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Clinical Manual of Psychopharmacology in the Medically Ill, Second Edition

Edited by James L. Levenson, M.D., and Stephen J. Ferrando, M.D.

  • ISBN 978-1-58562-501-7
  • Item #62501

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The new edition of Clinical Manual of Psychopharmacology in the Medically Ill continues the legacy and builds on the success of the first edition by offering a thoroughly up-to-date, comprehensive, and practical guide to the prescription of psychotropic medications in patients with medical illness. The book addresses the prevalence of psychiatric illness in patients with serious medical illness, the complications that may arise, and the implications for psychopharmacological treatment. There is increasing recognition that patients with medical and psychiatric comorbidity have more functional impairment, disability days, emergency department use, rehospitalization, and other medical care costs than do those without such comorbidity. As a result, health care systems have been incentivized to develop new and innovative models of population-based care that integrate medical and psychiatric care in an effort to increase quality and prevention while decreasing use of expensive services such as emergency department visits and hospitalizations. The book is a valuable guide for clinicians across a range of specialties operating in this new, more demanding health care environment.

The manual addresses critically important topics through the use of a variety of user-friendly features:

  • Psychiatric drugs that have become available since the first edition, as well as all recent relevant randomized controlled trials, systematic reviews, and meta-analyses, are covered thoroughly.
  • Each chapter addresses key differential diagnostic considerations and adverse neuropsychiatric side effects of disease-specific medications.
  • Disease-specific pharmacokinetic principles in drug prescribing, including interactions between psychotropic drugs and disease-specific drugs, are also addressed.
  • Key summary points pertaining to psychotropic prescribing in the specific medical disease(s) or specialty area covered are included at the end of each chapter, and a multitude of useful tables summarizing the most important information are provided as well.
  • Chapters are heavily referenced with source information should readers wish to expand their knowledge in a specific area.

The chapter authors were selected for their expertise in each area, then the text was edited for consistency, clarity, and maximum utility. Clinical Manual of Psychopharmacology in the Medically Ill is a rigorous and illuminating guide to this vital topic, and clinicians from a variety of specialties will find it indispensable.


  • Contributors
  • Dedication
  • Acknowledgments
  • Introduction
  • Part I: General Principles
  • Chapter 1. Pharmacokinetics, Pharmacodynamics, and Principles of Drug-Drug Interactions
  • Chapter 2. Severe Drug Reactions
  • Chapter 3. Alternative Routes of Drug Administration
  • Part II: Psychopharmacology in Organ System Disorders and Specialty Areas
  • Chapter 4. Gastrointestinal Disorders
  • Chapter 5. Renal and Urological Disorders
  • Chapter 6. Cardiovascular Disorders
  • Chapter 7. Respiratory Disorders
  • Chapter 8. Oncology
  • Chapter 9. Central Nervous System Disorders
  • Chapter 10. Endocrine and Metabolic Disorders
  • Chapter 11. Obstetrics and Gynecology
  • Chapter 12. Infectious Diseases
  • Chapter 13. Dermatological Disorders
  • Chapter 14. Rheumatological Disorders
  • Chapter 15. Surgery and Critical Care
  • Chapter 16. Organ Transplantation
  • Chapter 17. Pain Management
  • Chapter 18. Substance Use Disorders
  • Index


    Margaret Altemus, M.D.
    Rosalind M. Berkowitz, M.D.
    Philip A. Bialer, M.D.
    Jozef Bledowski, M.D.
    E. Cabrina Campbell, M.D.
    Jason P. Caplan, M.D.
    Stanley N. Caroff, M.D.
    Michael R. Clark, M.D.
    Catherine C. Crone, M.D.
    Catherine Daniels-Brady, M.D.
    Andrea F. DiMartini, M.D.
    Marian Fireman, M.D.
    Madhulika A. Gupta, M.D.
    J. Greg Hobelmann, M.D.
    Christopher P. Kogut, M.D.
    Jennifer Kraker, M.D.
    Jeanne Lackamp, M.D.
    Stephan C. Mann, M.D.
    Michael Marcangelo, M.D.
    Sahil Munjal, M.D.
    Mallay Occhiogrosso, M.D.
    Kimberly N. Olson, CRNP
    Adam P. Pendleton, M.D.
    Peter A. Shapiro, M.D.
    Yvette L. Smolin, M.D.
    Wendy Thompson, M.D.
    Robert M. Weinrieb, M.D.
    Shirley Qiong Yan, Pharm.D.

