antipsychotics | CARLAT PUBLISHING

Clinical Update

The Antipsychotic-Stimulant Combo

September 1, 2023

Avneet Soin, MD., Chris Aiken, MD, and Deepti Anbarasan, MD.

Avneet Soin, MD. Psychiatry resident, NYU Grossman School of Medicine. Deepti Anbarasan, MD. Associate Professor, Psychiatry & Neurology, New York University, New York.

Chris Aiken, MD. Editor-in-Chief, The Carlat Psychiatry Report; Assistant Professor, NYU Langone Department of Psychiatry; practicing psychiatrist, Winston-Salem, NC.

Deepti Anbarasan, MD. Associate Professor, Psychiatry & Neurology, New York University, New York

Dr. Soin, Dr. Anbarasan, and Dr. Aiken have no financial relationships with companies related to this material.

As antipsychotic indications have spread, more patients are taking them in combination with their opposite: a stimulant. We look at the risks, search for scenarios where it might make sense, and come up with an action plan for this paradoxical pairing.

Research Update

Antipsychotics in Inpatient Children and Adolescents with Seclusion and Restraint

August 1, 2023

Susie Morris, MD.

Susie Morris, MD. Dr. Morris has no financial relationships with companies related to this material

How effective are antipsychotic agents in reducing agitation in kids? According to this study, they don’t seem all that helpful, at least not in terms of reducing kids’ time in seclusion or restraints. While several confounding factors complicate the authors’ conclusions, try alternative interventions, like behavioral approaches, until we have more definitive data.

Research Update

Probiotics, Dietary Fiber, and Antipsychotic Weight Gain

July 3, 2023

Jeffrey Cardenas, MD

Jeffrey Cardenas, MD. Dr. Cardenas has no financial relationships with companies related to this material.

Probiotics may reduce metabolic side effects on antipsychotics, but do they need dietary fiber to work?

QT Intervals in Psychiatric Practice

June 19, 2023

Victoria Hendrick, MD and Prabhjot Gill

Several psychiatric medications prolong the QTc interval and place patients at risk of the dreaded torsade de pointes. Some patients are particularly vulnerable to QTc prolongation: the elderly, patients with heart disease and electrolyte imbalances, and patients taking certain medications, like thioridazine and ziprasidone. In this podcast, we provide a step-by-step guide so that you can keep your patients safe from this cardiovascular side effect.

Expert Q&A

Recognizing and Treating Psychosis in Autism

April 1, 2023

Kristin Cadenhead, MD

Kristin Cadenhead, MD.

Professor of psychiatry. Director, Cognitive Assessment and Risk Evaluation (CARE) Early Psychosis Treatment and Research Program, University of California, San Diego.

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

Is it autism or psychosis or both? Autistic traits and psychotic symptoms can look a lot alike. How common is psychosis in autism? And how can we differentiate co-occurring autistic traits from psychotic symptoms? Dr. Kristin Cadenhead gives us an approach for sorting through the history and addressing these problems separately.

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.

Research Update

Why Should We Care About Hyperprolactinemia With Antipsychotic Use?

April 1, 2023

Lara Tang, MD

Lara Tang, MD. Dr. Tang has no financial relationships with companies related to this material.

Highly prolactin-elevating antipsychotics, like haloperidol, risperidone, and paliperidone, are associated with an elevated risk of breast cancer, particularly among young women.

RESEARCH UPDATE

Aripiprazole-Related Psychotic Exacerbations

January 1, 2023

Brian Miller, MD, PhD, MPH.

Brian Miller, MD, PhD, MPH. Dr. Miller, author of this educational activity, receives research support from Augusta University, the National Institute of Mental Health, the Brain and Behavior Research Foundation, and the Stanley Medical Research Institute. Relevant financial relationships listed for the author have been mitigated.

This study identifies a common clinical scenario where aripiprazole may trigger psychotic symptoms.

Psychiatric Medication-Induced Hyperprolactinemia

October 30, 2022

Victoria Hendrick, MD and Prabhjot Gill

Medication–induced hyperprolactinemia is more common than you might think and it can produce detrimental long-term health sequelae. In this podcast, we will review the work-up and management of this common side effect.