Psychopharmacology

Article

Evaluating the Mortality Risks of Antipsychotics in Children and Youths

Topics: Antipsychotics | Psychopharmacology | Schizophrenia

There are reports of increased mortality from antipsychotics in older adults. Now, we have a paper showing increased mortality in children, adolescents, and young adults aged 5–24 years. Given the frequent use, both on- and off-label, of antipsychotics, does this change how we use them? And if so, how? What we already know In 2005, the FDA added a

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Article

Prescription CBD Is Available, But Are We Ready to Use It?

Topics: Anxiety | Cannabidiol | Psychopharmacology

Your patient comes in with a new medication on his list: CBD oil. He started taking it for anxiety and wants to know if it’s safe. You hedge, explaining that there is limited information available on unregulated products, but the patient is persistent. He says CBD oil is available as a prescription, and wonders if you could write one for it. Cannab

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Expert Q&A

Deprescribing Medication

Topics: Deprescribing | Psychopharmacology

There’s no shortage of information on prescribing medications, but when and how do we stop them? The Bruyere Deprescribing Guidelines Research Team is a group of clinicians and researchers who’ve set out to answer those questions. They’ve recently published 5 deprescribing guidelines, 3 of which are for psychiatric medications: benzodiazepines, an

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Article

Ask the Editor: Three Significant Food Interactions with ADHD Medications

Topics: Free Articles | Practice Tools and Tips | Psychopharmacology

Each month, Editor-in-Chief Chris Aiken, MD, gives advice on a different practice challenge. If you have a question you’d like Dr. Aiken to answer, please send an email to AskTheEditor@thecarlatreport.com. Dr. Aiken won’t be able to answer all questions received but will pick one each month that is of general interest. Dear Dr. Aiken: Patients of

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Article

Treating Chronic Pain When There’s Addiction: A Primer

Topics: Addiction | Practice Tools and Tips | Psychopharmacology

It can be challenging to manage chronic pain, even more so when our patients suffer from addiction. We can find ourselves walking a tightrope between the risk of relapse due to the inadequate treatment of pain, and the risk of relapse due to the use of opioid analgesics. Since our mission is to minimize suffering and optimize functioning while helpin

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Expert Q&A

Using Caution While Prescribing Opioids for Pain

Topics: Addiction | Practice Tools and Tips | Psychopharmacology

CATR: I know you’ve done a lot of research around overdose deaths, both intentional and unintentional, and how this may help psychiatrists more wisely prescribe opioids for pain. Can you start by giving us a little more background on that? Dr. Bohnert: Sure. I’ll start by talking a little about overdose deaths. The study that we did in the VA wit

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Article

Update on Medications for PTSD

Topics: Psychopharmacology | PTSD

Every five years or so, we do an update on PTSD treatments; the most recent was our August 2011 issue of TCPR, in which we declared that psychotherapy was the gold standard for treatment. Recently, the US Veterans Health Administration (VA) and the Department of Defense made this their official position. In their just-published 2017 treatment guidelines

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Article

Diagnosing and Treating Borderline Personality Disorder

Topics: Personality Disorders | Psychopharmacology

By and large, psychiatrists aren’t terribly comfortable when it comes to diagnosing and treating borderline personality disorder (BPD). The clinical picture is challenging, and the stigma attached to the term makes it difficult for patients to hear—in fact, many ­clinicians end up not making the diagnosis at all! But BPD, characterized by DSM-5 as

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News of Note

FDA Approves First Drug to Treat Tardive Dyskinesia

Topics: News of Note | Psychopharmacology

On April 11, the U.S. Food and Drug Administration approved Ingrezza (valbenazine) for the treatment of tardive dyskinesia (TD), a disabling movement disorder that afflicts 10%–20% of people on chronic antipsychotic ­medication. The approval was based on a clinical trial in which 234 patients with moderate to severe TD were randomly assigned to a

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Research Update

Which Are the Most Dangerous Antidepressants?

Topics: Antidepressants | Psychopharmacology | Research Updates

Review of: Nelson JC and Spyker DA, Am J Psychiatry 2017;174(5):438–450 Study type: Retrospective cohort We often prescribe antidepressants to patients who are suicidal, and unfortunately, some people use these very medications to try to kill themselves. It’s been known for some time that tricyclic antidepressants are among the most toxic in

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Research Update

Can a One-Week Naltrexone Detox Reduce Outpatient Opioid Relapse Rates?

Topics: Addiction | Psychopharmacology | Research Update | Substance Abuse

Review of: Sullivan M et al, Am J Psychiatry 2017; Epub ahead of print. Study Type: Randomized, open-label, parallel-groups trial Naltrexone is an opioid blocker that is FDA-approved for the treatment of alcoholism. However, it is also effective off-label for treating opioid use disorder. The medication comes in two forms: an oral pill (brand name

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Article

From the Street to the Prescription Pad: Psychedelics Return to Psychiatry

Topics: Practice Tools and Tips | Psychopharmacology | Psychotherapy | Substance Abuse

You’ve been treating Bob, a 37-year-old combat veteran with refractory PTSD, for the past 15 years. After two psychotherapists gave him a club drug, he returns to your office reporting he’s been symptom-free for two months. Jean, a 67-year-old woman you’ve been treating for anxiety associated with stage 4 breast cancer, tells you that after ­inge

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Expert Q&A

MDMA-Assisted Psychotherapy for Posttraumatic Stress Disorder

Topics: Practice Tools and Tips | Psychopharmacology | Psychotherapy | Substance Abuse

Ms. Petitt’s manages the program that selects and trains researchers for the MDMA-assisted psychotherapy protocols MAPS Public Benefit Corporation is conducting. The program has reviewed 300 applicants, and is in the midst of training 80 people who will work on therapy teams for Phase 3 trials. In addition to the training program, Ms. Petitt has also

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Research Update

Does CBT Improve Outcome in Buprenorphine Treatment?

Topics: Psychopharmacology | Psychotherapy | Research Update

Patients receiving buprenorphine for opioid use disorder are typically also referred for psychotherapy, either individual or group. However, several studies have failed to show that therapy improves outcomes in buprenorphine treatment program Review of: Moore B et al. Cognitive behavioral therapy improves treatment outcomes for prescription opioid us

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CME Post-Test

CME Post-Test - Street Drugs, CATR, March/April 2017

Topics: Addiction | Practice Tools and Tips | Psychopharmacology | Psychotherapy | Research Update | Substance Abuse

The post-test for this issue is available for one year after the publication date to subscribers only (December 31, 2017). By successfully completing the test you will be awarded a certificate for 2 CME credits. Click here to take your CME test. Note: All of the CME tests are available in the “My Account” section of the site when you are log

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News of Note

Concerta: Brand vs Generic

Topics: Child Psychiatry | News of Note | Pharmaceutical Industry | Psychopharmacology

In November 2016, the FDA announced that it was requiring two companies to withdraw their generic versions of Concerta (OROS methylphenidate) because of efficacy concerns. Such actions are quite unusual, and when they occur, they tend to shake doctors’ confidence in the generic drug system—which branded drug companies are often eager to encourage. B

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