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The Carlat Psychiatry Report

Drug Metabolism (November/December) | 2018

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CME Post-Test - Drug Metabolism, TCPR, November/December 2018

November 1, 2018

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits. Read More

New Approvals for TMS

November 1, 2018

Talia Puzantian, PharmD, BCPP and Chris Aiken, MD

We know that transcranial magnetic stimulation (TMS) works for treatment-resistant depression (TRD), but one disadvantage is the length of the treatment sessions. Read More

Is Clozapine the Next Step After a Single Failed Antipsychotic Trial?

November 1, 2018

Xavier Preud’homme, MD

Clozapine is often used as a last resort in schizophrenia, even though practice guidelines recommend a trial of this medication after failing 2 antipsychotics. The current study set out to test a treatment algorithm based on those guidelines in patients with first-episode psychosis. Read More

Does TMS Really Work in Depression?

November 1, 2018

Michael Posternak, MD

Repetitive transcranial magnetic stimulation (rTMS) has been FDA-approved for treatment-resistant depression (TRD) since 2008. This non-invasive therapy uses an electromagnetic coil to stimulate electrical activity in the frontal cortex. Read More

Probiotics for Bipolar Disorder

November 1, 2018

Adam Strassberg, MD and Chris Aiken, MD

Probiotics, the so-called “good” bacteria in the gut flora, have become popular as a natural treatment for various disorders. They are taken as capsules or through food sources like yogurt, vinegar, and fermented foods. Read More

Ask the Editor: Which Antipsychotic Is Best When Patients Complain of Akathisia?

November 1, 2018

Chris Aiken, MD

Akathisia is a sensation of inner restlessness so unpleasant that it independently elevates the risk of suicide. Among atypicals, quetiapine (Seroquel) has the lowest risk of akathisia, but that doesn’t mean it’s easy to take. Read More

Effects of Drug Interactions

November 1, 2018

Neil Sandson, MD

When it comes to computer alerts for drug interactions, the two issues to pay attention to are toxicity and loss of efficacy. Toxicity is the bigger concern, particularly if the drug has a “narrow therapeutic index,” where modest differences in the level can have dangerous effects. Read More

Harnessing Beneficial Drug Interactions

November 1, 2018

Rehan Aziz, MD and Chris Aiken, MD

It’s nice when we can get our patients better with a single medication, but that’s not always possible. Sometimes the right combination of meds can do the trick, but studies of polypharmacy are scarce. In this article we dig through that research, small and limited as it is, to highlight a few useful combinations where the drug interaction can benefit your patient. Read More

New Stimulants: From Remixed Amphetamines to Bedtime Ritalin

November 1, 2018

Chris Aiken, MD

You may have noticed that a confusing array of new stimulants has been approved in the last few years. Since 2012, there have been five new amphetamines and two new methylphenidates. What are these preparations? Are any of them worth prescribing to your patients? Read More