General Psychiatry
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EXPERT Q&A

How to Come Off a Psych Med Part 1: Antipsychotics

February 3, 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.

How do you taper off an antipsychotic? Swapnil Gupta gives a practical approach, and discusses dopamine hypersensitivity, a controversial theory that suggests antipsychotic withdrawal can cause dyskinesias, prolactinemia, and rebound psychosis.
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Stimulants and Creativity

February 3, 2021
Sean Ransom, PhD.
Sean Ransom, PhD. Assistant Clinical Professor, Department of Psychiatry at the LSU Health Sciences Center - New Orleans, and Clinical Director, Cognitive Behavioral Therapy Center of New Orleans. Dr. Ransom has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Does ADHD bring creative strengths? Can stimulants dampen creative thought? New research suggests they can, but the effect varies by patient.
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Does Abilify cause more weight gain than Seroquel?

February 3, 2021
Last October, we published a table on mood stabilizer side effects that raised an understandable alarm among astute readers. The table, which was based on a 2020 meta-analysis, suggested that aripiprazole (Abilify) has a greater chance of causing weight gain than quetiapine (Seroquel). What the table failed to specify was that the figures were based on long-term maintenance studies.
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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.
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How to Switch Antipsychotics

February 3, 2021
Peter Smith, PsyD.
Peter Smith, PsyD. Dr. Smith has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Should you stop the old antipsychotic and start the new? Or gradually cross-taper them? This new meta-analysis compared three titration strategies to find the best way to switch from one antipsychotic to another in schizophrenia.
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Roundup

February 3, 2021
CBT for Benzo Withdrawal. Medications have largely proven unsuccessful for benzodiazepine withdrawal, but CBT looked promising in this meta-analysis of three randomized controlled trials. Compared to gradual tapering without CBT, the addition of this psychotherapy allowed an extra 1 in 3 patients to successfully come off their benzodiazepine. A therapist...
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CLINICAL UPDATE

How to Use Lamotrigine

January 1, 2021
Chris Aiken, MD.
Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Lamotrigine is approved for the prevention of bipolar episodes, but Dr. Aiken explains why it may also treat active bipolar depression. This mood stabilizer is among the most tolerable in its class, and has additional benefits in OCD, borderline personality disorder, and depersonalization disorder.
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EXPERT Q&A

Probiotics in Psychiatry

December 31, 2020
Ted Dinan, MD, PhD

Ted Dinan, MD, PhD
Professor of psychiatry at University College Cork, Ireland. Dr. Dinan’s research focuses on depression, irritable bowel syndrome, and the influence of the gut microbiota on brain function. He has published over 500 scientific papers and numerous books, including 2019’s The Psychobiotic Revolution. Dr. Dinan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The gut microbiome is one of the newest entries in the list of causes of depression. Ted Dinan explains how the bacteria in the GI tract influence the brain, and whether a probiotic or a lifestyle change is the best way to address it.
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