Subject: Mental Health Nursing

Topic of assignment : Factor Affecting On Mental Health

& mental illness
Psychopharmaco dynamic
Submitted To : Madam Zunaira khadam
Submitted By : Muhammad Saif Ullah
Dated : 03-05-2024
Class : Bsn (Generic) 3rd Year
Semester 6
University : The Superior University
Department of Nursing ,
Kalma Chowk, Lahore

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Objectives
At the end of this lecture the student’s will be able to
 To introduce & define mental health and mental illness
 To Describe biological, sociocultural and interpersonal factors and their
impact on mental health and mental illness
 Discuss stress and adaptation, and its relationship with mental health and
mental illness

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Contents
• Introduction to mental health
• Definition of mental health
• Definition of mental illness
• Discuss the Biopsychosocial model of mental health
• Discuss Factors affecting mental health
• Discuss Factors affecting mental illness
• Define Stress and adaptation
• Stress and adaptaton, and its relationship with mental health and
mental illness
• The General Adaptation Syndrome
• Coping Mechanism
• References

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 MENTAL HEALTH

INTRODUCTION
Mental health is an integral and essential component of mental health .
Good mental health is when an individual can think clearly, solve problems they face in life, enjoy
happy relationships and feel spiritually at ease.
Mental illness
Mental illness is anything that affects a person’s thoughts, emotions or behaviour that results in:
• a negative effect on the person or those around him/her,
• an obvious change in their personality,
• friends or relatives feel that what is happening to the person is strange and hard to
understand

Biopsychosocial model
• George Libman Engel
• (December 10, 1913 – November 26, 1999)
• American Psychiatrist proposed this model in 1977
• Biological – (e.g. genetics, brain chemistry and brain damage)
• Social – (e.g. life traumas and stresses, early life experiences and family relationships)
• Psychological – (e.g. how we interpret events as signifying something negative about ourselves

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Factors affecting mental illness
• According to the biopsychosocial model, mental health is the result of many forces occurring at
different which have a cumulative effect on the individual.
• These forces can be positive or negative.

• If the negatives out way the positives then a person could develop a mental illness.

Biological Factors
 There are certain genes that are known to trigger mental health disorders.

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  Environmental triggers, such as alcohol abuse or a stressful home environment, would be
another factor

Sociocultural Factors
 Children develop attitudes and behavioral patterns from past experiences.
 The home being the first environment of the children influences their behavior
and attitude.
 The community in which an individual belongs may contribute to the
development of his/her mental health.
Schools and religious institutions may also help in molding child’s personality.
Interpersonal factors
 Loneliness is feeling sad about being by yourself, particularly over a long period of time.
 Grief is a natural response to loss.
Examples of loss may include:
 death of a loved one
 the end of a relationship
 a miscarriage
 loss of a job
 Physical harm - threats of self/physical harm, smashing things, hurting pets
 Social - controlling where you go and who you see
 Stalking – repeated threatening or harassing behavior such as following someone, making
excessive phone calls, texts or emails to them
 Emotional and psychological harm - humiliation, put downs and blaming
 Financial - strict or unfair control of money
 Verbal - name calling, yelling
 Sexual assault - and rape

 Spiritual or cultural - controlling practices or choices.

✓ According to their timing in relation to the illness, they can be
said to;
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  a)predispose the person to the illness,
 b)precipitate it or,
 c)perpetuate it:

Stress and adaptation, and its relationship with mental health and
mental illness
Stress
• Stress is a feeling of emotional or physical tension. It can come from any event or thought
that makes you feel frustrated, angry, or nervous.
• Stress is your body's reaction to a challenge or demand. In short bursts, stress can be
positive, such as when it helps you avoid danger or meet a deadline.

Stressors
• The change or stimulus that evokes this state is the stressor.

• The nature of the stressor is variable; an event or change that will produce stress in one
person may be neutral for another, and an event that produces stress at one time and
place for one person may not do so for the same person at another time and
place.
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Adaptation
• A person appraises and copes with changing situations. The desired goal is adaptation,or
adjustment to the change so that the person is again in equilibrium and has the energy and
ability to meet new demands.
• This is the process of coping with the stress, a compensatory process with physiologic and
psychological components.

