Psychiatry and Psychopharmacology Clinical Resource Center
Clinician-focused resources for depression, bipolar disorder, psychotic disorders, anxiety and PTSD, suicide-risk assessment, substance use, benzodiazepine tapering, ADHD, geriatric psychiatry, perinatal mental health, insomnia, psychotropic medication selection, therapeutic drug monitoring, organ-function dosing, adverse-effect management, and current GlobalRPh psychiatry reviews.
Clinical reference index
Psychiatric clinical domains
Clinical framework
Psychiatric treatment begins with diagnosis, safety assessment, functional impact, and longitudinal context
Psychiatric symptoms can arise from primary mental disorders, substance exposure, medication effects, sleep disorders, endocrine or neurologic disease, pain, cognitive disorders, trauma, psychosocial stressors, or combinations of these factors. Screening instruments can identify symptom burden or risk, but they do not replace a diagnostic interview, medical differential diagnosis, safety assessment, and clinical formulation.
We organize our Psychiatry resources by clinical problem rather than by medication class alone. Psychopharmacology is integrated with measurement-based care, psychotherapy, functional outcomes, adverse-effect monitoring, organ function, drug interactions, treatment adherence, patient preference, and referral or escalation when specialty care is indicated.
Benzodiazepine Tapering and Deprescribing
A multidisciplinary Joint Clinical Practice Guideline led by ASAM now provides a contemporary framework for determining when benzodiazepine risks outweigh benefits, selecting an appropriate level of care, tapering gradually, monitoring withdrawal, and individualizing the pace according to patient response. We place this guidance beside our older benzodiazepine converter rather than treating equivalence tables as a stand-alone tapering strategy.
FDA Removed the Clozapine REMS in 2025
FDA removed the Clozapine REMS effective June 13, 2025 after concluding that the restricted-distribution program was no longer necessary to ensure that benefits outweigh risks. Severe neutropenia remains a clinically important risk, and monitoring should follow current prescribing information and clinical judgment.
Screening tools, calculators, and medication decision support
Screening, dose conversion, therapeutic monitoring, and organ-function support
The existing Psychiatry portal combines validated screening instruments with medication calculators. We preserve those tools while making their purpose and limitations explicit.
Depression screening in older adults
- Geriatric Depression Scale – Short Version
- Geriatric Depression Scale – Long Version
- Geriatrics Portal
Antidepressant decision support
Benzodiazepines and alcohol
Therapeutic drug monitoring
Legacy status: antidepressant tools
Our antidepressant selection and organ-function pages contain useful comparative information but also include older sequencing assumptions, historical response estimates, older product data, and fixed treatment language. We have prioritized both pages for a current evidence and labeling review.
Legacy status: BAC and benzodiazepine equivalence
The BAC calculator is a population estimate and cannot determine actual intoxication or fitness to drive. The benzodiazepine converter is based substantially on older equivalence references and should not be used as an automatic cross-taper or withdrawal schedule.
Major depressive disorder and treatment-resistant depression
Diagnostic confirmation, measurement-based care, psychotherapy, pharmacotherapy, and advanced treatment
Depression management requires confirmation of diagnosis, assessment for bipolar disorder and psychotic features when clinically indicated, suicide-risk assessment, evaluation of medical or substance-related contributors, treatment preference, functional impairment, prior treatment, adherence, adverse effects, and systematic follow-up.
Current clinical guidance
GlobalRPh antidepressant resources
Treatment-resistant depression / advanced therapy
Bipolar disorder
Diagnosis, mania and hypomania, bipolar depression, maintenance, and medication monitoring
Bipolar disorder requires careful differentiation from unipolar depression, ADHD, substance-induced symptoms, personality disorders, sleep deprivation, and medical causes of mood or behavioral change. Treatment differs materially by current episode, severity, psychosis, suicidality, pregnancy status, prior response, and long-term recurrence risk.
Current bipolar guidance
GlobalRPh medication resources
Monitoring priorities
- Suicide risk and episode severity
- Sleep and behavioral activation
- Metabolic effects of antipsychotic therapy
- Renal and thyroid monitoring with lithium
- Hepatic, hematologic, reproductive, and interaction considerations for anticonvulsant mood stabilizers
Psychosis and schizophrenia
First-episode evaluation, antipsychotic treatment, clozapine, metabolic risk, and movement disorders
New psychosis requires assessment for primary psychotic illness, mood disorders with psychotic features, intoxication or withdrawal, delirium, neurologic disease, medication effects, endocrine or metabolic disorders, and other medical causes. Early specialty involvement and coordinated treatment are particularly important in first-episode psychosis.
Current schizophrenia guidance
GlobalRPh antipsychotic resources
Clozapine regulatory update
The REMS was removed effective June 13, 2025. Severe neutropenia remains a recognized risk and current prescribing information should guide monitoring and management.
