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Clinical Update

Prescribing Medications for Sleep Disorders in Older Adults

June 12, 2025

Evelina Sterina, MD, MSc, Julia Golden, MD, and Grace Ma, MD

Evelina Sterina, MD, MSc; Julia Golden, MD; Grace Ma, MD. Brigham & Women’s Hospital/Harvard Medical School Psychiatry Residency, Boston, MA.

Drs. Sterina, Golden, and Ma have no financial relationships with companies related to this material.

Sleep disorders affect nearly half of adults over 65, impairing quality of life and increasing risks of cognitive decline, mood disorders, falls, metabolic syndrome, heart disease, stroke, and cancer.

Clinical Update

Treating Irritability in Autism: Functional and Medication Approaches

April 1, 2023

Joshua Feder, MD

Joshua D. Feder, MD. Editor-in-Chief, The Carlat Child Psychiatry Report.

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

Antipsychotics can be very effective for irritability in autism, but they are often unnecessary, and the side effects are truly problematic. Don’t be the prescriber who hears irritability in autism and immediate prescribes antipsychotics. There are usually multiple steps to try before using the FDA approved antipsychotic medications.

7 Tips for Better Sleep

March 14, 2022

Chris Aiken, MD and Kellie Newsome, PMHNP

A new app for insomnia might also lift depression. We show you how it works and end with 7 practical tips to share with your patients who have insomnia.

Melatonin vs Memantine for ECT-Related Cognitive Impairment

September 13, 2021

Anne Li, MD.

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

Memantine appears more effective than melatonin in reducing post-ECT cognitive impairment.

Melatonin for Sleep-Onset Insomnia

March 12, 2021

Lauren Cashion, MD

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

So many of use melatonin to try to help children get to sleep, but does it really work? And if so, what is the optimal dosage? And what is the optimal timing of administration to optimize the use of this supplement? This research review will give you excellent practical guidance.

Buspirone: Still Effective After All These Years?

February 3, 2021

Eugene Rubin, MD.

Eugene Rubin, MD. Psychiatrist in private practice, Bingham Farms, MI. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buspirone (Buspar) is approved for generalized anxiety disorder, but its efficacy there is often questioned. Here we find out how it stacks up against the benzos and SSRIs, and explore its off-label potential in depression, sexual dysfunction, alcoholism, traumatic brain injury, and premenstrual dysphoric disorder.

Is Ramelteon an Effective Hypnotic?

November 12, 2020

Randall Moore, MD, JD. and Chris Aiken, MD.

Randall Moore, MD, JD. Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences at Texas A&M Health Science Center College of Medicine. Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Moore and Dr. Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Ramelteon (Rozerem) is one of the safer sleep medications, but how well does its efficacy stack up against other hypnotics? The answer surprised us.

How to Treat Tardive Dyskinesia

January 13, 2020

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report. 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.

The VMAT2 inhibitors are FDA approved for tardive dyskinesia (TD), but there are 8 off-label options to consider as well. See how they stack up here, and learn why the atypical antipsychotics ─ with one exception ─ have not put an end to this insidious side effect.