STRESSORS
External Internal
Deaths Expectations
Injuries Demands
Illnesses Misperceptions
Relationship breakdown Fear
Being a victim of crime Anger
Retirement

The General Adaptation Syndrome

• In the 1930s, 1940s, and 1950s Hans Selye enlarged on Cannon’s fight-or-flight hypothesis
to describe the general adaptation syndrome (GAS).
• The GAS describes how the body responds to stressors through the alarm reaction, the
resistance stage, and the exhaustion stage.
• GAS can be triggered either directly by a physical event or indirectly by a psychological
event
(Lazarus, 1999)

Definition of General Adaptation Syndrome

• The GAS is an immediate physiological response of the body to stress and involves several
body system, especially the Autonomic Nervous system and the Endocrine system.
• Stages of GAS:
1. Alarm Reaction (acute short term intense response)
2. Resistance stage (chronic long term, less intense response)
3. Exhaustion stage (body no longer to resist stressors)

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Types of Stress
• Selye identified two types of Stress:
1. Distress, or damaging stress
2. Eustress, stress that protects health. Eustress is motivating energy, such as
happiness, hopefulness, and purposeful movement.
There are many other types of stress:
• Work stress
• Family stress
• Chronic stress
• Acute stress

• Trauma
Coping
• Coping is the person's effort to manage psychological stress. Effectiveness of coping
strategies depends on individual’s needs.
• Factors which effect coping
– Intensity
– Scope duration
– Number and nature other stressors
• Personnel Characteristics:
– Level of personnel control
– Availability of social support
– Feelings Competence

Coping Mechanism
Psychological Adaptive Behavior
• Psychological adaptive behavior are also called
Coping mechanism.

• Such mechanism can be task oriented involving the use of direct problem-
solving techniques to cope with the threats.
Strategies to Improve Coping

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 – Regular exercise
– Support system
– Time management
– Progressive Muscle relaxation
– Assertiveness training
– Journal writing
– Stress management

Stress and Mental Health

 Stress-related disorders result from abnormal responses to acute or prolonged anxiety,
and can include obsessive-compulsive disorder and post-traumatic stress disorder.
 When you are stressed you may behave differently. For example, you may become
withdrawn, indecisive or inflexible. You may not be able to sleep properly 10. You may
be irritable or tearful.
 There may be a change in your sexual habits 11.Some people may resort to smoking,
consuming more alcohol, or taking drugs 12. Stress can make you feel angrier or more
aggressive than normal
 When stressed, some people start to experience headaches, nausea and indigestion. You
may breathe more quickly, perspire more, have palpitations or suffer from various
aches and pains.

Adaptation and Mental Health

 A primary function of the brain is to drive adaptation of the organism to its environment:
learning, memory, attachment, fear, aggression, etc., are all manifestations of how the brain
directs adaptation to the environment.
 One touch of a flame in youth is sufficient to engrain a learned behavior that lasts a lifetime
despite the memory of the specific event having long dissipated.
 To mediate these behaviors, the brain itself must adapt its transcriptional, structural and
neurotransmission functions. This type of imprinted memory has been modelled in young.
 Two closely related concepts, resilience and resourcefulness, help people to cope with
stress and to minimize the effects of illness.
 Resilience is defined as having healthy responses to stressful circumstances or risky
situations (Hill, 1998).
 Resourcefulness involves using problem-solving abilities and believing that one can cope
with adverse or novel situations.

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 People develop resourcefulness through interactions with others, that is, through
successfully coping with life experiences (Krafcik, 2002)

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References
• Brunner, L.S., & Suddarth, D.S. (2010). Text Book of Medical- Surgical Nursing (9th
Edition). Philadelphia: Lippincott.
• Smelter, S.C., & Bare, B.G. (2010). Text book of Medical-Surgical Nursing (9th ed.).
Philadelphia: Lippincott.
• Mary C. Townsend (2014). Essentials of Psychiatric Mental Health Nursing Concepts of
Care in Evidence-Based Practice (6th Edi)., Chapter No.18 p.n 460-490
• Gail W. Stuart. Psychiatric nursing: Principles and practice of psychiatric nursing (7th
edi). Louis.
• Nagasu M, Muto K, Yamamoto I (2021) Impacts of anxiety and socioeconomic factors on
mental health in the early phases of the COVID-19 pandemic in the general population in
Japan

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 Psychopharmaco Dynamic

Objectives
• To introduce Psychopharmacology
• To discuss classification and science of
Psychopharmacology
• To discuss the effects, pharmacodynamics &
Pharmacokinetics of Psychopharmacology
• Describe indications, ,contraindication, precautions, side effects, and nursing intervention
for the following classifications of drugs:
- Antipsychotic agents
- Antianxiety drugs
- Antidepressants drugs

