorder is associated with amygdala hyperactivity and insufficient prefrontal regulation across mood states. The ventrolateral PFC, which normally modulates emotional responses, shows structural and functional abnormalities. Ventral striatum dysregulation drives the elevated reward sensitivity and impulsivity of manic episodes. Amygdala volume enlargement (opposite to MDD's reduction) is among the most replicated findings.
Schizophrenia involves a complex interaction between hypofrontality (↓dopamine in DLPFC → negative/cognitive symptoms) and mesolimbic hyperdopaminergia (↑dopamine in striatum → positive symptoms). The thalamus acts as a sensory gating mechanism; thalamic abnormalities may explain the flooding of consciousness with irrelevant stimuli that contributes to psychosis. Superior temporal cortex (including Wernicke's area) volume loss correlates with auditory hallucinations. Hippocampal hyperactivation disrupts pattern completion and separation, potentially driving the associative loosening and false inference seen in delusions.
ADHD is a disorder of fronto-striatal attention and executive networks. The DLPFC and ACC are hypoactive, impairing working memory, planning, and error monitoring. Reduced dopaminergic and noradrenergic tone in the PFC is the primary target of stimulant therapy. Caudate volume reduction (which normalizes with stimulant treatment) reflects delayed neural maturation rather than fixed damage. The cerebellum contributes to timing deficits and cognitive coordination.
Autism involves differences in three interconnected systems: the social brain network (STS, fusiform face area, amygdala, mPFC — involved in face recognition, social perception, and theory of mind), long-range connectivity (frequently underconnected between distant regions, overconnected locally), and cerebellar circuits (affecting timing of social responses, motor coordination, and predictive processing). Amygdala differences contribute to atypical salience assignment to social stimuli.
Alzheimer pathology (amyloid plaques and tau neurofibrillary tangles) spreads in a stereotyped pattern described by Braak staging: beginning in the entorhinal cortex and hippocampus (explaining early episodic memory loss), progressing to temporal and parietal association cortices, then frontal lobes. The posterior cingulate and precuneus — hubs of the default mode network — show early hypometabolism on FDG-PET, making them important imaging biomarkers. Cholinergic depletion from the basal forebrain (nucleus basalis of Meynert) is the pharmacological target of acetylcholinesterase inhibitors.
Parkinson disease results from progressive loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc), depleting dopamine in the putamen and disrupting the motor basal ganglia circuit. Loss of the direct pathway's activation and overactivation of the indirect pathway → increased GPi inhibition of thalamus → reduced cortical motor output (bradykinesia, rigidity). Braak's staging of Parkinson pathology suggests it begins in the brainstem (locus coeruleus, dorsal vagal nucleus) before reaching the SNpc, explaining non-motor prodromal symptoms (REM sleep disorder, anosmia, constipation).
FTD involves selective degeneration of the frontal and anterior temporal lobes, with relative sparing of posterior regions (distinguishing it from Alzheimer). The behavioral variant (bvFTD) causes disinhibition, apathy, and social inappropriateness — reflecting orbitofrontal and anterior cingulate degeneration. Primary progressive aphasias (semantic dementia, PNFA) reflect asymmetric temporal or frontal language network loss. Unlike Alzheimer, episodic memory is often relatively preserved early; executive function and behavior are the first casualties.
Wernicke encephalopathy results from acute thiamine (B₁) deficiency, causing hemorrhagic necrosis in thiamine-dependent high-metabolic regions. The classic triad: ophthalmoplegia (periaqueductal gray/oculomotor nuclei), ataxia (cerebellum), and confusion/encephalopathy (thalamic and mammillary body involvement). MRI shows characteristic T2/FLAIR hyperintensity around the aqueduct and in medial thalami. Treatment must not be delayed — thiamine must precede glucose in suspected cases. Untreated, it progresses to Korsakoff syndrome.
The chronic amnestic syndrome following Wernicke encephalopathy. Bilateral mammillary body atrophy and mediodorsal thalamic lesions disrupt the Papez circuit, resulting in profound anterograde amnesia (inability to form new memories) with relatively preserved remote memory, procedural learning, and intellectual function. Confabulation — producing false memories without intent to deceive — is a characteristic feature, reflecting disinhibited memory retrieval processes. The MD thalamic nuclei serve as a relay between frontal lobes and hippocampus; their damage disrupts frontal monitoring of memory output.
