• Subscribe
  • Register for free Content
  • Cart
  • Login
  • Browse by Topic
    • 13 Reasons Why
    • Abstinence
    • Acamprosate
    • Addiction
    • Addiction Treatment
    • Addyi
    • Adhansia XR
    • ADHD
    • Adherence
    • adolescents
    • Adult ADHD
    • Adverse Childhood Experiences (ACES)
    • Affordable Care Act (ACA)
    • Agitation
    • air pollution
    • Akathisia
    • Alcohol
    • Alcohol Use
    • Alcohol use disorder
    • Alcoholism
    • Alpha Agonists
    • Alternative treatments
    • Amantadine
    • amphetamine
    • Amphetamines
    • Anorexia Nervosa
    • Antidepressant Augmentation
    • Antidepressants
    • Antipsychotic
    • Antipsychotics
    • Anxiety
    • Anxiety Disorder
    • APA CE Post-Test
    • Aripiprazole
    • ArModafinil
    • Asenapine
    • Assessment
    • asthma
    • atamoxetine
    • attention
    • Attention Deficit Hyperactivity Disorder
    • Atypical Antipsychotics
    • Austedo
    • Autism
    • Autism Spectrum Disorder
    • Autism Spectrum Disorder
    • Autism Spectrum Disorder autism spectrum disorder
    • Behavior therapy
    • Behavioral addiction
    • Behavioral therapy
    • Behavioral treatment
    • Belsomra
    • Benzodiazepines
    • Beta-blockers
    • Billing
    • Bipolar Depression
    • Bipolar Disorder
    • Bipolar II
    • Board Certification
    • Borderline Personality Disorder
    • BPD
    • Brain Devices
    • Brief psychotherapy
    • Brief Strategic Family Therapy (BFST)
    • Bullying
    • Buprenorphine
    • Bupropion
    • C-Reactive Protein
    • Caffeine
    • CAM Treatments
    • Cannabidiol
    • Cannabis
    • Caplyta
    • Carbamazepine
    • Cardiovascular
    • Cariprazine
    • Chantix
    • Child and adolescent
    • Child Psychiatry
    • Child Psychiatry
    • children
    • Chokroverty
    • Citalopram
    • Clinical practice
    • Clozapine
    • CME Post-Test
    • Co-occurring disorders
    • Cocaine
    • Cognition
    • Cognitive Behavioral Therapy
    • Cognitive Decline
    • cognitive impact
    • Cognitive Rehabilitation Therapy (CRT)
    • Collaborative care
    • community trauma
    • Comorbidity
    • Complementary treatments
    • Complimentary treatments
    • Computer addiction
    • Computers in Psychiatric Practice
    • Conduct Disorder
    • Confidentiality
    • Connect
    • Connection
    • Connections
    • Contagion
    • Coronavirus
    • Cosmetic pharmacology
    • COVID-19
    • COVID19
    • Crime
    • Criminal behavior
    • Crisis intervention
    • Crocus Sativus
    • CRP
    • Cultural Competence
    • Culture
    • Cymbalta
    • Dayvigo
    • Delusional Disorder
    • Dementia
    • Deplin
    • Deprescribing
    • Depression
    • Depressive Disorder
    • Deutetrabenazine
    • Diagnosis
    • Diagnostic Testing
    • Disaster
    • Disparities
    • Diversity
    • Dopamine
    • DSM
    • Dual diagnosis
    • Duloxetine
    • Dyslexia
    • Dysregulation
    • E-Cigarettes
    • Eating Disorders
    • eCigarettes
    • ECT
    • Effexor
    • efficacy
    • electronic use
    • emergent suicidality
    • Emotional dysregulation
    • End of Life Care
    • Engagement
    • Escitalopram
    • Esketamine
    • eTNS
    • Exercise
    • Existing marijuana
    • expressed emotion
    • extended-release
    • Falls