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CONTENTS
 Introduction to Psychopharmacology
 Classification of Psychopharmacology
 Science of Psychopharmacology
 Effects of Psychopharmacology
 pharmacodynamics &
Pharmacokinetics of Psychopharmacology
 Antipsychotic agents
 Antianxiety drugs
 Antidepressants drugs
 Sedative-Hypnotics
 ADHD Through The Life Cycle Drugs

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Introduction
• Psychopharmacology is the study of the regulation and stabilization of emotions, behavior,
and cognition through the interactions of endogenous signaling substances or chemicals in
the brain, such as acetylcholine, dopamine, glutamate, norepinephrine, or serotonin, with
drug.
(Wilcox & Gonzales,1998).

Clinical psychopharmacology
• It is the study of drug effects in clients and the expert use of drugs in the treatment of
psychiatric conditions.
• Abnormalities in emotions, behavior, and cognition are assumed to be caused by
biochemical alterations of neurotransmitters and their functions in the brain.

Classifications of psychotropic agents:

Psychoactive or psycho- therapeutic drugs:
• Antipsychotic agents/neuroleptics
• Antianxiety agents
• Antidepressants
• Stimulants used as mood elevators
• Antimanic agents used as mood stabilizers

Miscellaneous drugs
• Anticonvulsants used as mood and behavior stabilizers
• Anti-parkinsonism or anticholinergic agents that are used to alleviate extrapyramidal
symptoms or adverse effects of psychotropic agents

THE SCIENCE OF PSYCHOPHARMACOLOGY

The science of psychopharmacology focuses on neurotransmission. The sending of
impulses from one neuron to another across the synapse via the aid of specific substances
called neurotransmitters.

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 • Neurotransmitters -chemicals such as acetylcholine, dopamine, glutamate,
norepinephrine, and serotonin reside in tiny sacs at the end of axons, the long tube-like
parts of neurons, and are released when electrical impulses pass along the axon.
• Receptor: molecules situated on the cell membrane that are binding sites for
neurotransmitter

Six steps in synaptic transmission

These steps include:
1. Synthesis
2. Vesicular uptake
3. Transmitter release
4. Receptor binding
5. Cellular uptake
6. Transmitter metabolism.
Each of these steps offers a potential target for therapeutic intervention by a drug.

Effects of psychopharmacology

1. Primary effects occur as a drug is synthesized, released, and metabolized and as it acts on
the receptor sites of a neurotransmitter system
• I.e. noradrenaline, acetylcholine, dopamine, serotonin, glutamate, or GABA).
• For example, the antidepressant agent, sertraline (Zoloft), an SSRI, blocks the action of the
serotonin receptor site in the central nervous system (CNS).
2. Secondary effects result from interactions among the neurotransmitters, neuropeptides, and
hormones as they influence each other’s function in the brain.

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 • For example, the anti-parkinsonism agent, levodopa, a natural precursor of dopamine,
exerts a tonic inhibitory effect on the release of acetylcholine.
3. Tertiary effects are the final changes in the clinical symptoms induced by a drug, such as the
stabilization of anxiety or depression
(Khan, 1999; Shaddock & Shaddock, 2008).

Pharmacodynamics and Pharmacokinetics

 Pharmacodynamics:
Pharmacodynamics refers to the effects of a drug on the body
• Potency of a drug refers to the relative dosage of a drug that is required to achieve
a desired effect.
• Clinical efficacy refers to the maximum clinical response achievable by the
administration of a specific drug.
• Median effective dose is the dosage at which 50% of clients experience a specific
therapeutic effect when prescribed a certain psychotropic drug.
• Blood levels below the median effective dose are associated with a poor response
to the specific drug.
• Median toxic dose is the dosage at which 50% of clients experience a specific toxic effect
when taking a prescribed drug.
• Blood levels above the median dose may precipitate a toxic state.
• Therapeutic index or therapeutic window has been defined as the ratio of the median
effective dose to the median toxic dose.
• Tolerance refers to the need for markedly increased amounts of a specific drug over time
to achieve the same desired effect.

