Pathological narcissism is a desperate need to feel special—in fact, you can call it an addiction to feeling special. We tend to focus on one presentation, which is the loud, arrogant, conceited narcissist, but there are plenty of introverted narcissists (often called vulnerable or covert in the research), and these are the patients who often show up in our office. In this Expert Q&A Dr. Malkin shares his insight on helping narcissism patients.

The U.S. Food and Drug Administration approved Ingrezza (valbenazine) for the treatment of tardive dyskinesia (TD), a disabling movement disorder that afflicts 10%–20% of people on chronic antipsychotic ­medication.

We often prescribe antidepressants to patients who are suicidal, and unfortunately, some people use these very medications to try to kill themselves. It’s been known for some time that tricyclic antidepressants are among the most toxic in overdose, so we embraced the SSRIs and later medications in part because they are considered to be safer. But how safe are they?

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As director of psychiatry at Hebrew SeniorLife for 18 years, Dr. Metzger has witnessed a number of changes in how we manage agitation and other elements of BPSD. In this article, he outlines current thinking about such symptoms, as well as the latest techniques—both pharmacologic and non-pharmacologic—for managing them.

There used to be this rule of thumb that you don’t need to worry about people who are worried about their memory; you need to worry about people who aren’t worried. And that might be true for people with dementia, where there is often a loss of insight. But if you want to pick up memory problems at the earlier, mild cognitive impairment stage, do an evaluation when someone is worried about memory loss.

We’ve all seen the ads from companies such as Lumosity implying that fun, computer-based learning games will help your mind work better. Such methods are called computerized cognitive training (CCT), and past systematic reviews have had weaknesses, such as combining CCT with other interventions or including studies that were not randomized controlled trials. These researchers performed a systematic review that was more rigorous.

Do antidepressants cause bipolar II patients to switch from depression to hypomania? It’s a controversial question, and you’ll find academic psychiatrists who will argue passionately that antidepressants are either safe or dangerous in these patients. The latest study appears to endorse the “safe” camp.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

After reading these articles, you should be able to…