    • Family Separation
    • FDA Warnings
    • Female hypoactive sexual desire disorder
    • Female Issues in Psychiatry
    • Fluoxetine
    • Folate
    • Folic Acid
    • Free Articles
    • gabapentin
    • GAD
    • Gender
    • Gender & Sexuality
    • Gender Diverse
    • Gender Dysphoria
    • Gender Identity
    • Generalized Anxiety Disorder
    • Generics
    • GeneSight
    • Genetic Testing
    • Genetics and Psychiatry
    • Geriatric Psychiatry
    • Ginkgo
    • Guanfacine
    • Hair loss
    • Harm reduction
    • Head Trauma
    • Health Apps
    • Heart health
    • Heart rate
    • Hepatitis
    • Heroin
    • HIPAA
    • Histamine
    • HIV
    • Hormone Replacement Therapy
    • Hypnotics
    • Hypomania
    • Incarceration
    • Inflammation
    • Ingrezza
    • Inpatient Psychiatry
    • inquiry
    • Insomnia
    • Insurance
    • Internet
    • Interpreter
    • Intervention
    • Irritability
    • Keppra
    • Ketamine
    • l-methylfolate
    • Laboratory Testing in Psychiatry
    • Lamictal
    • Lamotrigine
    • Language
    • Lavender
    • Learning & Developmental Disabilities
    • Legal issues
    • Lemborexant
    • Levetiracetam
    • LGBT
    • LGBTQ+
    • Life coaching
    • Life expectancy
    • Light and Dark Therapy
    • Light therapy
    • Lightbox
    • Literacy
    • Lithium
    • Longevity
    • Low libido
    • Lumateperone
    • Lurasidone
    • Lyrica
    • Management
    • Mania
    • MAOIs
    • Marijuana
    • Media
    • Medical Comorbidities
    • Medication
    • Medication adherence
    • Melatonin
    • Meta-analysis
    • Metabolic syndrome
    • Metformin
    • Methadone
    • methylfolate
    • methylphenidate
    • Micronutrients
    • Mind-Gut Connection
    • Mindfulness
    • Minority
    • Mirtazapine
    • Mixed Features
    • Modafinil
    • Mood Stabilizers
    • Mortality
    • Motivational Interviewing
    • Naloxone
    • Naltrexone
    • Narcolepsy
    • Natural Medications
    • natural treatments
    • Negative Symptoms
    • Netflix
    • Neurology
    • Neuroscience in Psychiatry
    • Neurotoxicity
    • New York
    • News of Note
    • Nightmares
    • Norepinephrine
    • Nortriptyline
    • Novel Medications
    • Nuedexta
    • Nuplazid
    • Nutrition
    • Nuvigil
    • Obesity
    • OCD
    • olanzapine
    • online therapy
    • Opioid epidemic
    • Opioid Use Disorder
    • Opioids
    • Oral Contraceptives
    • Orexin
    • Orthostasis
    • Outpatient
    • Overdose
    • Oxcarbazepine
    • Pain
    • pandemic
    • Panic Disorder
    • Parenting Strategies
    • Parkinson’s
    • Parkinson’s Disease
    • Paroxetine
    • Particulate matter
    • Patch
    • Patient relationship
    • pediatric
    • Perseveration
    • Perseverative Behavior
    • Personality Disorders
    • Pharmaceutical Industry
    • Pharmacology
    • Pharmacology Tips
    • Pharmacy
    • phonemic awareness
    • Phonics
    • Physician assisted suicide
    • PICOT
    • Pimozide
    • Pitolisant
    • Podcast
    • polypharmacy
    • Postpartum Depression
    • Potency
    • Practice Tools and Tips
    • Practice Tools and Tips
    • Pramipexole
    • Prazosin
    • Pregabalin
    • Pregnancy
    • prescribing patterns
    • Prescription costs
    • Prevention
    • Primary care
    • Prison
