psychopharmacology algorithms

Harvard South Shore Psychiatry Residency Program

The book presents a node‑based algorithm for first‑episode schizophrenia, recommending amisulpride, aripiprazole, risperidone, and ziprasidone as first‑line agents while discouraging olanzapine and quetiapine due to metabolic risks. It emphasizes adequate trial periods before moving to subsequent treatment nodes and advises against first‑line use of typical antipsychotics because of movement disorder risks. Separate sections address bipolar disorder, highlighting lithium’s superior monotherapy sustainability, and discuss the speed of antidepressant response, noting mirtazapine’s relatively rapid onset and fluoxetine’s slower effect. The guidance integrates meta‑analyses and clinical observations to support decision‑making in psychopharmacology.