Chronic alcohol exposure causes direct neurotoxicity (ethanol and acetaldehyde), thiamine deficiency, glutamate excitotoxicity during repeated withdrawals, and oxidative stress. The frontal lobes — responsible for executive function — are disproportionately vulnerable, producing disinhibition, poor planning, and impulsivity. Cerebellar degeneration causes persistent ataxia. Corpus callosum demyelination (Marchiafava-Bignami disease in severe cases) disrupts inter-hemispheric communication. Unlike Korsakoff, ARBD involves broader, more diffuse damage with potential for partial recovery with abstinence.
📈 Network → Disorder Quick Reference
| Network / Circuit | Primary Disorders | Key Brain Regions |
|---|---|---|
| Amygdala Fear Network | PTSD, GAD, Panic Disorder | Amygdala, vmPFC, hippocampus, BNST |
| Orbitofrontal Loop | OCD, Tourette, FTD (behavioral) | OFC, caudate, thalamus, ACC |
| Frontostriatal Attention Network | ADHD, Schizophrenia (cognitive), MDD | DLPFC, caudate/putamen, ACC, cerebellum |
| Subgenual / Mood Network | MDD, Bipolar Disorder | sgACC, vmPFC, amygdala, NAc |
| Reward Network (Striatum) | Bipolar (mania), Addiction, MDD (anhedonia) | NAc, VTA, OFC, ventral striatum |
| DLPFC Cognitive Network | Schizophrenia (negative/cognitive), ADHD | DLPFC, thalamus, dorsal striatum |
| Memory Network (Hippocampus) | Alzheimer, Korsakoff, PTSD | Hippocampus, entorhinal cx, mammillary bodies, thalamus |
| Social Brain Network | ASD, Social Anxiety Disorder | STS, fusiform, amygdala, mPFC |
| Nigrostriatal Motor Network | Parkinson, Huntington, Tardive Dyskinesia | SNpc, putamen, GPi, motor cortex |
📚 References
- Harvey PD. Domains of cognition and their assessment. Dialogues Clin Neurosci. 2019;21(3):227–237.
- Nasreddine ZS, Phillips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695–699.
- Tariq SH, Tumosa N, Chibnall JT, et al. The Saint Louis University Mental Status (SLUMS) examination. Am J Geriatr Psych. 2006;14:900–910.
- Lezak MD, Howieson DB, Bigler ED, Tranel D. Neuropsychological Assessment. 5th ed. Oxford University Press; 2012.
- Folstein MF, Folstein SE, McHugh PR. Mini-Mental State. J Psychiatr Res. 1975;12:189–198.
- Paulsen JS, Salmon DP, Monsch A, et al. Discrimination of cortical from subcortical dementias. J Clin Psychol. 1995;51:48–58.
- Twamley EW, et al. Prospective memory impairment in schizophrenia. Schizophr Res. 2007;106:42–49.
- Alexander GE, DeLong MR, Strick PL. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986;9:357–381.
- Tekin S, Cummings JL. Frontal-subcortical neuronal circuits and clinical neuropsychiatry: an update. J Psychosom Res. 2002;53(2):647–654.
- Papez JW. A proposed mechanism of emotion. Arch Neurol Psychiatry. 1937;38(4):725–743.
- LeDoux JE. The emotional brain, fear, and the amygdala. Cell Mol Neurobiol. 2003;23(4–5):727–738.
- Schultz W. Predictive reward signal of dopamine neurons. J Neurophysiol. 1998;80(1):1–27.
- Haber SN. Corticostriatal circuitry. Dialogues Clin Neurosci. 2016;18(1):7–21.
- Cummings JL, Mega MS. Neuropsychiatry and Behavioral Neuroscience. Oxford University Press; 2003.
3D Brain Explorer
Interactive, expert-segmented 3D neuroanatomy for the structures that matter in psychopharmacology. Click a structure to see its role and jump to the related circuit or region.
Loading…
Cellular Neuroscience
The nerve and glial cells that matter in psychiatry — where they live, how they work normally, what goes wrong, and how a fever, a sodium of 118, or an arterial pH of 7.52 changes what they do.