    • Prodrome
    • Prolonged exposure
    • Promotoras
    • Pronouns
    • Provigil
    • Prozac
    • pseudobulbar affect
    • Psychiatric interviewing
    • Psychological First Aide
    • Psychopharm Myths
    • Psychopharmacology
    • Psychopharmacology Tips
    • Psychosis
    • Psychotherapy
    • Psychotherapy
    • Psychotic Depression
    • Psychotropic medication
    • PTSD
    • Public health
    • Quetiapine
    • Randomized controlled trial
    • rapid naming
    • Reading
    • Reading disorder
    • Reading Disorders
    • Reading remediation
    • Red Cross
    • Registered Articles
    • Relationships
    • Remediation
    • Repetitive Behavior
    • Repetitive behaviors
    • Research
    • Research Update
    • Research Updates
    • retention
    • Retirement
    • Risk
    • Risk Management
    • Risperidone
    • Ritalin
    • rTMS
    • safety
    • Saffron
    • Saphris
    • Schizophrenia
    • School Refusal
    • Seasonal Affective Disorder
    • Secuado
    • Self-injury
    • Self-Regulation
    • Serotonin Specific Reuptake Inhibitors (SSRIs)
    • Sertraline
    • Sex Therapy
    • Sexual Dysfunction
    • Sexual Side Effects
    • Side Effects
    • Silexan
    • Skype
    • Sleep
    • Sleep Apnea
    • Sleep Disorders
    • Smoking Cessation
    • Smoking Cessation Agents
    • smoking cessations
    • Social Anxiety Disorder
    • social cohesion
    • Special populations
    • SSRIs
    • Stereotypical Behavior
    • steroids
    • Stigma
    • stimulant
    • Stimulants
    • structured literacy
    • Suboxone
    • Substance Abuse
    • Substance Abuse
    • Substance Use
    • Substance Use Disorder
    • Substance use disorders
    • Suicidality
    • Suicide
    • Suvorexant
    • Symptom Assessment
    • Symptom Management
    • Systematic review
    • Tardive dyskinesia
    • Technology
    • Teen
    • teens
    • Telehealth
    • Telemed
    • Telemedicine
    • Telepsychiatry
    • test cme quiz
    • TGD
    • Therapy during medication appointment
    • Therapy with Med Management
    • TMS
    • Tobacco
    • tobacco research
    • Tobacco use disorder
    • Toxic Stress
    • Transcranial Magnetic Stimulation
    • Transdermal
    • Transgender
    • Translator
    • Trauma
    • Trauma Informed Care
    • Traumatic Brain Injury (TBI)
    • Trazodone
    • treatment
    • treatment pediatric
    • Treatment planning
    • Treatment-Resistant Depression
    • Trigeminal Nerve Stimulation
    • Trintellix
    • Understanding Psychiatric Research
    • Valbenazine
    • Vaping
    • Varenicline
    • Venlafaxine
    • videogaming addiction
    • Vitamin B6
    • Vitamin D
    • Vitamin E
    • VMAT2 Inhibitors
    • Vortioxetine
    • Vyleesi
    • Wakix
    • Weed
    • Weight gain
    • Weight Loss Medications
    • Wellbutrin
    • Wilderness Therapy Programs
    • Withdrawal
    • Women's Issues in Psychiatry
    • Women’s Issues in Psychiatry
    • Working With Families
    • Youth
  • HOME
  • STORE
  • CME CENTER
  • Blog
  • Podcast
  • NEWSLETTERS
    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
  • Archive
  • Archive
  • Archive
  • The Carlat Child Psychiatry Report
  • Suicide in Children and Adolescents (January/February)
  • Lithium: Practical Considerations for Children With Suicidal Thinking

