Indian Psychiatric Society Publication
Editor
PK Singh MBBS (AIIMS) MD (PGIMER)
Professor and Head Department of Psychiatry Patna Medical College Patna, Bihar, India
Headquarters
Jaypee Brothers Medical Publishers (P) Ltd
4838/24, Ansari Road, Daryaganj
New Delhi 110 002, India
Phone: +91-11-43574357
Fax: +91-11-43574314
Email: jaypee@jaypeebrothers.com
Overseas Office
J.P. Medical Ltd
83 Victoria Street, London
SW1H 0HW (UK)
Phone: +44 20 3170 8910
Fax: +44 (0)20 3008 6180
Email: info@jpmedpub.com
Website: www.jaypeebrothers.com
Website: www.jaypeedigital.com
© 2020, Jaypee Brothers Medical Publishers and Indian Psychiatric Society
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale .
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Advancing Frontiers of Psychiatric Therapeutics
First Edition: 2020
9789389776560
Printed at:
fm_5CONTRIBUTORS
- Anil Kakunje DPM MD
- Professor and head
- Department of Psychiatry
- Yenepoya Medical College
- Mangaluru, Karnataka, India
- AQ Jilani MD DNB DM (Geriatric Mental Health)
- Assistant Professor
- Department of Psychiatry
- Era's Lucknow Medical College
- Lucknow, Uttar Pradesh, India
- Ashlesha Bagadia MRCPsych FRANZCP
- Perinatal Psychiatrist and Psychotherapist
- The Green Oak Initiative Community
- Mental Health Centre
- Bengaluru, Karnataka, India
- Aswin Krishnan Ajit MD
- Director and Consultant Psychiatrist
- Dhanya Doctors Chamber
- Centre for Neurobehavioral Disorders
- Kochi, Kerala, India
- Bikash R Behera MS MCh FSFN
- Fellow (Stereotactic and Functional Neurosurgery)
- Jaslok Hospital and Research Centre
- Mumbai, Maharashtra, India
- BN Gangadhar MBBS MD
- Professor of Psychiatry
- Director
- National Institute of Mental Health and
- Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Chethan Basavarajappa DNB
- Assistant Professor
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Debasish Sanyal MD
- Professor and Head
- Department of Psychiatry
- KPC Medical College
- Kolkata, West Bengal, India
- Hemant Bhargav
- MBBS Diploma in Community Mental Health MD
- (Yoga and Rehabilitation) PhD (Yoga)
- Assistant Professor of Yoga
- Department of Integrative Medicine
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Indla Ramasubba Reddy MD DPM
- Director
- Vijayawada Institute of Mental Health and Neurosciences
- Vijayawada, Andhra Pradesh, India
- Jahnavi Kedare MBBS MD
- Associate Professor
- TNMC and BYL Nair Charitable Hospital
- Mumbai, Maharashtra, India
- Jitender Jakhar MBBS MD
- Senior Resident
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Kabir Garg MD MRCPsych
- Highly Specialized OCD/BDD
- services and Community Eating Disorder Services
- Hertfordshire Partnership University NHS Foundation Trust, UK
- Kaustav Chakraborty MD DNB
- Associate Professor and Head
- Department of Psychiatry
- College of Medicine and
- JNM Hospital, WBUHS
- Konasale M Prasad MD
- Department of Psychiatry
- University of Pittsburgh
- School of Medicine
- Pittsburgh, Pennsylvania, USA
- Manoj Shettar MD
- Assistant Professor
- Department of Psychiatry
- SDM Medical College
- Dharwad, Karnataka, India
- Meha Jain MPhil (Clinical Psychology)
- Child Psychologist
- Department of Pediatrics
- All India Institute of Medical Sciences
- Patna, Bihar, India
- Mohd Aleem Siddiqui MD DPM
- Professor
- Department of Psychiatry
- Era's Lucknow Medical College and Hospital
- Lucknow, Uttar Pradesh, India
- Nand Kumar MD
- Professor and In-charge
- Department of Psychiatry
- Neuromodulation
- All India Institute of Medical Sciences
- New Delhi, India
- Naresh Nebhinani MD DNB
- Associate Professor
- All India Institute of Medical Sciences
- Jodhpur, Rajasthan, India
- Nishitha Jasti BNYS MSc (Yoga)
- Research Associate
- Department of Integrative Medicine
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Pankaj Kumar MD
- Associate Professor and Head
- Department of Psychiatry
- All India Institute of Medical Sciences
- Patna, Bihar, India
- Paresh K Doshi MS MCh
- Director
- Department of Neurosurgery
- Jaslok Hospital and Research Centre
- Mumbai, Maharashtra, India
