Stopping Psych Meds Part 1 (February)

Date of Issue: 02/01/2021 | Volume: 19 | Number: 2

Issue Links:Learning Objectives | Editorial Information

How do you taper off an antipsychotic? Swapnil Gupta gives a practical approach, and new research clarifies how to switch from one antipsychotic to another. Stimulants may dampen creativity. SSRIs may raise risk of violence. Buspirone’s role in anxiety, depression, and beyond gets a full review.

In This Issue

Clinical Update

Buspirone: Still Effective After All These Years?

Topics: Anxiety | Anxiety Disorder | Benzodiazepines | Buspirone | GAD | Generalized Anxiety Disorder | Lavender | Medication | Melatonin | Pharmacology | Pregnancy | Psychopharmacology | Silexan

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.

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Expert Q&A

How to Come Off a Psych Med Part 1: Antipsychotics

Topics: Citalopram | Escitalopram | Fluoxetine | Prozac | Risk | Serotonin Specific Reuptake Inhibitors (SSRIs) | SSRIs | Violence

How do you taper off an antipsychotic? Swapnil Gupta gives a practical approach, and discusses dopamine hypersensitivity, a controversial theory that suggests antipsychotic withdrawal can cause dyskinesias, prolactinemia, and rebound psychosis.

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Clinical Update

Stimulants and Creativity

Topics: ADHD | Amphetamines | ArModafinil | Attention Deficit Hyperactivity Disorder | Creativity | methylphenidate | Modafinil | Provigil | Side Effects | stimulant | Stimulants

Does ADHD bring creative strengths? Can stimulants dampen creative thought? New research suggests they can, but the effect varies by patient.

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In Brief

Does Abilify cause more weight gain than Seroquel?

Last October, we published a table on mood stabilizer side effects that raised an understandable alarm among astute readers. The table, which was based on a 2020 meta-analysis, suggested that aripiprazole (Abilify) has a greater chance of causing weight gain than quetiapine (Seroquel). What the table failed to specify was that the figures were based on long-term maintenance studies.

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Research Update

Are SSRIs Associated With Increased Rates of Violence?

Topics: Deprescribing | Mania on Antidepressants | Medication adherence | polypharmacy | Psychosis | Psychotic Depression | Schizophrenia | Tags | Tardive dyskinesia | Withdrawal

SSRIs are often used to reduce irritability, but questions about they can cause violence have loomed over these antidepressants since the early 1990’s. This new study, with 700,000 patients followed over 7 years, suggests they can.

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Research Update

How to Switch Antipsychotics

Topics: Antipsychotics | Deprescribing | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips | Psychosis | Research Update | Schizophrenia

Should you stop the old antipsychotic and start the new? Or gradually cross-taper them? This new meta-analysis compared three titration strategies to find the best way to switch from one antipsychotic to another in schizophrenia.

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CME Post-Test

CME Post-Test - Stopping Psych Meds Part 1, TCPR, February 2021

Topics: CME Post-Test

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 1 CME credit.

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