Anxiety disorders and posttraumatic stress disorder
Diagnostic specificity, psychotherapy, pharmacotherapy, trauma-focused care, and benzodiazepine risk
Anxiety symptoms can occur in generalized anxiety disorder, panic disorder, PTSD, obsessive-compulsive disorder, depression, bipolar disorder, substance-related conditions, hyperthyroidism, arrhythmia, medication effects, and other medical syndromes. Treatment should be matched to the diagnosed condition.
PTSD guidance
Medication resources
Benzodiazepine deprescribing
Suicide risk, acute psychiatric safety, and emergency assessment
Risk identification, comprehensive assessment, acute management, and continuity after crisis
Suicide-risk assessment is a clinical process rather than a single score. Acute risk assessment should incorporate current thoughts and intent, plan and access to means, recent behavior, prior attempts, intoxication or withdrawal, psychosis, agitation, mood state, protective factors, treatment engagement, social context, and the reliability of available information.
Current suicide-risk guidance
GlobalRPh acute psychiatry reviews
Acute assessment priorities
- Medical stability and intoxication / withdrawal
- Suicidal and homicidal thoughts, intent, plan, means, and recent behavior
- Psychosis, mania, severe depression, agitation, catatonia, or delirium
- Capacity, ability to participate in safety planning, and treatment engagement
- Appropriate level of care, follow-up, and transition after acute evaluation
Substance use disorders and medication-related dependence
Alcohol, opioids, tobacco, sedative-hypnotics, withdrawal risk, and medication treatment
Substance-use treatment requires diagnosis of the specific disorder, assessment of intoxication and withdrawal risk, medical and psychiatric comorbidity, overdose risk, treatment readiness, evidence-based medication options when indicated, psychosocial treatment, and longitudinal follow-up.
Current SUD guidance
GlobalRPh substance-use resources
Modernization priority
Our Addiction Aids table contains older brand names, older OUD treatment language, and historical tobacco-treatment information. We plan to update current medications for alcohol, opioid, and tobacco use disorders, withdrawal management, naloxone, fentanyl-era overdose risk, organ-function dosing, pregnancy, and current federal prescribing requirements.
Attention-deficit / hyperactivity disorder
Developmental history, functional impairment, comorbidity, medication selection, and monitoring
ADHD diagnosis requires evidence of a persistent neurodevelopmental pattern with clinically significant impairment and appropriate developmental history. In adults, retrospective childhood history, comorbid mood or anxiety disorders, sleep problems, substance use, trauma, and medical causes of concentration difficulty require careful consideration.
GlobalRPh ADHD / stimulant resources
Pediatric ADHD guidance
Medication-table review status
Our stimulant table includes older products and non-ADHD weight-loss stimulants alongside current ADHD medications. We plan to reorganize it by indication and current product status and add cardiovascular assessment, misuse/diversion risk, sleep, appetite/weight, blood pressure, heart rate, growth in pediatric patients, and interaction monitoring.
Geriatric psychiatry
Depression, cognitive disorders, delirium, medication burden, falls, and late-life pharmacotherapy
Psychiatric symptoms in older adults require attention to cognitive impairment, delirium, sensory loss, grief, sleep, pain, medical illness, polypharmacy, anticholinergic burden, falls, renal and hepatic function, and the increased vulnerability to sedative and orthostatic adverse effects.
Depression screening
Medication burden / cognition
High-risk psychotropic patterns
- Long-term benzodiazepines and other sedative-hypnotics
- Anticholinergic psychotropics
- Multiple CNS depressants
- Orthostatic and QT-prolonging combinations
- Antipsychotics without a continuing documented indication
Perinatal psychiatry
Depression, anxiety, bipolar disorder, suicidality, postpartum psychosis, and medication risk-benefit assessment
Pregnancy and lactation do not eliminate the need to treat clinically significant psychiatric illness. Management requires individualized assessment of illness severity, relapse risk, prior response, medication-specific reproductive data, untreated-disease risk, lactation, patient preference, and coordination among psychiatric, obstetric, primary-care, and pediatric clinicians when appropriate.
ACOG screening and diagnosis
ACOG treatment and management
GlobalRPh pregnancy / lactation legacy page
This GlobalRPh page still uses the former FDA A/B/C/D/X pregnancy categories and requires a complete update to the current Pregnancy and Lactation Labeling Rule framework.
Sleep, insomnia, and psychiatric comorbidity
Insomnia assessment, CBT-I, psychiatric comorbidity, sedative burden, and sleep-disorder differential diagnosis
Insomnia can be a primary disorder or occur with depression, anxiety, bipolar disorder, PTSD, substance use, pain, medication effects, obstructive sleep apnea, restless legs syndrome, circadian disorders, or other medical conditions. Treatment should address the underlying sleep diagnosis and avoid reflexive long-term sedative escalation.