- PK Singh MBBS (AIIMS) MD (PGIMER)
- Professor and Head
- Department of Psychiatry
- Patna Medical College
- Patna, Bihar, India
- Pooja Patnaik Kuppili
- Assistant Professor
- Department of Psychiatry
- Sri Venkateshwaraa Medical College Hospital and Research Centre
- Puducherry, India
- Rajeev Ranjan MD
- Assistant Professor
- Department of Psychiatry
- All India Institute of Medical Sciences
- Patna, Bihar, India
- Rakesh K Chadda
- MBBS MD FAMS FRCPsych DFAPA
- Professor and Head
- Department of Psychiatry
- Chief, National Drug Dependence Treatment Centre
- All India Institute of Medical Sciences
- New Delhi, India
- Rashmi Arsappa MBBS MD
- Assistant Professor
- Department of Psychiatry
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Ravi Gupta MD PhD
- Certified Sleep Physician (WSF)
- Additional Professor
- Department of Psychiatry
- All India Institute of Medical Sciences
- Rishi Gupta MD
- Senior Resident
- Department of Psychiatry
- Chief, National Drug Dependence Treatment Centre
- All India Institute of Medical Sciences
- New Delhi, India
- Ruksheda Syeda MBBS DPM
- Psychiatrist
- Trellis Family Centre
- Mumbai, Maharashtra, India
- Sai Krishna Tikka MD DPM
- Assistant Professor
- Department of Psychiatry
- All India Institute of Medical Sciences
- Raipur, Chhattisgarh, India
- Sai Spoorthy Mamidipalli MD
- Senior Resident
- Department of Psychiatry
- All India Institute of Medical Sciences
- Raipur, Chhattisgarh, India
- Santosh Kumar MD DNB Fellowship in Geriatric Mental Health
- Associate Professor
- Department of Psychiatry
- Nalanda Medical College
- Patna, Bihar, India
- Saurabh Kumar MD
- Assistant Professor
- Department of Psychiatry
- Patna Medical College
- Patna, Bihar, India
- Shahul Ameen MD
- Consultant Psychiatrist
- St Thomas Hospital
- Changanassery, Kerala, India
- Shivarama Varambally MBBS MD
- Professor of Psychiatry and Head
- Department of Integrative Medicine
- National Institute of Mental Health and Neurosciences (NIMHANS)
- Bengaluru, Karnataka, India
- Smita N Deshpande MD DPM
- Senior Consultant and Professor
- Department of Psychiatry
- De-Addiction Services and
- Resource Center for Tobacco Control
- Centre of Excellence in Mental health
- Atal Bihari Vajpayee Institute of
- Medical Sciences and
- Dr Ram Manohar Lohia Hospital
- New Delhi, India
- Varun S Mehta MD DNB MRCPsych
- Associate Professor
- Department of Psychiatry
- Central Institute of Psychiatry
- Ranchi, Jharkhand, India
- Vijendra Nath Jha MD
- Assistant Professor
- Department of Psychiatry
- Darbhanga Medical College
- Darbhanga, Bihar, India
- Vishal Indla MD DNB
- Director
- Vijayawada Institute of Mental Health and Neurosciences
- Vijayawada, Andhra Pradesh, India
- Vishwajit L Nimgaonkar MD
- Professor of Psychiatry and
- Human Genetics
- Director
- Program for Genetics and Psychosis
- University of Pittsburgh
Health professionals are known for their healing touch. Their identity, authority, respectability and livelihood, all revolves around this healing touch. There used to be a time when healing touch was a simple touch, but advances of civilization and burgeoning power of science, this touch has evolved to include almost the universe. It has become more remote, multifaceted and complex. Despite all this the personal touch, however, have to be maintained.
The chapters embodied in this book Advancing Frontiers of Psychiatric Therapeutics are diverse and cover almost all aspects of current psychiatric therapeutics comprehensively. Our learned authors have tried intelligently and diligently to explore the different facets and interfaces of varied psychiatric therapeutics that have emerged in recent times. These newer paradigms and strategies will definitely empower mental health professional to become a more effective therapist. It is revealing to go through various chapters of this book to get a glimpse of the possibilities that are yet to be fully utilized for the care and help of people who are afflicted with mental disorders. This is of great practical and everyday importance. We are sure that all you will find it of great value.
