When new mothers are admitted to the inpatient psychiatric unit, they might ask about the safety of taking psychiatric medications while breastfeeding.

Prenatal depression is common, affecting 10%–15% of pregnant patients.

Many of your patients will most likely have been exposed to significant trauma, such as adverse childhood experiences, domestic or sexual violence, and the hardships associated with homelessness or substance use.

Occasionally you will encounter patients who report having multiple personalities or distinct identities, also called alters. Formerly called “multiple personality disorder,” this condition is now termed dissociative identity disorder (DID). 

Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD).

Naltrexone, an opioid antagonist, is the first-line medication for alcohol use disorder (AUD)—though it is also approved for opioid use disorder (OUD).

Gabapentin is effective as an off-label medication to ease alcohol withdrawal symptoms and to reduce cravings over the long term in patients with alcohol use disorder (AUD).

Disulfiram is an aversive treatment, causing a buildup of ethanol’s metabolite acetaldehyde in the serum, which in turn causes symptoms such as flushing, dizziness, nausea, and vomiting if patient consumes alcohol.

Acamprosate is best for maintaining abstinence in patients who have already quit drinking, but it can be helpful even after patients relapse. Naltrexone is the better choice for patients who are still drinking, since it is better at helping patients quit. Acamprosate is preferred over naltrexone in patients with hepatic impairment.