Current insomnia guidance
GlobalRPh sleep reviews
Sedative / hypnotic crossover
Psychopharmacology
GlobalRPh antidepressant, antipsychotic, stimulant, benzodiazepine, addiction, and movement-disorder references
We retain the medication tables from the existing Psychiatry portal and reorganize them by clinical role. Many pages contain useful dosing and pharmacology information but were developed across different eras of product labeling and require systematic modernization.
Mood and anxiety pharmacotherapy
Psychosis / bipolar pharmacotherapy
ADHD / substance-use pharmacotherapy
Organ-function and PK support
Medication safety
Current FDA safety resources
Alphabetical GlobalRPh drug index
Psychotropic medication monitoring and safety
Metabolic, neurologic, cardiovascular, laboratory, organ-function, interaction, and withdrawal monitoring
Psychotropic medication monitoring should be driven by the specific drug, indication, patient characteristics, comorbid disease, concurrent medications, and treatment duration. A medication list should be reviewed as a whole because adverse effects and interaction burden are often cumulative.
Metabolic / cardiovascular
- Weight and body composition when clinically relevant
- Blood pressure and heart rate
- Glucose / A1c and lipid monitoring for applicable antipsychotics
- QT and ECG assessment when drug- and patient-specific risk warrants
Neurologic / movement disorders
- Akathisia and drug-induced parkinsonism
- Acute dystonia
- Tardive dyskinesia
- Sedation, cognition, falls, and driving impairment
Laboratory / organ function
- Renal and hepatic function where medication-specific dosing requires it
- Lithium concentration, renal function, thyroid, and related monitoring
- Valproate and other mood-stabilizer laboratory monitoring as indicated
- Clozapine neutropenia monitoring according to current labeling and clinical circumstances
Interactions / CNS burden
- Opioids plus benzodiazepines or other sedatives
- Alcohol and sedating psychotropics
- Serotonergic combinations
- CYP inhibition / induction and smoking-related metabolism changes
- Anticholinergic and orthostatic burden
Withdrawal / discontinuation
Medication reconciliation
Confirm indication, actual use, duration, prescribers, adherence, PRN frequency, over-the-counter sedatives, cannabis or alcohol exposure, supplements, duplicate therapy, prior failed tapers, and medications prescribed to treat adverse effects of other psychotropics.
GlobalRPh Psychiatry article library
Current and established psychiatry reviews
The existing portal surfaces only a small set of older articles. We now include a broader portion of our Psychiatry archive, including current work on neuromodulation, sleep, pediatric mental health, ethics, digital psychiatry, ADHD, benzodiazepine deprescribing, collaborative care, and treatment resistance.
2026
GlobalRPh Psychiatry video library
Existing behavioral-health videos and priority clinician education topics
The current Psychiatry portal shows only two loneliness videos, while the main GlobalRPh video library contains additional mental-health material. We retain the existing content and identify priority topics for a structured psychiatry video library.
Existing Psychiatry videos
Priority psychiatry video topics
- Measurement-based depression care and treatment sequencing
- Bipolar depression versus unipolar depression
- First-episode psychosis and medical differential diagnosis
- Clozapine after removal of the REMS
- Benzodiazepine conversion versus benzodiazepine tapering
- Suicide-risk assessment beyond screening scores
- Psychotropic metabolic and movement-disorder monitoring
- Adult ADHD diagnostic pitfalls and stimulant monitoring
- Perinatal psychopharmacology and postpartum psychiatric emergencies
- CBT-I and reducing long-term sedative burden
Clinical content modernization
Priority updates within the GlobalRPh Psychiatry library
Our Psychiatry section contains useful psychopharmacology references and calculators, but many individual pages were created under older product, guideline, diagnostic, and regulatory frameworks. We plan to preserve useful dosing and comparative content while updating evidence, labeling, monitoring, terminology, and clinical positioning.
Priority resource reviews
- Antidepressant Drug Selection App: replace fixed class-sequencing assumptions with a contemporary diagnostic and measurement-based framework incorporating prior response, adverse-effect priorities, comorbidity, suicidality, bipolar screening, psychotherapy, advanced treatments, organ function, pregnancy, and patient preference.
- Antidepressants in Renal / Hepatic Dysfunction: systematically verify current labeling, active metabolites, dialysis considerations, hepatic impairment, dose limits, half-lives, drug interactions, and indication-specific dosing.
- Antidepressant Drug Table: review currently marketed formulations, new agents, current boxed warnings, QT considerations, serotonin toxicity, bleeding, hyponatremia, sexual adverse effects, weight effects, discontinuation risk, CYP interactions, pregnancy/lactation, and older-adult considerations.
- Antidepressant Discontinuation Syndrome: revise the older epidemiology and generic-substitution language, distinguish relapse from withdrawal, add drug-specific risk, tapering principles, fluoxetine bridging considerations where clinically appropriate, and current consensus terminology.