Loading…
Medication Comparison
Compare up to 6 medications across receptor binding, predicted side effects, and neuropsychiatric circuit targets.
⚖ Select Medications
Tolerability Comparison
Compare the relative side-effect profiles of two to four medications side by side, then switch between a clinician view (full tiers, incidence, class safety) and a simplified patient handout view for chairside discussion.
Loading…
Find Similar Medications
When a medication that once worked best loses its effect (tachyphylaxis, or “poop-out”), identify the medications with the most similar pharmacology — a rational starting point for a switch. Filter by route of administration, target residual symptoms the switch must not lose ground on, and show more matches six at a time.
Loading…
FDA Indication Search
Type a diagnosis — the agents carrying an FDA-approved label for it are listed, grouped by indication and phase. Add a phase or subtype to narrow the results: Bipolar II, bipolar maintenance, acute mania, bipolar depression. Acronyms work too (MDD, OCD, GAD, PTSD).
Loading…
Find Complementary Medications
The mirror of “Find Similar.” For a reference medication, this surfaces two things: the curated, evidence-based combination strategies that agent participates in (TRD, treatment-resistant schizophrenia, and bipolar augmentation), and the agents that treat the same condition but act through a different receptor set — rational candidates for combination or augmentation rather than a like-for-like switch.
Loading…
Chem Structure
Compare two psychotropic drugs side by side — their 2D structures, molecular properties, and the fat/water, protein-binding, and receptor-binding regions that shape their behavior. Built-in lineages show how each newer-generation agent was chemically re-engineered from an older one, and why the change was expected to help.
Loading…
Medication Taper / Start Scheduler
Generate a dose titration or tapering schedule for psychiatric medications.
💊 Single Drug Schedule
Clinical Dementia Rating (CDR) Staging Tool
Interactive CDR calculator with box scores, global CDR derivation per Morris (1993) scoring algorithm, CDR Sum of Boxes (CDR-SB), and clinical staging interpretation.
Loading…
Autism Spectrum Disorder Severity Rating Tool
DSM-5 severity level assessment across both core domains (Social Communication and Restricted/Repetitive Behaviors), with clinical interpretation, support needs mapping, and screening instrument guidance.
Loading…
Suicide Risk Assessment Tools
Clinical screening instruments for suicide ideation, behavior, and risk stratification. Three validated assessment approaches: C-SSRS Screen (rapid screening), C-SSRS Full Risk Assessment (comprehensive), and Risk/Protective Factors Framework (AFSP).
Loading…
SLUMS Examination
Saint Louis University Mental Status Examination — 30-point cognitive screening tool for detecting mild neurocognitive disorder and dementia, with domain-specific impairment analysis.
Loading…
PANSS (Positive and Negative Syndrome Scale)
Standardized clinical assessment for schizophrenia and psychosis symptom severity. Two validated approaches: PANSS-6 (brief 6-item screening) and PANSS-30 (full 30-item assessment with Positive, Negative, and General Psychopathology subscales plus Marder factor analysis).
Loading…
Bush-Francis Catatonia Rating Scale (BFCRS)
Standardized bedside assessment for catatonia. Two approaches: 14-item Catatonia Screening Instrument (CSI) for rapid detection, and full 23-item severity rating scale (CRS) with subtype classification and malignant catatonia screening.
Loading…
CIDI 3.0 Bipolar Screening Scale
The CIDI 3.0 Bipolar Screening Scale is a brief, validated screening tool for bipolar disorder in primary care and general clinical settings. It uses stem questions about mood elevation and irritability, followed by a gate question and symptom assessment to estimate the probability of bipolar disorder. Not a diagnostic instrument—results should inform further clinical evaluation.
Loading…
PCL-5 (PTSD Checklist for DSM-5)
A 20-item self-report measure assessing PTSD symptoms according to DSM-5 criteria. Items are rated 0-4 based on distress in the past month. Total scores range from 0-80, with scores ≥33 suggesting possible PTSD diagnosis.
Loading…
YMRS (Young Mania Rating Scale)
The Young Mania Rating Scale (YMRS) is an 11-item clinician-administered scale for assessing the severity of manic symptoms in adults. Total score ranges from 0 to 60, with higher scores indicating greater manic severity. Useful for baseline assessment and monitoring treatment response in bipolar I and bipolar II disorders.