Pharmacokinetics
Pharmacokinetics is the study of movement of drugs and their metabolites through body by the
process of drug absorption, distribution, metabolism and excretion/ elimination.
How the body handles the drug.
• The peak plasma concentration is defined as the greatest accumulation of the drug in the
plasma. It varies depending upon the route of administration and rate of absorption of the
drug.
• Drug half-life refers to the amount of time it takes for metabolism and excretion to reduce
the plasma concentration of a specific drug by half.
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 • First-pass effects describe the initial metabolism of an orally administered drug within the
hepatic circulation and the fraction of the absorbed drug that reaches systemic circulation
unmetabolized.
• For example, drugs administered sublingually enter the blood- stream directly and avoid
first-pass effects.
• Clearance refers to the amount of a drug excreted from the body in a specific period of
time.

Antipsychotic agents
Primarily used for to treat psychosis, such as
• Schizophrenia
• Schizoaffective disorder
• Delusional disorder
• Mood disorder with psychosis and

• Psychoses associated with delirium and dementia.

Indication
• Impaired communication or the inability to relate to others,
• Delusions
• Hallucinations
• lack of responsiveness to external stimuli
• Inability to identify reality.
• Confusion
• Behavior problems
• Personality disorders.
• Anxiety, tension, agitation, dizziness, intractable hiccups

Mode of action (MOA)

• Antipsychotic agents provide symptom control by blocking the dopamine receptors in the
brain.

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 • Dopamine is a chemical messenger that regulates thinking, emotion, behavior, and
perception.
• Excess amounts of dopamine cause nerve impulses in the brain stem to be transmitted faster
than normal, resulting in strange thoughts, hallucinations, and bizarre behavior.
• Blocking dopamine activity lessens or prohibits the development of such thoughts and
behaviors.

Adverse effect
• Blurred vision
• Constipation
• Drowsiness
• Dry mouth

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 • GI disturbances
• Insomnia
• Hypoglycemia or hyperglycemia
• Libido changes (sexual dysfunction)
• Tachycardia
• Akathisia
• Acute dystonia

Nursing intervention
• If antacids are needed, administer them either 2 hours before or 1 hour after administration
of the antipsychotic medication.
• Be aware that both olanzapine (Zyprexa) and risperidone (Risperdal-M-TAB) come in an
orally disintegrating form; therefore, monitor the client’s compliance to ensure adequate
absorption.
• Do not administer antipsychotic drugs subcutaneously unless specifically ordered.
• If a client is noncompliant, expect to administer the antipsychotic drug intramuscularly.
• Know that antipsychotic agents may provoke seizures in clients with seizure disorders.

• Closely observe the client receiving antipsychotic drugs for Therapeutic effects of the
drugs, such as decreased agitation, decreased hallucinations and also for the adverse effect.

Client education
• The nurse informs clients taking antipsychotic medication about the types of side effects
that may occur and encourages clients to report such problems to the physician instead of
discontinuing the medication.
• The nurse teaches the client methods of managing or avoiding unpleasant side effects and
maintaining the medication regimen.
• Drinking sugar-free fluids and eating sugar-free hard candy ease dry mouth.
• The client should avoid calorie-laden beverages and candy because they promote dental
caries, contribute to weight gain, and do little to relieve dry mouth.
• Methods to prevent or relieve constipation include exercising and increasing water and
bulk-forming foods in the diet.
• If the client forgets a dose of antipsychotic medication, he or she can take the missed dose
if it is only 3 or 4 hours late.

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 • If the dose is more than 4 hours overdue or the next dose is due, the client can omit the
forgotten dose.
• The nurse encourages clients who have difficulty remembering to take their medication to
use a chart and to record doses.

Antianxiety Drugs (Anxiolytics)

• Indication
• Anxiety and anxiety disorders
• Insomnia
• OCD
• Depression
• Posttraumatic stress disorder

• Alcohol withdrawal.

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Mechanism of Action
• Benzodiazepines mediate the actions of the amino acid GABA, the major inhibitory
neurotransmitter in the brain.
• Because GABA receptor channels selectively admit the anion chloride into neurons,
activation of GABA receptors hyperpolarizes neurons and thus is inhibitory.
• Benzodiazepines produce their effects by binding to a specific site on the GABA receptor.
• Buspirone is believed to exert its anxiolytic effect by acting as a partial agonist at serotonin
receptors, which decreases serotonin turnover.
(Arniel &Mathew, 2007).

