Withdrawal - Articles - Page 2

Management of Opioid Withdrawal in the Emergency Setting

March 19, 2021

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

An emergency department visit can be a “reachable moment” for people with unhealthy opioid use. Here, we review pharmacologic and harm-reduction strategies for use in those settings—and how to advocate for your patients when consulting with emergency clinicians.

How to Come Off a Psych Med Part 2: Antidepressants, Stimulants, and Benzos

March 11, 2021

Swapnil Gupta, MD

Swapnil Gupta, MD

Associate Professor at Icahn School of Medicine at Mount Sinai. Co-author of Deprescribing in Psychiatry (Oxford, 2019). Dr. Gupta has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

What do you do when a patient comes to you on a high dose of Adderall and Klonopin without any clear reason to be on them? Swapnil Gupta tackles this in part II of our interview on deprescribing, and describes how to fine-tune and microdose antidepressants and benzodiazepines to manage withdrawal symptoms.

Kratom: A Primer

February 3, 2021

Alison Knopf

Alison Knopf Editor, Alcoholism & Drug Abuse Weekly Ms. Knopf has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

With opioid-like properties, kratom’s recreational use is increasingly reported among those seeking pain relief or a high. This primer reviews what’s known about this unregulated substance, how to talk about it in the clinic, and early evidence on how to treat its withdrawal syndrome.

Are SSRIs Associated With Increased Rates of Violence?

February 3, 2021

Michael Posternak, MD.

Michael Posternak, MD. Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

SSRIs are often used to reduce irritability, but questions about they can cause violence have loomed over these antidepressants since the early 1990’s. This new study, with 700,000 patients followed over 7 years, suggests they can.

How to Safely Prescribe Z-Drugs

August 13, 2020

There’s good reason to be careful prescribing Z-drugs. Here’s an overview of Dr. Reban Aziz’s recent article in The Carlat Addiction Treatment Report.Safety Tips Go short-term or intermittent to reduce the potential for adverse events and withdrawal. Avoid for SUD or complex sleep disorders. Use as last resort after considering...

Outpatient Management of Opioid Addiction

October 3, 2019

Sandra Gomez-Luna, MD

Sandra Gomez-Luna, MD

Child, adolescent, and adult psychiatrist in Darien, CT. Medical Director of Parent Child Support Center, a subsidiary of Behavioral Health Care (BHcare)

Dr. Gomez-Luna has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The opioid crisis demands that child psychiatrists understand more about outpatient treatment in adolescents as more of us are asked to participate in assessment and treatment planning for this population. In this QA, we discuss some of the well-laid-out approaches for child psychiatrists to manage opioid treatment within the child or teen’s community.

Assessing and Treating Cannabis Use Disorder

October 3, 2019

Gabriella Gobbi, MD, PhD

Gabriella Gobbi, MD, PhD

Professor, Department of Psychiatry, McGill University; Psychiatrist and Clinical Scientist at the McGill University Health Center

Dr. Gobbi has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Child psychiatrists are grappling with the problem of pervasive use of marijuana in an age where legalization of use for adults has led to even greater use in teens. In this QA, we discuss the impact of cannabis, its interaction with depression, and the conundrum of cannabis withdrawal so that child psychiatrists can gain tools for addressing marijuana use and addiction in their outpatient practice.

RESEARCH UPDATE

A New Proposal for SSRI Withdrawal

July 3, 2019

Greg Sazima, MD and Chris Aiken, MD

Drs. Sazima and Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The way we taper serotonergic antidepressants may need to be rethought, and this study suggests a new method.

SSRI withdrawal symptoms

July 3, 2019

Use this PDF tool to check if the patient is having any SSRI withdrawal symptoms at baseline.

Managing Substance-Related Agitation

May 21, 2019

Thomas Jordan, MD, MPH

Thomas Jordan, MD, MPH Contributing writer to the Carlat newsletters. Dr. Jordan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

In emergency departments, psychiatrists are often consulted on patients presenting with agitation. In many cases, these patients are under the influence of substances—either from intoxication or withdrawal.