Lithium: Practical Considerations for Children With Suicidal Thinking

The Carlat Child Psychiatry Report, Volume 9, Number 1, January 2018
https://www.thecarlatreport.com/newsletter-issue/ccprv9n1/

From The Carlat Child Psychiatry Report, January 2018, Suicide in Children and Adolescents

Issue Links: Learning Objectives | Editorial Information | PDF of Issue

Topics: Child Psychiatry | Depressive Disorder | Free Articles | Practice Tools and Tips | Psychopharmacology Tips

Print Friendly, PDF & Email

Eve Dreyfus, MD

Pediatric psychiatrist for Beacon Medical Group Behavioral Health, South Bend, IN

Dr. Dreyfus has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Josh Feder, MD

Editor-in-chief of The Carlat Child Psychiatry Report

Dr. Feder has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Billy, age 10, has periods of intense aggression alternating with moments of wanting to be dead, severe mood swings, poor sleep, and pervasive irritability. He has a family history of bipolar disorder. Other family members have responded well to lithium. Since they want to act assertively to help him, Billy’s family is open to medication trials and any other measures. You obtain baseline laboratory studies quickly and begin treatment within days, including individual and family therapy, and a starting dose of lithium. Billy responds well; his follow-up lithium levels are stable, as are his renal and thyroid function tests. It appears that the plan has averted potential disaster.

While we occasionally see situations such as the above (a supportive family, a compliant patient, and a positive response to a medication trial), the more common scenario resembles the following:

Billy has been told that his attitude and behavior are bad, and he is often in trouble at school and at home for misbehaving, including failing to go to sleep, overreacting to peers and adults, and defiance of rules. Billy has been spoken to many times, suspended, and taken to several counselors before coming to see you. He has been treated with stimulants and antidepressants (SSRIs) to no avail, and perhaps even to his detriment. His parents are exhausted, frustrated, and worried, but spent. When you suggest laboratory studies, they say getting blood from Billy will be impossible, and he will not stay still for an EKG. Considering their prior experience with medications, Billy’s parents are against further medication trials, particularly with medications that might have even more side effects than the “safe” ones they’ve already tried. When you mention that lithium might be helpful to consider, Billy’s parents look at you aghast for suggesting such a powerful drug—they claim lithium is only used for people who are truly insane, and they openly wonder what you must think of their son.

These challenging situations demand that we stay calm and remain receptive to the frustrations of the family, while at the same time addressing the child’s difficulties, chief among them the risk of suicide. This article will cover the judicious consideration and use of lithium in children with suicidal thinking and behavior as part of their overall mental health picture.

Effectiveness of lithium in children
Lithium is FDA approved for the treatment of bipolar disorder in children and adults. It is indicated both for acute mania and maintenance treatment. Studies on lithium’s helpfulness for suicidality in adults date back to 1972. Multiple studies, mostly retrospective and some prospective, report 15%–25% reductions in suicide rates for patients taking lithium (Tondo L and Baldessarini RJ, Epidemiol Psychiat Soc 2009;18(3):179–183). Conversely, there are reports of as much as a 24-fold increase in suicide rates when lithium is discontinued (Bocchetta A et al, J Clin Psychopharmacol 1998;18(5):384–389).

As lithium has been in use for so long, the evidence showing its effectiveness for mania in children is robust. The largest double-blind placebo-controlled study to date, the Collaborative Lithium Trials, looked at acute and maintenance treatment and found lithium to be both effective and well tolerated in patients with bipolar disorder ages 7–17 (Findling RL et al, Pediatrics 2015;136(5):885–894). There is little data, however, on the reduction of suicide attempts or completed suicides in children and adolescents. Even so, when symptoms include suicidal ideation or behavior, the general consensus of expert panels is to consider lithium for children and adolescents (World Health Organization 2012. See http://bit.ly/2jv8wHg).

Prescribing lithium
For bipolar disorder, lithium is typically used when other mood stabilizers—such as valproate, carbamazepine, and lamotrigine—have not been helpful, and after failed neuroleptic trials with medications such as risperidone and aripiprazole. Lithium is also employed in depressive disorders after adequate trials of two or three antidepressants.