Side effect
• Drowsiness, confusion, lethargy.
• Physical & psychological dependence

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 • Ability to potentiate the effect of other CNS depressants.
• Possibility of aggravating symptoms in depressed persons
• Dry mouth
• Nausea / vomiting
• Orthostatic hypertension

Nursing intervention
• Administer the daily dose at bedtime to promote sleep, minimize adverse effects, and allow
more normal daytime activities to occur.
• Observe for therapeutic effects.
• Observe for adverse effects such as oversedation, hypotension, pain at the injection site,
skin rashes.
• When administering antianxiety agents parenterally, do not administer solutions that are
cloudy or contain a precipitate.

• Be alert for possible drug-drug interactions.

Client Education
• Clients need to know that antianxiety agents are aimed at relieving symptoms such as
anxiety or insomnia but do not treat the underlying problems that cause the anxiety.
• Benzodiazepines strongly potentiate the effects of alcohol: One drink may have the effect
of three drinks.
• Therefore, clients should not drink alcohol while taking benzodiazepines.
• Clients should be aware of decreased response time, slower reflexes, and possible sedative
effects of these drugs when attempting activities such as driving or going to work.
• Benzodiazepine withdrawal can be fatal.

• After the client has started a course of therapy, he or she should never discontinue
benzodiazepines abruptly or without the supervision of the physician.

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Antidepressant Drugs
Indication
Primarily used in the treatment of
• Major depressive illness
• Anxiety disorders
• The depressed phase of bipolar disorder
• Psychotic depression.
Off-label uses of antidepressants include the treatment of
• Chronic pain, migraine headaches, peripheral and diabetic neuropathies, sleep
apnea, dermatologic disorders, panic disorder, and eating disorders.

Classifications
Antidepressants are divided into four groups:
1. Tricyclic and the related cyclic antidepressants
2. Selective serotonin reuptake inhibitors (SSRIs)
3. MAO inhibitors (MAOIs)
4. Other antidepressants such as bupropion (Wellbutrin).

Antidepressant drugs
Selective Serotonin Reuptake Inhibitors
• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
Cyclic Compounds
• Imipramine (Tofranil)
• Desipramine (Norpramin)
Monoamine Oxidase Inhibitors
• Phenelzine (Nardil)

• Tranylcypromine (Parnate)

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Other Compounds
• Bupropion (Wellbutrin)
• Venlafaxine (Effexor)

MECHANISM OF ACTION
• The precise mechanism by which antidepressants produce their therapeutic effects is not
known, but much is known about their action on the CNS.
• The major interaction is with the monoamine neurotransmitter systems in the brain,
particularly norepinephrine and serotonin.
• Both of these neurotransmitters are released throughout the brain and help to regulate
arousal, vigilance, attention, mood, sensory processing, and appetite.
• Norepinephrine, serotonin, and dopamine are removed from the synapses after release by
reuptake into presynaptic neurons.
• After reuptake, these three neurotransmitters are reloaded for subsequent release or
metabolized by the enzyme MAO.
• The SSRIs block the reuptake of serotonin
• The cyclic antidepressants and venlafaxine block the reuptake of norepinephrine primarily
and block serotonin to some degree

• The MAOIs interfere with enzyme metabolism.

Side effects of SSRIs Cyclic Antidepressants
• Anxiety • Dry mouth
• Agitation, • Constipation
• Akathisia (motor restlessness) • Urinary hesitancy or retention
• Nausea • Dry nasal passages
• Insomnia • Blurred near vision.
• sexual dysfunction • Agitation
• weight gain. • Delirium
• Ileus may occur, particularly in
older adults.
• Orthostatic hypotension
• Sedation
• Weight gain
• Tachycardia.

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Side Effects of MAOIs
• Daytime sedation
• Insomnia
• Weight gain
• Dry mouth
• Orthostatic
• Hypotension
• Sexual dysfunction.
Drug Interactions
• An uncommon but potentially serious drug interaction, called serotonin
syndrome (or serotonergic syndrome)
• It can result from taking an MAOI and an SSRI at the same time.
• It also can occur if the client takes one of these drugs too close to the end of
therapy with the other.
• one drug must clear the person’s system before initiation of therapy with the
other.
Symptoms
• Agitation, sweating, fever, tachycardia, hypotension, rigidity, hyperreflexia,
and, in extreme reactions, even coma and death (Krishnan, 2006).
• These symptoms are similar to those seen with an SSRI overdose.
Nursing intervention
• Monitor vital signs to detect potential adverse effects such as hypertension,
hypotension, arrhythmias, or infection during therapy.
• Establish safety precautions if CNS changes such as confusion, drowsiness,
incoordination, or weakness occur.

