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Pharmacology Episodes

The Best SSRI - Part 2

August 2, 2020 | Podcasts

Are the SSRIs really that different? If a patient doesn't respond to one will they respond to another? We sift through three decades of research to find answers. Published On: 8/3/20 Duration: 19 minutes, 13 seconds Transcript:  Tony Soprano: “Here we go, here comes the Prozac” Welcome to the Carlat Psychiatry Podcast, keeping ps


Which Medications Should You Stop Before ECT? [60 Sec Psych]

August 1, 2020 | Podcasts

Electroconvulsive therapy (ECT) depends on the seizure threshold, so you don’t want to throw that off before starting it. Anticonvulsants and benzodiazepines are concerning, as are antidepressants. Although bupropion has a notorious risk for seizures, a recent meta-analysis of all antidepressants found buproprion’s risk was about average with the


Here’s What Happens When You Treat ADHD in the Elderly [60 Sec Psych]

July 15, 2020 | Podcasts

In 2004 the FDA approved the first stimulant for adult ADHD: Adderall XR. Now it’s nearly 20 years later, and some of those patients are elderly. Yet there are only a few studies of stimulants in people over age 50 ─ yes that’s the medical definition of elderly these days ─ and they are limited to case reports and patient surveys. [Link] Publ


Celebrex for Bipolar Depression

July 1, 2020 | Podcasts

This week we’re podcasting from the International Society for Bipolar Disorders 2020 conference, where we’ve been scouring the virtual halls for all that is practical and newsworthy. The yield is high so tune in for a new episode every day. Today, new results on an anti-inflammatory medication in bipolar depression. Published On: 7/1/2020 Durat


Will the Best Atypical Stand Up?

June 29, 2020 | Podcasts

Daily dispatches from the International Bipolar Disorders Conference. There are four atypical antipsychotics that treat bipolar depression, but which have the best balance of efficacy and tolerability? Published On: 6/29/2020 Duration: 5 minutes, 15 seconds Transcript: Will the Best Atypical Stand Up? This week we’re podcasting from


The Stats on a Dayvigo: A New Hypnotic [60 Sec Psych]

June 27, 2020 | Podcasts

Lemborexant/Dayvigo is the second in sleep med to join the orexin receptor antagonist family. It’s now on the pharmacy shelves, where it sits beside Suvorexant/Bellsomra, released in 2015. Landry I, Nakai K, Ferry J, et al. Pharmacokinetics, pharmacodynamics, and safety of the dual orexin receptor antagonist lemborexant: Findings from single-dose a


The Strongest Meds for Treatment Resistant Depression [60 Sec Psych]

June 24, 2020 | Podcasts

Lithium, atypical antipsychotics, ketamine, thyroid… these consistently rank among the most effective medications for treatment resistant depression, but which is the strongest? Strawbridge R, Carter B, Marwood L, et al. Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis. Br J Psychiatry. 2019;214(1):42


3 Signs of Deviant Benzo Prescribing [60 Sec Psych]

June 20, 2020 | Podcasts

A group of French psychiatrists released two papers this month that looked into how often physicians prescribe benzodiazepines and hypnotics in ways that deviate from the guidelines. The result: 20-30% of these prescriptions deviated, and the rate was even higher in chronic medical and psychiatric disorders: 45-68%. But what I found most useful in the


Can You Stop the Thyroid Med after Stopping Lithium? [60 Sec Psych]

June 17, 2020 | Podcasts

Hypothyrodism is fairly common on lithium, affecting about 14-17% of patients. Subclinical hypothyroidism is twice as common, and the risk is greater in the elderly. We know what to do about it ─ start thyroid supplement ─ but what hasn’t been clear is whether we should continue that supplement if lithium is stopped. Lieber I, Ott M, Öhlund L, et


Antidepressants in Bipolar [60 Sec Psych]

May 28, 2020 | Podcasts

Do they help? Do they harm? And can mood stabilizers protect patients who take them? A review of Bahji A, Ermacora D, Stephenson C, Hawken ER, Vazquez G. Comparative efficacy and tolerability of pharmacological treatments for the treatment of acute bipolar depression: A systematic review and network meta-analysis. J Affect Disord. 2020;269:154‐184.