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Clinical Update

Medication Treatments for Alcohol and Opioid Use Disorder in Older Adults

May 11, 2023

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.

With three FDA-approved medications for alcohol use disorders and three FDA-approved medications for opioid use disorders, it can be hard to know where to start. Here we review the pros and cons of these six medications—and provide recommendations for their use in older adults.

Clinical Update

Naltrexone: A Jack of All Trades?

April 1, 2023

Julio Cesar Nunes, MD

Julio Cesar Nunes, MD. Psychiatry resident, Yale University. New Haven, CT.

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

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

Naltrexone was once hailed as a treatment for all addictive disorders. While the hype has not entirely panned out, it still holds an important place in our armamentarium of addiction treatments. Here, we review the evidence for its use and provide prescribing recommendations.

Management of Psychogenic Polydipsia

July 11, 2022

Victoria Hendrick, MD and Zachary Davis

Psychogenic polydipsia (PP), also known as primary polydipsia and potomania, was first described in the 1930s. It is surprisingly common with a prevalence rate between 3 to 25% in institutionalized patients. In this podcast, we will discuss how to accurately diagnose and manage psychogenic polydipsia in patients.

Management of Psychogenic Polydipsia

March 23, 2022

Susie Morris, MD.

Susie Morris, MD. Assistant professor of psychiatry and forensic psychiatrist, UCLA. Los Angeles, CA. Dr. Morris has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Compulsive water drinking, or psychogenic polydipsia, is surprisingly common on inpatient psychiatric units. We learn how to diagnose and manage this potentially life-threatening condition.

Meds for Alcohol Use Disorders

January 18, 2022

Mikveh Warshaw, NP.

Mikveh Warshaw, NP. Ms. Warshaw has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Naltrexone has shown efficacy for the treatment of alcohol use disorder in tightly controlled trials. Here, researchers demonstrate the efficacy of naltrexone in a large scale naturalistic study.

Suboxone vs. Vivitrol for Opioid Use Disorder: How Do you Choose?

November 5, 2021

Gregory Lande, MD.

Gregory Lande, MD. Dr. Lande has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buprenorphine and long acting injectable naltrexone are both effective for the treatment of opioid use disorder; however, until now, we had little data to predict which patients would do better on which medications. Here, researchers identify patient characteristics predictive of success on buprenorphine versus naltrexone.

Battle of the Bulge: Obesity and Antipsychotic-Induced Weight Gain

July 14, 2021

Farah Khorassani, PharmD. Clinical Assistant

Farah Khorassani, PharmD. Clinical Assistant Professor of Pharmacy Practice, St. John’s University, Queens, NY. Dr. Khorassani has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

With so many weight loss medications on the market, it’s hard to know which to choose. Dr. Khorassani tells us everything we need to know to about selecting and prescribing these agents. Also, she gives us additional tips for managing antipsychotic-induced weight gain.

The COMBINE Study: A Core Paper in the Treatment of AUD

November 22, 2019

Brian Frankel, MD

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

This research update summarizes the results of the landmark COMBINE study which evaluated the effectiveness of stand-alone and combined pharmacological and behavioral interventions for treating alcohol use disorder.

Treating Alcohol Use Disorder

October 2, 2019

Albert J. Arias, MD, MS

Albert J. Arias, MD, MS
Associate Professor, Psychiatry Virginia Commonwealth University School of Medicine. Associate Division Chair, Addiction Psychiatry and Addiction Medicine. Dr. Arias has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

We have five main medications to offer patients with alcohol use disorder: acamprosate, disulfiram, gabapentin, naltrexone (PO or IM), and topiramate. The combination of naltrexone and gabapentin may work better than either of these two medications alone.

Treating Addiction in Patients Transitioning to/from Incarceration

August 1, 2019

Karen Cropsey, PsyD

Karen Cropsey, PsyD

Conatser Turner Endowed Professor of Psychiatry, University of Alabama at Birmingham.

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

Addiction treatment during incarceration is limited, and release from incarceration presents its own set of challenges. In this QA interview, Dr. Karen Cropsey discusses effective treatment options for patients with substance use disorders transitioning to or from incarceration.