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1.  Robert William Kerwin 
BMJ : British Medical Journal  2007;334(7604):1170.
Leading psychopharmacologist in schizophrenia
PMCID: PMC1885325
2.  Psychopharmacology Today: Where are We and Where Do We Go From Here? 
Mens Sana Monographs  2010;8(1):6-16.
Since the 1950s we have had the same three neurotransmitters to work with to treat depression, one transmitter for psychoses, three for anxiety. We have developed newer drugs that are more tolerable, but we have not developed drugs that are better in efficacy. The last 50-60 years should be considered the decades that allowed us to treat a greater number of patients with safer and more tolerable drugs. We have also decreased stigma and allowed primary care clinicians to become more comfortable treating the mentally ill. We clearly treat more patients than before, and sometimes are now accused of over-prescribing wantonly as our drugs are safer. Without any clear blockbuster new drug ready to be added to our armamentarium, what can we do as psychopharmacologists today, and tomorrow, to obtain better results? This introductory manuscript will attempt to provide an overview of ideas so that an adept, well-rounded clinician might be able to obtain better outcomes despite using neurotransmitter pharmacodynamics that have been around since the 1950s. Finally, I will comment on the psychotropic pipeline, which may be added to our armamentarium in the future.
PMCID: PMC3031936  PMID: 21327167
Psychopharmacology; Pharmacodynamics; Psychiatric outcomes; Prescribing practices
3.  Murray Elias Jarvik 
BMJ : British Medical Journal  2008;336(7658):1442.
Psychopharmacologist who studied the effects of LSD and co-invented the nicotine patch
PMCID: PMC2432160
4.  Psychopharmacology of anxiety disorders  
Exposure of the general population to a 1:4 lifetime risk of disabling anxiety has inspired generations of fundamental and clinical psychopharmacologists, from the era of the earliest benzodiazepines (BZ) to that of the selective serotonin reuptake inhibitors (SSRIs) and related compounds, eg, the serotonin and norepinephrine reuptake inhibitors (SNRIs). This comprehensive practical review summarizes current therapeutic research across the spectrum of individual disorders: generalized anxiety disorder (GAD), panic disorder (PD) and agoraphobia (social anxiety disorder), compulsive disorder (OCD), phobic disorder (including social phobia), and posttraumatic stress disorder (PTSD). Specific diagnosis is a precondition to successful therapy: despite substantial overlap, each disorder responds preferentially to specific pharmacotherapy. Comorbidity with depression is common; hence the success of the SSRIs, which were originally designed to treat depression. Assessment (multidomain measures versus individual end points) remains problematic, as-frequently-do efficacy and tolerability The ideal anxiolytic remains the Holy Grail of worldwide psychopharmacologic research.
PMCID: PMC3181684  PMID: 22033867
generalized anxiety disorder; panic disorder; social anxiety disorder; posttraumatic stress disorder; obsessive compulsive disorder; benzodiazepine; antidepressant
5.  Psychopharmacological Practice: The DSM Versus The Brain 
Mens Sana Monographs  2013;11(1):25-41.
In 1952, the Diagnostic and Statistical Manual of Mental Disorders (DSM) system of creating, validating, studying and employing a diagnostic system in clinical psychiatric practice was introduced. There have been several updates and revisions to this manual and, regardless of its a theoretical framework, it actually does have a framework and presupposition. Essentially the DSM dictates that all psychiatric disorders are syndromes, or a collection of symptoms that commonly occur together and impair psychosocial functioning. These syndromes allow for homogenous groups of patients to be studied and psychotherapies and pharmacotherapies to be developed. This editorial will examine the DSM system with regards to its applicability to central nervous system dysfunction where psychiatric disorders are concerned. Specifically, the brain does not follow categorical, or syndromal, constructs. In fact, the psychiatric patient likely inherits several risk genes that promote abnormal proteins along several neuropathways in the brain. These abnormalities create dysfunctional neurocircuits which create individual psychiatric symptoms, but not a categorical syndrome or diagnosis. The concept that the DSM may be excellent for clinical diagnostic purposes, but less correct in its assumptions for a psychopharmacologist's treatment approaches will be discussed.
PMCID: PMC3653225  PMID: 23678236
Diagnostic systems; Neuroimaging; Neuroscience; Psychopharmacology
6.  Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder 
Journal of clinical psychopharmacology  2013;33(3):10.1097/JCP.0b013e3182900c6f.
We sought to understand the association of specific aspects of care satisfaction, such as patients’ perceived relationship with their psychiatrist and access to their psychiatrist and staff, and therapeutic alliance with participants’ likelihood to adhere to their medication regimens among patients with bipolar disorder.
We examined data from the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder, an effectiveness study investigating the course and treatment of bipolar disorder. We expected that participants (n = 3037) with positive perceptions of their relationship with their psychiatrist and quality of psychopharmacologic care, as assessed by the Helping Alliance Questionnaire and Care Satisfaction Questionnaire, would be associated with better medication adherence. We utilized logistic regression models controlling for already established factors associated with poor adherence.
