# 01 - Drugs Used in Psychiatry

# Drugs Used in Psychiatry

Drugs Used in Psychiatry
This guide contains color reproductions of some commonly prescribed psychotherapeutic
drugs. This guide mainly illustrates proprietary tablets and capsules. A † preceding the
name of a drug indicates that other doses are available. Check directly with the
manufacturer. (Although the photos are intended as accurate reproductions of the drug, this
guide should be used only as a quick identification aid.)

COLOR PLATE 1.2-3
Emotional facial expressions.1 In the 1960s, Paul Ekman demonstrated that facial
expressions of emotion are universal and thus, presumably, biological in origin as
Charles Darwin once theorized (Ekman & Friesen, 1975). Since Ekman’s discovery,
photographs of emotional expressions have been widely used in psychological research
to understand how people recognize another’s emotions. Neuroimaging research has
focused on two areas that are involved in emotion recognition: (A) The amygdala,
known to be involved in fear conditioning, is most active when recognizing fear
compared to other facial expressions (Whalen, 1998). (B) The anterior insula, associated
with taste processing, subserves the recognition of another’s disgust (Calder, Lawrence,
& Young, 2001). (From Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s Comprehensive
Textbook of Psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.)
1Development of the MacBrain Face Stimulus Set was overseen by Nim Tottenham and
supported by the John D. and Catherine T. MacArthur Foundation Research Network on
Early Experience and Brain Development.

COLOR PLATE 1.2-6
Map of quantitative blood flow obtained in a healthy individual with arterial spin
labeling magnetic resonance imaging. (From Sadock BJ, Sadock VA, Ruiz P. Kaplan &
Sadock’s Comprehen sive Textbook of Psychiatry. 9th ed. Philadelphia: Lippincott Williams
& Wilkins; 2009.)
COLOR PLATE 1.2-7
Three-dimensional reconstruction based on diffusion data acquired on a 3-T General
Electric scanner, Department of Radiology, Brigham and Women’s Hospital, Harvard
Medical School, Boston, MA. Diffusion tensor imaging (DTI) image shows major long
fiber tracts of the brain. (Courtesy of Hae-Jeong Park, Ph.D., at the Laboratory of
Molecular Neuroimaging, Department of Diagnostic Radiology, Yonsei University
College of Medicine, Seoul, South Korea.)
COLOR PLATE 1.2-8
Three-dimensional image reconstructed based on diffusion data acquired on a 3-T
General Electric scanner, Brigham and Women’s Hospital, Harvard Medical School,
Boston, MA, which shows several major white matter fiber bundles identified through
diffusion tensor imaging: Fornix (magenta), right cingulum (green), right inferior

longitudinal fasciculus (yellow), right uncinate fasciculus (blue), corpus callosum
(orange). (Courtesy of Sylvain Bouix, Ph.D., Psychiatry Neuroimaging Laboratory,
Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School,
Boston, MA.)
COLOR PLATE 1.4-16
This figure from the Human Connectome Project is a resting-state functional magnetic
resonance (rfMRI) spatial map of functional connectivity of cortical signals, which show
strong and distinct patterns of activation. The term “connectome” refers to the mapping
of connectivity throughout the brain using imaging modalities such as rfMRI and
diffusion MRI. rfMRI is used to study connectivity in the brain by acquiring fMRI data
from a subject lying “at rest” in the scanner, and utilizing the fact that the spontaneous
time series from functionally related brain regions are correlated. (Courtesy of Stephen
M. Smith, M.D.)
COLOR PLATE 1.7-5
The Human Karyotype. The normal human genetic material contains two copies of the
3,000,000,000 DNA-base genomic sequence packaged into 22 matched pairs of
autosomes and X and Y sex chromosomes. Here the human karyotype has been stained
using different colored chromosome-specific probes. Identical twins share identical

copies of genomic DNA. (Adapted from Bentley D. The Geography of Our Genome.
Supplement to Nature, 2001, with permission.)
COLOR PLATE 5.8-4
Functional MRI during rhyming tasks in normal people and people with dyslexia. The
left hemisphere is depicted in green. Normal (top) and dyslexic (bottom) subjects were
shown two letters and asked to determine whether the letters rhymed (B-T) or not (B-K).
To perform the task, the subjects had to translate the letters into sounds, or phonemes,
(/bee/,/lee/), then compare only the rhyming part of the phonemes (/ee/). In normals,
three contiguous areas were activated, including Broca’s area, Wernicke’s area, and the
intervening insula. In those with dyslexia, only Broca’s area was activated. Dyslexic
patients required much more time to complete the task and were more prone to make
errors. (Reprinted with permission from Frith C, Frith U. A biological marker for
dyslexia. Nature. 1996;382:19.)

COLOR PLATE 1.8-5
Topographic quantitative electroencephalography map of theta absolute power (z score
departures from normative database mean). The patient is a male 24 years of age with
a closed head injury. The focus of increased theta voltage is at the locus of an earlier
head injury that occurred approximately 2 years before the recording. After recording
and quantification, the color bar scale was adjusted to maximize the bull’s-eye
localization effect. Theta voltage was also elevated to a lesser extent over a wide, right
frontal area and even spread somewhat across the midline. Theta relative power (not
shown) was also elevated over the right frontal region, but mapping did not produce a
sharp relative power focus at the locus of injury. Important note: A very sharply defined
bull’s eye can also be produced by artifact from a faulty electrode, and it is imperative
to monitor electrical impedance and check the integrity of the electrode in the event
that deviant activity appears confined to only one lead with no spread to adjoining
electrodes. (From Sadock BJ, Sadock VA, Ruiz P. Kaplan & Sadock’s Comprehensive
Textbook of Psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.)

COLOR PLATE 5.8-5
Stages of the superimposition of a single photon emission computed tomography
cerebral blood flow image (A), which has been redefined (B), and a magnetic resonance
T1-weighted image (C), to produce a combination (D). (Reprinted from Besson JAO.
Magnetic resonance imaging and its application in neuropsychiatry. Br J Psy chiatry.
1990;(9 Suppl):25–37, with permission.)
COLOR PLATE 9.1-1
Statistical map of functional magnetic resonance imaging (fMRI) blood oxygenation
level–dependent signal intensity differences demonstrating significantly increased
activity in the right amygdale in subjects with posttraumatic stress disorder (PTSD)
compared with traumatized subjects without PTSD. The response to masked, fearful
faces in PTSD and non-PTSD groups were compared after normalizing to masked, happy
faces. fMRI data are displayed in Talairach template space and are co-registered with
structural magnetic resonance imaging data.

COLOR PLATE 13.5-1
Exophthalmos. This patient has Graves’ disease. Note the lid retraction and proptosis.
COLOR PLATE 13.6-2
Factitial ulcerations. These were created by the patient. Note their geometric
appearance.
COLOR PLATE 29.18-1
Erythema multiforme minor caused by hypersensitivity to certain antiepileptic drugs in
psychiatry (e.g. lamotrigine).