About the Authors

James L. Levenson, M.D., is Professor of Psychiatry, Medicine, and Surgery and Vice-Chair for Clinical Services in the Department of Psychiatry at Virginia Commonwealth University School of Medicine in Richmond, Virginia.

Stephen J. Ferrando, M.D., is Professor of Psychiatry and Chairman of the Department of Psychiatry at Westchester Medical Center Health Network of New York Medical College in Valhalla, New York.

Psychiatric disorders and medical illness are often comorbid. Psychopharmacological treatment thus poses several efficacy and safety challenges. This manual covers the main—if not all of—the needs that psychiatrists and medical specialists have in the psychopharmacological treatment of medical patients. It is extraordinary well documented, updated, and precise. The manual is both a very useful resource for the clinician and a clear educational tool for students. This second, enriched new edition promises an even better success than the previous one.—Prof. Massimo Biondi, M.D., Full Professor of Psychiatry, Director of Postgraduate School in Psychiatry, Department of Neurology and Psychiatry, SAPIENZA University of Rome

The first edition of this book was an instant must have for all psychiatrists, whether they treat patients with comorbid medical conditions or not. The second edition of the Manual is even better, updated and another must have book for all psychiatrists. The evidence supporting the use for or against a medication in a particular medical illness is reviewed succinctly. I particularly liked the Key Points at the end of each chapter as they provided a summary of the take home messages. Congratulations to the authors and editors for producing such a valuable textbook.—Philip R. Muskin, M.D., M.A., DLFAPA, Professor of Psychiatry at CUMC, Chief of Service: Consultation-Liaison Psychiatry, NYPH-Columbia Campus/Allen, Lawrence & Milstein Hospitals, Chair: APA2017 Scientific Program Committee

(This manual) is a timely, highly pragmatic, thorough, and essential volume for psychosomatic medicine (PSM). Thoughtfully dedicated to their late colleague and collaborator James Owen (who was an author on several chapters), the book takes a clinically and scientifically grounded approach to the myriad challenges of the management of co-morbid psychiatric and systemic illness. This volume should be available to every PSM psychiatry service and should also be of interest to the general psychiatrist who is expected to function in a PSM role on occasion.—James A. Bourgeois, O.D., M.D., Clinical Professor, Psychiatry, Weill Institute for Neurosciences, Department of Psychiatry/Langley Porter Psychiatric Institute, University of California, San Francisco, San Francisco, CA

As patients live longer medical comorbidity has become exceedingly common with various psychiatric disorders, including major depression and bipolar disorder. Indeed, some of our primary treatments for these disorders may actually lead to this comorbidity because of biological consequences of specific pharmacology agents. Thus, today we can no longer easily separate medical and psychiatric disorders in our approaches to specific patients. Indeed, a wider knowledge of the interface is needed for everyday practice. In this vein we need to consider medical status when prescribing psychotropic agents. The Second Edition of this Manual helps all of us to practice better and is a must read. Its first edition was an enormous step forward for the field and this Second Edition will only bring us further up to date on how best to prescribe psychotropic drugs in treating co-morbid patients.—Alan F. Schatzberg, M.D., Kenneth T. Norris, Jr., Professor, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine

This is a particularly useful tool for those in medical training. It is well organized by topic, with clear explanations and uncomplicated language. It also provides sufficient background information for each topic, starting with very basic concepts, making it ideal for those at the beginning of residency training. The charts and diagrams throughout the book are probably the strongest features. I tend to prefer online resources for day-to-day practice, given the ability to easily access them and the (possibly false) belief that they are more relevant or up to date than print resources. However, I will keep this book out, as its appendixes and tables are superior to what I have found in commonly used online sites. Also, the relevance to pharmacokinetic interactions and quick comparison to other medications would both require a more time-intensive search online to get a similar depth of information. I would highly recommend this book to anyone treating patients with psychiatric and medical comorbidities.—Shayna Bailey, M.D., Doody's Book Review

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