YEAR IN REVIEW

These are the most-read articles from the past year. They are free to read even if you don't have Total Access to the Carlat archives. Scroll through them to get to the top article of the year.

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#15 Which SSRI Is Best for Panic Disorder?
By Rushaniya Khairova, MD, PhD.

Guidelines recommend SSRIs first line, but it’s not clear how these options compare in efficacy and tolerability. This network meta-analysis aimed to address that.
 
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#14 What to Know About Injectable Buprenorphine (Sublocade)
By Audrey Abelleira, PharmD, BCPP

Long-acting formulations of sublocade have been developed to enhance adherence, with a subcutaneous injectable called ­Sublocade leading the pack. Let’s take a closer look.
 
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#13 Is It Worth Adding Coenzyme Q10 to Atomoxetine for ADHD?

By Dorothy Chyung, MD

In this study, researchers tested whether augmentation of atomoxetine with the antioxidant coenzyme Q10 would further improve ADHD symptoms.
 
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#12 Interpreting Urine Drug Tests
With Karen Moeller, PharmD

How reliable are urine tests? Reliability depends on the type of drug test. Immunoassays are commonly the first method of testing because they are fast and inexpensive, but their specificity is low, so they can produce false positives.
 
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#11 Treating Irritability in Autistic Children: Functional and Medication Approaches
By Joshua Feder, MD

Don’t be the prescriber who hears irritability in autism and immediately prescribes antipsychotics. There are usually multiple steps to try before using the FDA-approved antipsychotic medications.
 
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Listen to the podcast episode »

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#10 Zuranolone: 10 Questions about a New Antidepressant
By Chris Aiken, MD

Zuranolone (Zurzuvae) is newly approved for postpartum depression, but does it work in regular depression? And why did they put so many “Zs” in the name?

 Listen to the podcast episode »

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#9 Recognizing and Treating Psychosis in Autism
With Kristin Cadenhead, MD

How often does psychosis co-occur with autism? It’s more often than the 1% in the general population.

 Read the Expert Q&A »

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#8 SSRIs and Hydroxyzine for Avoidant/Restrictive Food Intake Disorder (ARFID)?
By Joshua Feder, MD

Clinicians use olanzapine, mirtazapine, and other appetite-inducing medications off label to treat ARFID, but with little research to support their use. This study unpacks the potential role of medications in treating comorbid symptoms associated with ARFID.

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#7 Dissociative Identity Disorder vs Plural Identity in Teens and Young Adults
With Paroma Mitra, MD

The DSM-5 diagnostic criteria for DID includes two or more distinct personalities, each with the sense of consciousness and memory.

 Read the Expert Q&A »

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#6 Mania in Older Adults
By Julia Cromwell, MD

Although less common, a first episode of mania can present in late life. Older patients will often present with standard manic symptoms.

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#5 Mood Stabilizers for Bipolar Disorder in Older Adults: Special Considerations
By Rehan Aziz, MD

Bipolar disorder (BD) is one of the most challenging illnesses to treat in psychiatry, especially bipolar depression. In older adults, changes in metabolism and medical comorbidities can result in a higher risk of side effects with first-line agents.

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#4 Auvelity: A Fast-Acting Antidepressant?
By Chris Aiken, MD

Auvelity is a combination of two older medications: bupropion (circa 1985) and dextromethorphan (circa 1958), a cough suppressant found in Robitussin DM.

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#3 Stimulant Dosing Limits
By Chris Aiken, MD and Kelvin Quiñones-Laracuente, MD, PhD

Stimulant dosing presents a unique challenge. These medications are inherently rewarding, which means we can’t take a purely collaborative approach and let patients guide the dose.

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#2 Deprescribing Anti-anxiety Medications in Older Adults
By Rachel Meyen, MD

Our inclination may be to “not rock the boat” when a patient is stable and not misusing prescribed medication. However, tapering anti-anxiety medications in older adults is often a good idea when considering the risks of falls, sedation, and accidents.

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#1 Viibryd Goes Generic, But Is It Worth Prescribing?

By Chris Aiken, MD

After 11 years of market exclusivity, vilazodone (Viibryd) lost its patent in June of 2022. The price of this “multimodal” antidepressant has fallen to $40 a month and may fall further as more manufacturers enter the market. More patients can afford to take it, but whether we should prescribe more vilazodone is less clear. 

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