Loading…
Y-BOCS (Yale-Brown Obsessive Compulsive Scale)
Comprehensive assessment of obsessive-compulsive symptoms and severity. The Y-BOCS includes a symptom checklist to identify current and past obsessions and compulsions, plus a 10-item severity scale (items 1–10) that measures time occupied, interference, distress, resistance, and control. Supplemental items (1b, 6b) and investigational items (11–19) provide additional clinical context but are not included in the total score.
Loading…
AIMS (Abnormal Involuntary Movement Scale)
Standardized assessment tool for detecting and monitoring tardive dyskinesia and other abnormal involuntary movements. A positive screen (Schooler–Kane: ≥2 on two or more of items 1–7, or ≥3 on any one) suggests need for further evaluation. Administer the complete examination procedure for accurate assessment.
Loading…
Movement Disorder Assessment
A structured bedside phenomenology exam: describe every movement on the seven descriptive axes, match a signature to a category, and copy a description-first chart note. Built on The Movement Disorder Examination: A Region-by-Region Phenomenology Atlas. A documentation aid, not a diagnostic device.
Loading…
BPRS (Brief Psychiatric Rating Scale)
18-item clinician-rated scale for psychiatric symptom severity. Each item scored 0 (not assessed) to 7 (extremely severe). Validated severity anchors: mildly ill ≈ 31, moderately ill ≈ 41, markedly ill ≈ 53 (Leucht et al., 2005).
Loading…
ADL / IADL Functional Assessment
Evaluate activities of daily living (ADL) and instrumental activities of daily living (IADL) to assess functional independence and care needs.
Loading…
Aid to Capacity Evaluation (ACE)
Structured 7-domain assessment of decision-specific capacity for a medical decision (Etchells et al., Joint Centre for Bioethics, University of Toronto). Yields an EMR-ready note and a printable blank form.
Loading…
McLean Screening Instrument for BPD (MSI-BPD)
10-item self-report screening tool for Borderline Personality Disorder. A score of 7 or higher warrants further diagnostic evaluation.
Loading…
PHQ-9 (Patient Health Questionnaire-9)
Validated 9-item depression screening and severity tool. Scores range 0–27 with five severity bands. Generates an EMR-ready summary.
Loading…
GAD-7 (Generalized Anxiety Disorder 7-item Scale)
Validated 7-item anxiety screening and severity tool. Scores range 0–21 with four severity bands. At ≥10 it also detects panic disorder, social anxiety, and PTSD with moderate sensitivity (about 66–74%; Kroenke 2007). Generates an EMR-ready summary.
Loading…
DSM-5-TR Substance Use Disorder Tool
Select a substance; the 11 DSM-5-TR criteria populate with substance-specific examples. Generates an EMR-ready text summary on completion.
Loading…
Medication History Form
Comprehensive psychiatric medication history — documents prior trials, experiences, side effects, and generates a structured EMR-ready summary with failed-trial overlap analysis.
Loading…
CIWA-Ar (Alcohol Withdrawal Assessment)
The Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) is a 10-item, clinician-rated tool for assessing severity of acute alcohol withdrawal. Total score ranges from 0 to 67. Higher scores indicate more severe withdrawal and greater risk for seizures and delirium tremens. Commonly used to guide symptom-triggered benzodiazepine dosing protocols.
Loading…
COWS (Clinical Opiate Withdrawal Scale)
The Clinical Opiate Withdrawal Scale (COWS) is an 11-item clinician-administered instrument that reproducibly rates common signs and symptoms of opiate withdrawal. It is used to quantify withdrawal severity, monitor trajectory, and guide the timing of buprenorphine induction. Total score ranges approximately 0–48; severity bands: 5–12 mild, 13–24 moderate, 25–36 moderately severe, >36 severe.
Loading…
24-Hour Caffeine Intake Calculator
Document the caffeine-containing products a patient used over a 24-hour period to estimate total caffeine intake in milligrams. Per-serving values are typical estimates and can be edited to match a specific brand or brew strength.