The Publication Committee, especially Professor PK Singh needs to be appreciated for this novel update. We must put on record that his contributions as Chair of this committee are historic. The book has been beautifully produced and for this M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, deserves a big thank you.
Long live Indian Psychiatric Society (IPS).
Mrugesh Vaishnav
President, IPS
PK Dalal
President-elect, IPS
Vinay Kumar
fm_11Preface
We, the mental health professionals, are constantly engaged in providing freedom from pain and suffering to all seekers of help for mental health issues through our armoury of varied therapeutic tools. This skill of inducting therapy is in fact the ultimate arbiter of our acceptance, respect and power in society as well as our source of livelihood. Different therapeutic paradigms are actually weapons in our hands for our adaptive struggle against all diseases and disorders that are integral part of our life. There immediate aim is freedom from suffering but larger aim is to increase the survival potential of human race as a member of the biosphere. Simultaneously, it also influences their quality of living as well as their productive and creative potentials. It is this linkage of therapy with life that provides justification and meaningfulness to all our related scientific and para-scientific activities, be it hard-core research or their applications in the community.
All systems in the universe, which includes our own species, have a natural tendency to move towards disorderliness. Even though there are naturally occurring, inbuilt homeostatic regulatory mechanisms to take care of this tendency, but often they prove to be inadequate and require to be supplemented by externally introduced, man-made interventions which require constant investment of time, energy and various other resources. There is a constant race and struggle between the order and the disorder. Therapeutic sciences play the role of tilting the balance in favor of orderliness.
The phenomenon of mind itself has hitherto remained inadequately unexplored and continues to remain a perpetual mystery. Mental disorders can be understood properly only when we are able to make some headway in understanding the true nature of mind. Complexity of human mind is reflected in the equally complex nature of its disorders which require varied inputs of a very wide spectrum to reclaim orderliness. Despite our ignorance about the primary order, the disorders of mind continue to be felt in everyday life because of the distress and dysfunctions associated with it and therefore need to be rectified. In fact, the insights gained through our attempts at successfully treating mental disorders, allow us to retrospectively extrapolate them in trying to understand the true nature of mind.
For last several years Indian Psychiatric Society (IPS) has been publishing a series of books annually under a generic heading of “Different Strokes” with varied themes and topics for internal circulation. Last year it was decided to focus on the theme of therapeutics where all knowledge seems to converge. In the book, we had tried to bring together some completely new and innovative therapeutic strategies along with the newer versions of older established treatment strategies. This ranges from spirituality to psychosurgery, from fm_12recent drugs to drug-assisted psychotherapy, from pharmacogenomics to stem-cell therapy, from cognitive enhancers to antiviral therapy, from issues related to integration of pharmacotherapy and psychotherapy to issues of polypharmacy, from nutraceuticals to psychobiotic therapy, from cosmetic psychopharmacology to therapeutic role of sleep and exercise, from management of resistant auditory hallucination to non-pharmacological management of psychotic disorders. There are a few more topics from the cutting edge interface of advancing frontier that has been included in the book. We are extremely thankful to all our esteemed and erudite authors for having spared enough time out of their extremely busy schedules, to write outstanding chapters on topics which are mostly unconventional.
Seeing the warm reception and also relevance of this theme, we decided to go for larger circulation of this book to a much wider audience. We are thankful to Jaypee Brothers Medical Publisher, a recognized and established name in the field of medical publishing in India and abroad, to come to our help for this venture. Without their forth-right cooperation and positive interest, this book in its present form would not have seen the light of the day. We express our gratitude to them for the same. Our colleagues at Publication Subcommittee of IPS, Dr Shahul Ameen and Dr Naresh Nebhinani have always been very supportive, helpful and encouraging. Higher leadership of Indian Psychiatric Society, the President, the President-elect, and the Hon General Secretary have been a constant source of strength and support. Especially Dr Vinay Kumar, the present Hon General Secretary, who also happens to be the immediate-past Chairperson of the Publication Subcommittee, has always been a great source of help, support, encouragement, and guidance. With his exemplary dynamism and resourcefulness, he has proved to be a great problem-buster at all stages of this project. At the end, having gone through the ordeal, we have been able to come up with a rich bouquet of rare flowers in the form of this unique book, which we are confident, shall prove a great asset for all, the researchers as well as the practitioners of science of mental health.
Long live Indian Psychiatric Society.
PK Singh
fm_13Acknowledgments
I would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Nedup Denka Bhutia (Development Editor) and the publishing staff at M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their work in completing this book.fm_14fm_15fm_16