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The Carlat Psychiatry Report

Adult ADHD (November/December) | 2019

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CME Post-Test - Adult ADHD, TCPR, November/December 2019

November 15, 2019

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 2 CME credits. Read More

Highlights From This Issue

November 15, 2019

Quick hits on what you’ll find in this issue. Read More

Adult-Onset ADHD

November 15, 2019

Michael Posternak, MD. and Chris Aiken, MD.

“I think I have ADHD” is a common complaint of psychiatric patients. Just about every disorder in the DSM can cause symptoms of ADHD, as can a host of medical problems. In this article we’ll show you how to sort through the possibilities. Read More

Micronutrients in Mental Health

November 15, 2019

Julia Rucklidge, PhD

Vitamins like B12 and folate have mental benefits, but what happens when you combine dozens of vitamins and nutrients in a single pill? We were skeptical, but the studies were positive, so we invited Julia Rucklidge to explain how these “micronutrients” work in ADHD, depression, autism, and general mental health. Read More

Adult ADHD: What Else Could It Be?

November 15, 2019

Chris Aiken, MD.

In this issue, we tackle one of the vexing problems in outpatient psychiatry: adults who present with ADHD. Read More

Stimulants as Cognitive Enhancers

November 15, 2019

Chris Aiken, MD.

From the Oval Office to the college dorm, stimulants are often used as performance-enhancing drugs. The ethics of this practice are questionable, but so is the science. New research suggests their pro-cognitive effects are mild at best and come with an unexpected cost on working memory. Read More

A Practical Guide to Light Therapy

November 15, 2019

Chris Aiken, MD.

Few natural therapies perform well when stacked head-to-head with medication. Light therapy is an exception. When used correctly, it can treat winter and non-winter depression and augment antidepressants. Learn which lightboxes work, how to use them, and a new light therapy protocol for bipolar depression. Read More

Meet the First H3 Antagonist

November 15, 2019

Chris Aiken, MD

Pitolisant (Wakix) is now FDA-approved for narcolepsy and is the first histamine H3 agonist released. Though used for a neurologic condition, its novel mechanism has potential psychiatric effects that are worth monitoring. Read More

An Antipsychotic Patch

November 15, 2019

Chris Aiken, MD.

Secuado, the first transdermal patch for schizophrenia, is newly approved version of asenapine (aka Saphris). It promises to reduce side effects and enhance adherence. However, it adds a new side effect of its own, and transdermal delivery isn’t clearly better than sublingual, which is how the older Saphris is absorbed. Read More

Pharmacology for GAD: Complex Choices

November 15, 2019

Randall Moore, MD.

A meta-analysis of 25 medications in over 25,000 patients with generalized anxiety disorder. The usual FDA-approved options are there, along with some surprises. Not all are equal, but the most effective of the bunch carries so many side effects that we can only recommend it as a last resort. Read More

Olanzapine for Anorexia Nervosa

November 15, 2019

Kristen Gardner, PharmD.

A randomized, double- blind, placebo-controlled trial studying the effects of olanzapine on change in body weight and obsessionality in adult outpatients with anorexia nervosa. Although strength of the study includes its large sample size, it is undetermined if patient weight gain is due to a therapeutic effect on anorexia or to olanzapine’s known metabolic effects. Read More

In Brief: Antipsychotic Update

November 15, 2019

Outdoor activity, massage, and touch therapy ranked most effective for agitation in dementia. Risperidone doesn’t appear to cause fractures. Read More