Loading…
24-Hour THC Intake Calculator
Document the cannabis products a patient used over a 24-hour period to estimate total THC content in milligrams. Flower, vape oil and concentrate are entered as amount × potency; edibles, beverages and tinctures are entered as milligrams per unit × units.
Loading…
24-Hour Alcohol Intake Calculator
Document the alcoholic beverages a patient used over a 24-hour period to total US standard drinks and grams of ethanol. Preset volumes and ABV are editable to match the actual drink.
Loading…
Anticholinergic Burden Assessment
Build a patient’s medication list from a searchable library of anticholinergic agents to see the cumulative burden on two validated scales — the Anticholinergic Cognitive Burden (ACB) scale and the Anticholinergic Risk Scale (ARS) — with older-adult (≥65) flags and an EMR-ready report.
Loading…
Adult ADHD Self-Report Scale (ASRS v1.1)
18-item screening tool for adult ADHD. Part A (6 items) is the primary screener; Part B (12 items) provides supplemental diagnostic information.
Loading…
Epworth Sleepiness Scale (ESS)
Assess daytime sleepiness across 8 common situations. A simple screening tool to identify excessive daytime somnolence.
Loading…
Insomnia Severity Index (ISI)
Seven-item self-report measure of insomnia severity over the past two weeks (Morin). Total 0–28 across four severity bands. First-line treatment for chronic insomnia is CBT-I.
Loading…
Burnout Assessment Tool (BAT)
The Burnout Assessment Tool (BAT) is a validated 23-item (work-related) or 22-item (general) self-report measure of burnout across four core dimensions: exhaustion, mental distance, cognitive impairment, and emotional impairment. An additional 10-item secondary symptoms scale covers psychological and psychosomatic complaints. Developed by Schaufeli, De Witte & Desart (2019) at KU Leuven. Scored 1–5 (Never to Always); domain mean scores are reported.
Loading…
SMI-FRAIL-20: Medical Frailty Documentation Tool
A 20-item structured checklist to support individualized documentation of medical frailty in patients with severe mental illness (SMI), developed in response to the June 2026 CMS interim final rule (CMS-2454-IFC) narrowing the Medicaid work-requirement medical frailty exemption. Includes an optional 8-item substance use disorder (SUD) add-on module. Generates an EMR-ready summary.
Loading…
DV / IPV Assessment
A point-of-care intimate partner violence tool combining the validated HITS screen (Hurt, Insult, Threaten, Scream) with a structured, evidence-based lethality / danger review. Generates an EMR-ready summary. Use it to support recognition, danger assessment, and safety planning — see the Domestic & Intimate Partner Violence chapter for clinical context.
Loading…
Autism Screening (AQ)
The Autism Spectrum Quotient (AQ) is a self-report screening instrument developed by Baron-Cohen et al. (2001) at the Autism Research Centre, University of Cambridge. The AQ-10 is a brief 10-item screener for rapid identification of adults who may benefit from a full autism evaluation. The AQ-50 provides a comprehensive 50-item assessment across five domains: social skills, attention switching, attention to detail, communication, and imagination. Items are scored 0 or 1 based on endorsement direction; higher scores indicate greater autistic traits.
Loading…
OTC & Non-Prescription Sleep Aid Comparison
Compare non-prescription sleep aids side by side — OTC antihistamines, melatonin, herbals, minerals and amino acids, and cannabis — by mechanism, typical dose, onset/duration, evidence grade, key risks, and interactions. Filter by category or evidence and flag agents to avoid in older adults.
Loading…
Fatigue / Low Energy Workup
A tiered symptom and red-flag checklist that builds a suggested laboratory workup and differential for low energy, with an urgent-evaluation flag for red flags and an EMR-ready summary. Covers non-psychiatric causes across every organ system.
Loading…
Therapy Courses
A practical, step-by-step course for clinicians, trainees, and advanced students — how to actually deliver the core techniques of the behavioral therapies with fidelity, adapt them, and measure progress.
