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Home » Topics » Clinical Update

Clinical Update
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Clinical Update

Binge Eating Disorder: Management and Treatment Options

November 9, 2023
Michael Posternak, MD.
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Michael Posternak, MD. 

At the time of writing, Dr. Posternak had no financial relationships with companies related to this material.

We regret that Dr. Posternak passed away after finishing this piece. He had a warm heart, a bright mind, and a keen eye for the needs of psychiatric patients.

We have one FDA-approved treatment for binge eating disorder (Vyvanse), but therapy is first line, and there are practical ways to start that process during a medication visit. We also cover off-label medications for times when a stimulant is not a good choice. 


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CLINICAL UPDATE

Supportive Psychotherapy: An Underappreciated Yet Effective Treatment

November 8, 2023
Martin M. Klapheke, MD
From The Carlat Psychotherapy Report
Issue Links: Editorial Information

Martin M. Klapheke, MD. Professor of Psychiatry and Founding Faculty, Department of Clinical Services, University of Central Florida (UCF) College of Medicine; Director of Psychotherapy Training, UCF/HCA Orlando Psychiatry Residency Program. 

Dr. Klapheke has no financial relationships with companies related to this material.

Martin M. Klapheke, MD, explores the effectiveness, historical roots, and the pivotal role of supportive psychotherapy in modern mental health treatment. Sometimes the most impactful therapeutic tool is simply being there for the patient.


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Clinical Update

Lithium for Children and Adolescents

November 2, 2023
Max S. Rosen, MD
From The Carlat Child Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Max S. Rosen, MD. Assistant Professor of Psychiatry (Child); Director, Child & Adolescent Psychiatry Outpatient Services; Washington University School of Medicine, St. Louis, MO.

Dr. Rosen has no financial relationships with companies related to this material.

Lithium is FDA-approved for bipolar disorder in children and adolescents 12 years and up; however, its potential off-label utility is broad, from affective aggression to anorexia nervosa. This clinical update covers how to prescribe lithium for children and adolescents and how to talk with patients and parents about lithium. 


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Clinical Update

Tapering Antipsychotics

November 1, 2023
Charmi Patel Rao, MD, DFAACAP
From The Carlat Child Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Charmi Patel Rao, MD, DFAACAP. Director of Psychiatric Services, Positive Development; Health Sciences Assistant Clinical Professor, Department of Psychiatry, Child and Adolescent Psychiatry; UCSD, San Diego, CA.

Dr. Patel Rao has no financial relationships with companies related to this material.

Antipsychotics offer remarkable, even lifesaving treatment for children and adolescents, however, their side effects include metabolic and neurologic problems, including neurotoxicity. This clinical update guides you through a rational process for employing these powerful medications when necessary but also reducing and discontinuing them when possible.


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Clinical Update

Capacity Evaluation

October 31, 2023
Rehan Aziz, MD
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Rehan Aziz, MD. Associate program director, geriatric psychiatry fellowship program, Jersey Shore University Medical Center, Neptune, NJ; associate professor of psychiatry and neurology, Hackensack Meridian School of Medicine, Nutley, NJ.

Dr. Aziz has no financial relationships with companies related to this material. 

A patient’s decision-making capacity is not an all-or-nothing phenomenon. Here we review its four components and how to individualize your assessment based on a patient’s unique situation.



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Clinical Update

Safe Driving for Older Adults

October 31, 2023
Francisco Covino-Deaso, MSN, CNP, PMHNP-BC and Jennifer Holiman, MSN, CNP, PMHNP-BC
From The Carlat Geriatric Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Francisco Covino-Deaso, MSN, CNP, PMHNP-BC. Psychiatric nurse practitioner, Partial Program (PHP) at HRI Hospital, Brookline, MA.

Jennifer Holiman, MSN, CNP, PMHNP-BC. Psychiatric nurse practitioner, geriatric psychiatry outpatient program and geriatric psychiatry research program, McLean Hospital, Belmont, MA. 

Mr. Covino-Deaso and Ms. Holiman have no financial relationships with companies related to this material. 

Understanding when patients are no longer safe to drive is no easy task. We’ll show you how to estimate driving abilities from your clinic, and what to do when you’re concerned.  


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Clinical Update

Xylazine: An Emerging Threat in the Opioid Overdose Epidemic

October 31, 2023
Roberto Sanchez, MD and Noah Capurso, MD
From The Carlat Addiction Treatment Report
Issue Links: Editorial Information | PDF of Issue

Roberto Sanchez, MD. Addiction psychiatry fellow, Yale University School of Medicine, New Haven, CT.

Noah Capurso, MD, MHS. Assistant professor of psychiatry, Yale University, New Haven, CT; Editor-in-Chief, The Carlat Addiction Treatment Report.

Dr. Sanchez and Dr. Capurso have no financial relationships with companies related to this material.

Xylazine is the latest contaminant being found in the American illicit drug supply. A non-opioid itself, xylazine is usually combined with fentanyl, with which it has synergistic sedative effects. Patients using xylazine can have profound levels of sedation and develop severe peripheral wounds. In this article, we discuss xylazine essentials and cover harm reduction strategies to help keep your patients safe.


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Clinical Update

Benzodiazepines: The Basics and Beyond

October 31, 2023
Audrey Abelleira, PharmD, BCPP
From The Carlat Addiction Treatment Report
Issue Links: Editorial Information | PDF of Issue

Audrey Abelleira, PharmD, BCPP. Clinical pharmacist practitioner, VA Connecticut Healthcare System; clinical instructor, Yale School of Medicine, New Haven, CT.

Dr. Abelleira has no financial relationships with companies related to this material.

Benzodiazepines vary widely in their pharmacologic properties such as half-life, lipophilicity, and medication interactions. Here, we review the essential pharmacology of the prominent benzodiazepine agents and draw clinical correlates to how these properties translate to patient care.


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Clinical Update

Diagnosing and Treating Postpartum Depression

October 3, 2023
Amanda Koire, MD, PhD
From The Carlat Hospital Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Amanda Koire, MD, PhD. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA. Dr. Koire has no financial relationships with companies related to this material.

Postpartum depression is surprisingly common, yet often missed. We discuss screening techniques to ensure you won’t miss it, and share treatment approaches, including novel strategies like brexanolone, zuranolone, and TMS.


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Clinical Update

Postpartum Psychosis: A Primer

October 3, 2023
Victoria Hendrick, MD and Reid Mergler, MD
From The Carlat Hospital Psychiatry Report
Issue Links: Editorial Information | PDF of Issue

Reid Mergler, MD. Assistant Professor of Clinical Psychiatry, Center for Women’s Behavioral Wellness, University of Pennsylvania, Philadelphia, PA. 

Victoria Hendrick, MD. Chief of Inpatient Psychiatry and Clinical Professor, UCLA Medical Center, Los Angeles, CA; Editor-in-Chief, The Carlat Hospital Psychiatry Report.

Dr. Mergler and Dr. Hendrick have no financial relationships with companies related to this material.

Postpartum psychosis can develop very quickly in new mothers who looked well just hours earlier. While rare, it is a true psychiatric emergency. 


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