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      The Emerging Role of Clinical Pharmacopsychology


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          Clinical pharmacopsychology is an area of clinical psychology that is concerned with the application of clinimetric methods to the assessment of psychotropic effects of drugs on psychological functioning, and the interaction of such drugs with specific or non-specific treatment ingredients. Clinical pharmacopsychology derives its data from observational and controlled studies on clinical populations and refers to the therapeutic use of medical drugs, not to the effects of substances used for other purposes.


          Domains and operational settings of clinical pharmacopsychology are illustrated.


          The domains of clinical pharmacopsychology extend over several areas of application which encompass the psychological effects of psychotropic drugs (with particular emphasis on subclinical changes), the characteristics that predict responsiveness to treatment, the vulnerabilities induced by treatment (i.e., side effects, behavioral toxicity, iatrogenic comorbidity), and the interactions between drug therapy and psychological variables. A service for clinical pharmacopsychology is here proposed as an example of the innovative role of clinical psychology in medical settings.


          Clinical pharmacopsychology offers a unifying framework for the understanding of clinical phenomena in medical and psychiatric settings. Its aim is to provide a comprehensive assessment of the clinical important changes that are concerned with wanted and expected treatment effects; treatment-induced unwanted side effects; and the patient's own personal experience of a change in terms of well-being and/or quality of life. It is now time to practice clinical pharmacopsychology, creating ad hoc services in Europe.


          • Clinical pharmacopsychology assesses the effects of medications on psychological functioning

          • Since clinical psychologists visit medicated patients, a comprehensive clinical evaluation is crucial

          • Vulnerabilities induced by psychotropic drugs are an important area of application of clinical pharmacopsychology

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          Most cited references54

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          The WHO-5 Well-Being Index: a systematic review of the literature.

          The 5-item World Health Organization Well-Being Index (WHO-5) is among the most widely used questionnaires assessing subjective psychological well-being. Since its first publication in 1998, the WHO-5 has been translated into more than 30 languages and has been used in research studies all over the world. We now provide a systematic review of the literature on the WHO-5.
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            The Safety, Tolerability and Risks Associated with the Use of Newer Generation Antidepressant Drugs: A Critical Review of the Literature.

            Newer generation antidepressant drugs (ADs) are widely used as the first line of treatment for major depressive disorders and are considered to be safer than tricyclic agents. In this critical review, we evaluated the literature on adverse events, tolerability and safety of selective serotonin reuptake inhibitors, serotonin noradrenaline reuptake inhibitors, bupropion, mirtazapine, trazodone, agomelatine, vilazodone, levomilnacipran and vortioxetine. Several side effects are transient and may disappear after a few weeks following treatment initiation, but potentially serious adverse events may persist or ensue later. They encompass gastrointestinal symptoms (nausea, diarrhea, gastric bleeding, dyspepsia), hepatotoxicity, weight gain and metabolic abnormalities, cardiovascular disturbances (heart rate, QT interval prolongation, hypertension, orthostatic hypotension), genitourinary symptoms (urinary retention, incontinence), sexual dysfunction, hyponatremia, osteoporosis and risk of fractures, bleeding, central nervous system disturbances (lowering of seizure threshold, extrapyramidal side effects, cognitive disturbances), sweating, sleep disturbances, affective disturbances (apathy, switches, paradoxical effects), ophthalmic manifestations (glaucoma, cataract) and hyperprolactinemia. At times, such adverse events may persist after drug discontinuation, yielding iatrogenic comorbidity. Other areas of concern involve suicidality, safety in overdose, discontinuation syndromes, risks during pregnancy and breast feeding, as well as risk of malignancies. Thus, the rational selection of ADs should consider the potential benefits and risks, likelihood of responsiveness to the treatment option and vulnerability to adverse events. The findings of this review should alert the physician to carefully review the appropriateness of AD prescription on an individual basis and to consider alternative treatments if available.
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                Author and article information

                Clin Psychol Eur
                Clinical Psychology in Europe
                Clin. Psychol. Eur.
                28 June 2019
                : 1
                : 2
                : 32158
                [a ]Department of Health Sciences, University of Florence , Florence, Italy
                [b ]Department of Psychiatry & Neuropsychology, Maastricht University , Maastricht, the Netherlands
                [c ]Department of Psychology, University of Bologna , Bologna, Italy
                [d ]Department of Psychiatry, State University of New York at Buffalo , Buffalo, NY, USA
                [5]Philipps-University of Marburg, Marburg, Germany
                Author notes
                [* ]Department of Psychology, University of Bologna, viale Berti Pichat, 5 40127 Bologna, Italy. giovanniandrea.fava@ 123456unibo.it

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY) 4.0 License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 04 December 2018
                : 17 January 2019
                Self URI (journal-page): https://journals.psychopen.eu/
                Scientific Update and Overview

                clinical service,psychopharmacology,psychotropic medication,antidepressant drugs,clinical pharmacopsychology


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