Loading…
Module 3 — Behavioral Activation & CBT for Depression
A practical how-to for delivering Behavioral Activation, with interactive worksheets and goal-setting tools. ← Back to course overview · ↓ Download blank worksheets (PDF) · Measure baseline severity with the ISI →
Loading…
Module 4 — Exposure-Based CBT for Anxiety Disorders (incl. ERP for OCD)
A practical how-to for delivering exposure therapy with the inhibitory-learning model, with interactive worksheets and goal-setting tools. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 2 — ABA & Naturalistic Approaches for Autism Spectrum Disorder
A practical, assent-based, neurodiversity-affirming how-to for Discrete Trial Training, PRT/ESDM, and function-based support, with interactive worksheets. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 6 — CBT for Psychosis (CBTp) & Related Approaches for Schizophrenia
A practical, collaborative, normalizing how-to for CBTp — formulation, working with voices and beliefs, functioning goals, and staying-well planning, with interactive worksheets. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 1 — Foundational Principles of Behavioral & Cognitive-Behavioral Therapy
The shared core: behavioral & cognitive principles, functional analysis, case formulation, session structure, measurement, and Socratic method. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 5 — CBT for Anger Management & Parent Management Training
Two routes to reducing anger, irritability, and aggression: CBT for anger (adults/adolescents) and PMT for caregivers, with interactive worksheets. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 7 — Integration, Advanced Topics & Implementation
Sequencing therapies, combining with medication, fidelity & supervision, telehealth & stepped care, and a capstone action plan. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 8 — EMDR Therapy for Trauma & PTSD
A practical how-to for the eight-phase EMDR protocol — target sequencing, stabilization & resourcing, NC/PC and SUDS/VOC assessment, and set-by-set reprocessing, with interactive worksheets. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 9 — CBT for Insomnia (CBT-I)
A practical how-to for delivering first-line CBT for chronic insomnia — the 3-P formulation, sleep restriction with weekly titration, stimulus control, and cognitive restructuring, with interactive worksheets and a live sleep-efficiency calculator. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Module 10 — Marriage & Couples Therapy
A practical how-to for treating marriage and other committed couples: safety and assessment, the major evidence-based models, couple-based protocols for individual disorders, and the ethics of secrets and documentation, with interactive worksheets. ← Back to course overview · ↓ Download blank worksheets (PDF)
Loading…
Question Bank
1,494 USMLE-style psychiatry questions across 32 categories and 120 source chapters. Sign in to start a quiz.
Loading…
Handouts
Plain-language, one-page handouts you can view here or download as a PDF to give patients. Each opens in its own page with a Download / Print PDF button.
Understanding Insomnia & Sleep Hygiene
What insomnia is and the behavioral habits that retrain the brain for sleep.
Open handout →Calming Your Fight-or-Flight Response
The biology of anxiety plus fast skills: square breathing and 5-4-3-2-1 grounding.
Open handout →My Safety Plan
A fill-in safety plan: warning signs, coping steps, supports, and crisis contacts.
Open handout →Understanding Abuse
What abuse and coercive control are, why it’s not your fault, and that support exists.
Open handout →Getting Help & Resources
Hotlines, what advocates do, online safety, planning ahead, and legal options.
Open handout →Worry Management
Sort solvable worries from "what ifs," use worry time, and let the rest go.
Open handout →Progressive Muscle Relaxation
A step-by-step tense-and-release sequence to drain physical tension.
Open handout →Behavioral Activation & Scheduling
Act your way into feeling better with planned pleasure and mastery activities.
Open handout →Mood Tracking & Monitoring
A daily 30-second log of mood, sleep, and triggers to spot patterns.
Open handout →Self-Care Assessment & Plan
Rate how you're caring for yourself and pick one small change per area.
Open handout →Stress Management & Burnout
Spot burnout early and rebalance demands against real recovery.
Open handout →Setting Healthy Boundaries
What boundaries are, why guilt is normal, and how to state them kindly.
Open handout →Assertive Communication
The middle path between bottling up and blowing up, using "I" statements.
Open handout →Diet & Exercise: The Basic Science
How movement and nutrition shape mood, energy, and the stress response.
Open handout →SMART Goals & Committed Action
Turn values into specific, doable goals and follow through on tough days.
Open handout →Grounding Techniques
Come back to the present with sensory, physical, mental, and soothing grounding.
Open handout →Facing Fears: Exposure Hierarchies
Build a fear ladder and face avoided situations one manageable step at a time.
Open handout →Healthy Habits & Gratitude
Anchor your day, stack small habits, and train attention toward the good.