- Benzodiazepine Converter: retain approximate equivalence support while replacing older equivalence sources where possible and integrate the 2025 Joint Clinical Practice Guideline on tapering, withdrawal risk, level-of-care assessment, opioid/CNS-depressant risk, pregnancy, older adults, and patient-centered taper adjustment.
- Benzodiazepine Drug Table: separate benzodiazepines from non-benzodiazepine hypnotics, remove obsolete products, update current labeling and indications, clarify dependence and withdrawal, address falls/cognition, sleep-apnea risk, alcohol/opioid interactions, and current insomnia positioning.
- Antipsychotic Drug Table: update currently marketed oral and long-acting injectable products, clozapine after FDA REMS removal, metabolic risk, QT effects, prolactin, EPS, tardive dyskinesia, akathisia, orthostasis, anticholinergic burden, neutropenia, myocarditis, constipation/ileus, and indication-specific dosing.
- Tardive Dyskinesia: update the table beyond the original valbenazine monograph to include current VMAT2 treatment options, current labeling, CYP interactions, QT considerations, parkinsonism, Huntington disease distinctions, and systematic movement-disorder assessment.
- Stimulant / ADHD Drug Table: reorganize current ADHD medications separately from historical weight-loss stimulants, remove discontinued products, update cardiovascular monitoring, misuse/diversion risk, sleep, appetite/weight, pediatric growth, adult ADHD, and current labeling.
- Addiction Pharmacotherapy: update alcohol, opioid, and tobacco use disorder medications; modernize buprenorphine language; incorporate naloxone and fentanyl-era overdose risk; verify renal/hepatic dosing, pregnancy, and current federal prescribing requirements.
- Therapeutic Drug Levels: verify psychiatric therapeutic ranges and sampling guidance for lithium, valproate, carbamazepine, tricyclic antidepressants, and other monitored agents, with indication-specific interpretation and toxicity context.
- Geriatric Depression Scale Pages: preserve the validated instruments while improving language around screening versus diagnosis, cognitive impairment, functional assessment, grief, medical causes, and suicide-risk escalation.
- Psychotropic Medication Monitoring: develop a unified dashboard for metabolic, movement-disorder, QT, renal, hepatic, hematologic, endocrine, pregnancy, interaction, and sedative-burden monitoring.
- Perinatal Psychiatry: create a dedicated resource aligned with ACOG screening, treatment, postpartum psychosis, bipolar assessment, lactation, medication risk-benefit counseling, and current FDA Pregnancy and Lactation Labeling Rule principles.
- Suicide-Risk Assessment: add a clinician pathway based on the 2024 VA/DoD framework that separates screening from comprehensive assessment, addresses acute risk and level of care, and avoids presenting a numerical score as proof of safety.
- Sleep / Insomnia: align psychiatry sleep content with the 2025 VA/DoD insomnia guideline, CBT-I, sleep-disorder differential diagnosis, OSA crossover, and reduction of unnecessary chronic sedative exposure.
- Blood Alcohol Calculator: modernize the forensic and clinical context, clearly state uncertainty and population assumptions, remove any implication that a calculated BAC establishes actual legal impairment, and emphasize measured concentrations when clinically or legally required.
Current external clinical standards
Authoritative psychiatric and psychopharmacology guidance integrated with GlobalRPh resources
Psychiatric practice evolves through changing evidence, regulatory updates, new formulations, new safety data, and revised treatment frameworks. We therefore provide direct links to current professional guidance while progressively modernizing our individual Psychiatry resources.
Supporting GlobalRPh clinical resources
Neurology, geriatrics, pediatrics, pharmacokinetics, pain, toxicology, and laboratory support
Neurologic / cognitive crossover
Medication / organ-function support
Pain / substance / safety crossover
Rationale for retaining established psychiatry calculators and medication tables
Many GlobalRPh Psychiatry resources remain useful as comparative drug references, validated screening instruments, or longstanding clinical links. We are retaining those resources while modernizing product status, diagnostic framing, current guidelines, FDA labeling, organ-function dosing, withdrawal guidance, therapeutic monitoring, and medication-safety information.
Common LAB Values Renal Dosing
Internal Medicine Sections
- Cardiology
- Critical Care
- Dermatology
- Endocrinology
- ENT (Ear, Nose, Throat) + Cough/cold
- Gastroenterology
- Geriatrics
- Hematology
- Hepatology
- Infectious Disease
- Internal Medicine Sections
- Miscellaneous Medical Sections
- Nephrology
- Nutrition / Diet
- Oncology
- Pain Management / Palliative Care
- Pediatrics
- Pharmacokinetics – Calculators, Tools, Etc.
- Psychiatry
- Pulmonary
- Rheumatology
- Toxicology
- Urology
