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NbN3
NbN3 Vs. Waco Guide- Psychopharmacology

NbN3 與 Waco Guide- Psychopharmacology 使用情況與統計

It has become clear that the current pharmacological nomenclature of psychotropic medications does not reflect our contemporary knowledge, nor does it inform properly the clinician of neuroscience-based prescriptions. Very often we prescribe “antidepressants” for “anxiety” disorders or “second-generation antipsychotics” to depressed patients. This practice is confusing. • Five international organizations ECNP, ACNP, AsCNP, CINP & IUPHAR decided five years ago to establish a taskforce and gave it the mission to embed our current neuroscience advances in the nomenclature. • The scope is to include all the medications with CNS indications and to harness this new nomenclature to help clinicians when they are trying to figure out what would be the next rational “neuropsychopharmacological step”. • In this second edition 22 new medications were added so NbN includes now 130 medications. This proposed nomenclature aims to reflect the current pharmacological knowledge base and cannot necessarily represent the ultimate scientific truth. The taskforce that assembled could have taken the stand that our current knowledge base is not enough to define the primary target or the correct mechanisms of action. But as a taskforce, we feel that it’s better to present a cutting-edge scientific interpretation than to wait for the definitive conclusion. We need to treat our patients now, and we cannot postpone treatment until all the facts are known. Therefore this nomenclature is based on: 1. The need to treat now. 2. Updated neuroscience insights. 3. The judgment of the members of the taskforce. Along these lines, we have come up with the following proposal: The Nomenclature: Pharmacology and Mode of Action – reflects the current knowledge and understanding about the targeted neurotransmitter/ molecule/system being modified and the mode/mechanism of action. We also added 4 additional dimensions 4 Additional Dimensions: Approved Indications – based on the recommendations of major regulatory bodies (e.g. FDA, EMA, etc.) Efficacy and Side Effects – Driven from positive single, large, RCT and/or “heavy solid weight” clinical data. Only prevalent or life-threatening side effects were included Practical Note – Summarizes the clinical knowledge that has been "filtered" through the taskforce's "sieve" Neurobiology – This dimension is focused on the biology. It is divided into preclinical and clinical sections, with the emphasis on the latter For those who would like to know more abo derived from empirical data.ut the pharmacology, there is a direct link to the relevant site of IUPHAR – our collaborator in this endeavour. As this is on-going process, we recognize that the product is imperfect. Based on your feedback (and taking into account the feedback of other colleges) new reports and findings, appropriate updates (e.g. later editions) will be undertaken.

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Waco Guide- Psychopharmacology

The Waco Guide to Psychopharmacology in Primary Care is a tool developed by faculty of the Waco Family Medicine Residency in consultation with faculty of the Massachusetts General Hospital Psychiatry Academy. Tools combine top-level evidence and expert opinion from world-renowned psychiatrists with primary care expertise from one of the nation’s premier family medicine training programs. This resource is intended for use in communities where the mental and behavioral health needs outpace psychiatric specialty resources. Ideal for primary care clinicians, including physicians, nurse practitioners, and physician assistants. The tools succinctly reflect standard and advanced primary care mental health practices and psychopharmacology for: • Adult • Pediatric & Adolescent • Geriatric • Perinatal and Women’s Mental Health • Substance Use Disorders Special Population considerations offering individually tailored pharmacotherapy recommendations include: • Obesity • Cardiac Impairment • Renal Impairment • Hepatic Impairment • Geriatric Why use The Waco Guide? • High-yield, evidence-based psychopharmacology • In office usability at the point-of-care to enhance medical decision making • Common language and framework for integrated and collaborative care practices • Tools account for cost and medication availability • Titration schedules, monitoring recommendations, and a list of side effects accompany each tool Treatment recommendations for the following disorders: Adult: • Major Depressive Disorder • Anxiety Disorders— Panic Disorder, Generalized Anxiety Disorder, Social Anxiety Disorder • Bipolar Disorder • Posttraumatic Stress Disorder • Acute and Chronic Insomnia • Schizophrenia Spectrum and Other Psychotic Disorders • Acute Stress Disorder • Anorexia Nervosa • Antipsychotic Side Effect Management • Binge Eating Disorder • Bulimia Nervosa • Fibromyalgia • Intermittent Explosive Disorder • Neuropsychiatric Dementia • Obsessive-Compulsive Disorder • Tobacco Use Disorder • ADHD Pediatric & Adolescent Decision Support Tools • ADHD • Depression • Generalized anxiety • Bipolar disorder • Psychosis • Anorexia Nervosa • Binge Eating • Bulimia Nervosa • Autism Spectrum Disorder • Opioid Use Disorder Perinatal (Preconception, Antepartum, and Postpartum)/Women’s Mental Health: • Sexual Interest/Arousal Disorder • Obsessive Compulsive Disorder • Premenstrual Dysphoric Disorder • SSRI-Induced Sexual Dysfunction • Antepartum Tobacco Use Disorder Substance Use Disorders: • Alcohol Use Disorder • Antepartum Alcohol Use Disorder • Tobacco Use Disorder • Benzodiazepine Deprescribing • Opioid Use Disorder • Stimulant Use Disorder The decision support tools included are designed to be informational and to reflect current accepted practices at the time of publication. These tools are not intended to replace professional medical judgment or treatment of specific conditions. Heart of Texas Community Health Center (dba Waco Family Medicine) and the authors accept no responsibility for any damages, obligations, losses, liabilities, costs or expenses arising from use of the decision support tools contained herein. By using this app, you acknowledge that you have reviewed the above and accept these terms.