Open handout →Understanding Dementia
What dementia is, the main types, how it progresses, and what to expect.
Open handout →Communicating & Daily Care
Communication techniques, validation, and gentler daily-care routines.
Open handout →Managing Challenging Behaviors
The ABC approach for agitation, sundowning, wandering, and repetition.
Open handout →Home Safety Checklist
Fall prevention, wandering, medications, driving, and emergency readiness.
Open handout →Caregiver Stress & Self-Care
Recognize burnout, manage grief and guilt, and get real support.
Open handout →Planning Ahead: Legal & Care
Advance directives, powers of attorney, and care options and costs.
Open handout →Later Stages: Comfort & Grief
Advanced dementia, hospice and palliative care, and caregiver grief.
Open handout →Alcohol Use Disorder
Standard drinks and limits, the dangers of withdrawal, medications, and skills to cut back.
Open handout →Opioid Use Disorder
Overdose and naloxone, life-saving medications, withdrawal, and harm reduction.
Open handout →Cannabis Use
When use becomes a problem, effects of regular use, withdrawal, and cutting back.
Open handout →Nicotine Dependence
Why quitting is hard, medications that double your odds, quit-day planning, and cravings.
Open handout →Methamphetamine Use Disorder
What meth does, health effects, what treatment works, and the crash and early recovery.
Open handout →SSRIs
How to take them, the under-25 warning, sexual and GI side effects, and what to watch for.
Open handout →SNRIs
Taking with food, blood-pressure monitoring, discontinuation, and serious side effects.
Open handout →Bupropion (Wellbutrin)
Activating, weight-neutral; the seizure risk, who should avoid it, and monitoring.
Open handout →Mirtazapine (Remeron)
Sleep and appetite, why low doses sedate more, and weight and lipid checks.
Open handout →Tricyclic Antidepressants
Overdose danger, heart effects, anticholinergic side effects, and EKG monitoring.
Open handout →MAO Inhibitors
The tyramine diet, dangerous drug interactions, washout periods, and blood pressure.
Open handout →Atypical (2nd-Gen) Antipsychotics
Metabolic and movement effects, the dementia warning, and the full monitoring schedule.
Open handout →Typical (1st-Gen) Antipsychotics
Movement side effects, tardive dyskinesia, the dementia warning, and AIMS/EKG checks.
Open handout →Clozapine
Why it works when others don't, the required blood (ANC) monitoring, and heart and bowel warnings.
Open handout →Lithium
Salt and fluids, toxicity signs, and blood-level, kidney, and thyroid monitoring.
Open handout →Lamotrigine (Lamictal)
Why the dose goes up slowly, the serious-rash warning, and interactions.
Open handout →Valproate (Depakote)
Liver, pancreas, and pregnancy warnings, plus LFT, platelet, and level monitoring.
Open handout →Carbamazepine (Tegretol)
Rash and blood-count warnings, HLA-B*1502 testing, drug interactions, and monitoring.
Open handout →Oxcarbazepine (Trileptal)
The low-sodium and serious-rash cautions, interactions, and sodium monitoring.
Open handout →Gabapentin & Pregabalin
Breathing risk with opioids, dependence, kidney dosing, and common side effects.
Open handout →Benzodiazepines
The opioid and dependence warnings, alcohol danger, and why never to stop abruptly.
Open handout →Stimulants (ADHD)
Timing to protect sleep, the misuse warning, and heart, blood-pressure, and growth checks.
Open handout →Sleep Medications (Z-Drugs)
Taking them safely, the complex-sleep-behavior warning, and dependence.
Open handout →Antihistamines & Anticholinergics
Benadryl, Vistaril, and Cogentin: uses, anticholinergic side effects, and cautions in older adults.
Open handout →Printable Clinical Forms
Download and print blank rating scales for bedside or clinic use.
Loading…
Chapters
124 evidence-based clinical articles on psychopharmacology, psychiatric disorders, clinical practice, and more.
Loading…
This article has moved to its own page.
Read: Smoking Cessation →This article has moved to its own page.
Read: Obesity & Weight Loss →Contact
Questions, feedback, or suggestions? Send a message below.
Your email is used only to respond to your message and is never shared or stored beyond what is necessary for correspondence. No attachments are accepted.