Patients’ perceptions of collaboration, empathy, and accessibility were significantly associated with adherence to treatment in individuals with bipolar disorder completing at least 1 assessment. Patients’ perceptions of their psychiatrists’ experience, as well as of their degree of discussing medication risks and benefits, were not associated with medication adherence.
Patients’ perceived therapeutic alliance and treatment environment impact their adherence to pharmacotherapy recommendations. This study may enable psychopharmacologists’ practices to be structured to maximize features associated with greater medication adherence.
PMCID: PMC3873324  PMID: 23609394
therapeutic alliance; clinical practice; medication adherence; bipolar disorder; treatment
7.  SMARTS (Systematic Monitoring of Adverse events Related to TreatmentS): The development of a pragmatic patient-completed checklist to assess antipsychotic drug side effects 
Antipsychotic drug side effects are common and can cause stigmatisation, decreased quality of life, poor adherence, and secondary morbidity and mortality. Systematic assessment of anticipated side effects is recommended as part of good clinical care, but is uncommon in practice and patients may not spontaneously report side effects. We aimed to develop a simple patient-completed checklist to screen systematically for potential antipsychotic side effects.
The SMARTS checklist was developed over a series of group meetings by an international faculty of 12 experts (including psychiatrists, a general physician and a psychopharmacologist) based on their clinical experience and knowledge of the literature. The emphasis is on tolerability (i.e. assessment of side effects that ‘trouble’ the patient) as subjective impact of side effects is most relevant to medication adherence. The development took account of feedback from practising psychiatrists in Europe, the Middle East and Africa, a process that contributed to face validity.
The SMARTS checklist assesses whether patients are currently ‘troubled’ by 11 well-established potential antipsychotic side effects. Patients provide their responses to these questions by circling relevant side effects. An additional open question enquires about any other possible side effects. The checklist has been translated into Italian and Turkish.
The SMARTS checklist aims to strike a balance between brevity and capturing the most common and important antipsychotic side effects. It is appropriate for completion by patients prior to a clinical consultation, for example, in the waiting room. It can then form the focus for a more detailed clinical discussion about side effects. It can be used alone or form part of a more comprehensive assessment of antipsychotic side effects including blood tests and a physical examination when appropriate. The checklist assesses current problems and can be used longitudinally to assess change.
PMCID: PMC3896136  PMID: 24490026
antipsychotics; checklist; rating scale; side effects; tolerability
8.  Towards a framework for treatment effectiveness in schizophrenia 
Prompt administration of antipsychotic treatment that is adhered to is essential for the optimal treatment of schizophrenia. Many patients have benefited from the advent of second-generation antipsychotics, which can offer good symptomatic control with reduced incidence of extrapyramidal symptoms, although with higher risk of metabolic side effects. It is unsurprising that accounts as to whether first- and second-generation antipsychotics differ in their efficacy vary, since treatment effectiveness is a broad notion and difficult to define.
Numerous factors may be used to gauge treatment effectiveness and, while it has largely been defined in terms of improvements in four domains (symptoms of disease, treatment burden, disease burden, and health and wellness), the real-world clinical utility of this consensus is unclear. Therefore, this article aims to provide a framework that can aid psychiatrists in making assessments about treatment effectiveness.
Methods and results
A panel of 12 psychiatrists and psychopharmacologists convened to develop and propose an accessible and globally-applicable framework for assessing the effectiveness of antipsychotic treatments in patients with schizophrenia. Following presentation of a preliminary proposal to a wider group of psychiatrists from across Europe, it was refined into a framework comprising five domains: symptomatic remission and retention of treatment; affective symptoms; cognitive functioning; treatment satisfaction; and personal and social functioning – each of which is discussed in this article.
This article provides a framework that can aid psychiatrists in making assessments about treatment effectiveness. It is anticipated that the framework outlined here may contribute to improving clinical practice through the promotion of a patient-centered approach to the assessment of treatment effectiveness, using five specified domains, in patients with schizophrenia.
PMCID: PMC4181746  PMID: 25285010
antipsychotic; assessment scales; functioning; mental illness; satisfaction
9.  Split-Care Patients and Their Caregivers 
This study assessed the experiences of patients receiving split-care treatment, focusing on communication between the two treating professionals and its impact on patient satisfaction. Studies have documented that for more than 20% of patients, no communication occurs between providers, and the present study provides further data. Split-care patients completed a 23-item questionnaire on SurveyMonkey via Mechanical Turk, a crowd-sourcing Website, assessing patients’ split-care experiences, including whether their providers had communicated and the impact of communication on patients’ satisfaction with treatment. Of respondents who knew if their providers communicated, 30% reported that no communication occurred. Similarly, 30% and 36% of respondents were never asked by their psychotherapist or psychopharmacologist, respectively, for permission to speak to the other professional. Non-communication yielded significantly lower patient satisfaction with treatment. This study replicates the high frequency of non-communication between providers of split care and has great implications for the impact of communication on treatment compliance and outcome.
PMCID: PMC4452006  PMID: 25938507
Split care; split treatment; provider communication; patient satisfaction with split care

Results 1-9 (9)