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 • Administer medication with food to decrease adverse GI effects such as
anorexia and GI upset.
• Expect to administer lower doses or administer the drugs less frequently if the
client is older.
• Do not administer serotonin with MAOI administration.
• Monitor liver and hepatic function tests in clients with a history of liver or
renal impairment.
• Monitor the client closely for possible overdose and have medications readily
available should signs and symptoms occur.
• Take drugs exactly as prescribed. Never attempt to alter the dosage.
Client education
• Clients should take SSRIs first thing in the morning unless sedation is a
problem; generally, paroxetine most often causes sedation.
• If the client forgets a dose of an SSRI, he or she can take it up to 8 hours after
the missed dose.
• To minimize side effects, clients generally should take cyclic compounds at
night in a single daily dose when possible.
• If the client forgets a dose of a cyclic compound, he or she should take it
within 3 hours of the missed dose or omit the dose for that day.
• Clients should exercise caution when driving or performing activities
requiring sharp, alert reflexes until sedative effects can be determined.
• Clients taking MAOIs need to be aware that a life threatening hyperadrenergic
crisis can occur if they do not observe certain dietary restrictions.
• They should receive a written list of foods to avoid while taking MAOIs.
• when taking MAOIs and instruct them not to take any additional medication,
including over-the-counter preparations, without checking with the physician

ADHD Through The Life Cycle Drugs Used For Treatment

• Drugs most used are various forms of

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: a) Ritalin (methylphenidate)(Various forms, Concerta)
b) Dextro-amphetamines (Various forms)
c) Tricyclics and/or antihipertensives
d) Wellbutrin, Clonidine, neuroleptics etc
e) Monoamine oxidase inhibitors (effective but very dangerous, particularly in
children)
f) Focalin and Ritalin La g) Atomoxetine (Strattera)
Sedative-Hypnotics

What are Sedative-Hypnotics

• Tranquilizers may be a more familiar term used to describe sedative-hypnotic
agents
• Downer drugs
• Drugs that take the edge off
• Calm your mood when you are feeling anxious
• Induce sleep (1)
Benzodiazepines
• Most frequent class of drugs that have a tranquilizing-type effect
• Prescription drugs
Taking the Drugs
• This class of drugs is fairly safe when taken for their intended use and not used in
excess (1)
• Most sedatives come in capsules or tablets
• Multi-colored
• Liquid and injection forms are also available
• The use of benzodiazepines can lead to abuse, whether they are taken
properly or for the wrong reasons
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Benzodiazepine Pharmacology
• CNS Depressant
• The major action of the benzodiazepine drug class is focused in the brain
• Can cross the blood brain barrier (BBB)
• Easy access to the brain where the drugs exert their effect
• Affects other body systems as well
• Heart
• Acts on different sites (receptors) of the heart
• Benzodiazepines act on the GABA system in the brain
• Increase function
Withdrawal Symptoms
• Tachycardia – increase in heart rate
• Severe headaches
• Panic attacks can occur
• Tremors
• Changes in perception – not fully in tune with, or aware of, everything going
on around you
• Weight loss
Client education
• One of the aims of client education is to reduce RECIDIVISM: the tendency to
relapse into a previous mode of behaviour requiring readmission to a treatment
programme
• Assess learning capacity – especially with chronically ill patients – and use most
relevant and appropriate teaching method
• Explore cognitive, psychological, cultural, personal and social factors affecting
attitudes and beliefs concerning medication

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REFRENCES

 AuthorLastName, A. A. (Year). Title of the book. Publisher.Example:Smith, J. D. (2018).

Psychopharmacology: Fundamentals. Academic Press
 Johnson, R. S., & White, A. L. (2020). Advances in psychopharmacology research. Jour-
nal of Psychopharmacology, 25(4), 123-135.
 Davis, P. (2018, April). The future of psychopharmacology. Psychology Today, 41(2),
36-41.
 American Psychiatric Association. (2022, March 20). Introduction to psychopharmacol-
ogy. Retrieved from https://www.psychiatry.org/psychopharmacology/introduction
 Brown, M. S. (2017). Psychopharmacology in clinical practice. In P. Johnson (Ed.), Clin-
ical Psychopharmacology (pp. 45-68). Springer.
 https://web2.aabu.edu.jo/tool/course_file/lec_notes/1001442_Psychopharmacology.pdf

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