Research Update

Melatonin for Sleep-Onset Insomnia

Topics: Dosage Timing | Melatonin | Sleep | Sleep Onset Insomnia

REVIEW OF: Wei S et al, Sleep Medicine 2020;68:1–8 Sleep-onset insomnia, characterized by difficulty falling asleep and daytime fatigue, is a common problem among youth. While sleep hygiene is the first step, families often have trouble implementing such measures, which include regular wake-up times, daily exercise, shutting down screens in the eve

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How to Treat Tardive Dyskinesia

Topics: Amantadine | Austedo | Deutetrabenazine | Ginkgo | Ingrezza | Keppra | Levetiracetam | Melatonin | Psychopharmacology | Psychopharmacology Tips | Side Effects | Tardive dyskinesia | Valbenazine | Vitamin B6 | Vitamin E | VMAT2 Inhibitors

Your patient is a 56-year-old male who recovered from a difficult-to-treat depression 4 years ago after quetiapine was added to his citalopram. As he talks, you notice that his fingers are tapping in a rapid, random pattern and his feet are wiggling. When questioned, he explains, “I just do that when I’m anxious.” Should you stop the antipsychotic

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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

When buspirone was released in 1986, it was advertised as providing “a different kind of calm.” Unfortunately, physicians and their patients weren’t ready to accept the kind of calm that required several weeks to take effect, when punchier, quicker benzos were the standard route to tranquility. Although buspirone is FDA approved for generalized an

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Clinical Update

Is Ramelteon an Effective Hypnotic?

Topics: Belsomra | Benzodiazepines | Geriatric Psychiatry | Hypnotics | Lemborexant | Melatonin | Sleep | Suvorexant

Ramelteon (Rozerem) stands out from other hypnotics in several ways: It is not a controlled substance and has no risk of addiction or ­withdrawal. It is relatively safe in the elderly. It has a low risk of falls and complex sleep behaviors. However, ramelteon’s use has been limited by its high cost and modest efficacy. Now that it’s gone ge

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