Before starting lithium, consider reducing or eliminating medications that might aggravate the condition, such as antidepressants, if there is mood instability; stimulants, if there is sleep disturbance; and benzodiazepines, if there is withdrawal agitation. Once you’ve made these adjustments, start lithium using the gradual approach described here.

Before starting lithium, you should order baseline studies, including a complete blood count with differential; a comprehensive metabolic profile, including creatinine and blood urea nitrogen; thyroid-stimulating hormone and thyroxine levels; and an EKG. After completing the baseline studies, consider the following:

  • In young children, a reasonable starting dose might be 150 mg at night, followed by a trough level after about 5 days, taken 8–12 hours after the dose. The target blood level range should be 0.8–1.2 mEq/L. Dosage increases of 150 mg can be done week by week with serial trough blood tests to check the level.
  • In an effort to get more even 24-hour coverage (the half-life of lithium is 18–36 hours, with an average of 24 hours), dosing is typically increased by adding a morning dose, then an evening dose, and so forth.
  • So that the child’s behavior and symptoms stabilize at a lower level, it is always wiser to use lower doses when possible. There is then no need to increase the dose to achieve the 0.8–1.2 mEq/L target range.
  • For children 13 and older, a starting dosage of 300 mg and dosage increments of 300 mg are more efficient, with the same target trough level.
  • If possible, all patients should be formally assessed and monitored at least every six months for abnormal involuntary movements using the Abnormal Involuntary Movement Scale (AIMS). Some children cannot cooperate with this test; if so, clinical observation and history from collateral sources (parents, teachers, etc) must suffice.

Discussing lithium with parents
When a clinician mentions the possibility of lithium, parents often become very concerned, and it’s important that we listen to them. If we respond to the high level of complexity and danger by moving too quickly, we lose the opportunity to gain parental trust. Then, they may have a hard time listening closely enough as we work with them to consider possible treatment options.

Before trying lithium, we may need to work with the child and family over a period. This may feel like lost time and may even result in more symptoms, escalation, and a need for more intensive levels of care. But our steady persistence is necessary to help families work with us on how things are going and what we might try next. That’s why you should consider the following while talking to patients and their parents or guardians:

  • Talk with families about potential side effects of lithium, such as toxicity, hypothyroidism, renal effects, arrhythmia, tremor, polydipsia and polyuria, and acne, as well as the rare chance of tardive dyskinesia or normal-pressure hydrocephalus. Counsel families about signs of lithium toxicity, such as ataxia, diarrhea, dizziness, nausea, slurred speech, seizures, and coma. Assure them that, with good clinical and laboratory monitoring, most side effects are quite manageable.
  • Advise parents to make sure that the child stays hydrated, particularly in hot weather when patients should drink 6–8 glasses of water per day. Many children will be thirsty, and they will need to urinate more often, so provisions should be made, especially at school, to allow them sufficient water and bathroom breaks.
  • Tell families to avoid sugary beverages that might contribute to weight gain.
  • Let parents know that many children will also have a mild tremor. While not a sign of toxicity, it can nevertheless be disconcerting. This is usually benign, and if the child’s psychiatric symptoms remain in check, it can be lessened by reducing the dose of lithium.
  • Thyroid changes might lead to discontinuation; however, supplemental thyroxine can often be used if it is deemed that the lithium itself is beneficial to the child’s symptoms. As they can increase lithium levels, it is important for families to understand that non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen and naproxen, should not be used concurrently with lithium. Acetaminophen, which is not an NSAID, can be used for fever and pain.

When children cannot cooperate in blood tests and EKGs, as in Billy’s scenario, this may preclude the use of lithium and other medications, such as valproate and carbamazepine. Strategies for obtaining blood tests, however, can include special labs, perhaps at a children’s hospital (where staff have experience in calming children); through mobile lab services that can come to the home (if a medical setting is problematic and if phlebotomy in the home is not unduly intrusive); and through the use of mild sedation.

CCPR Verdict: Lithium certainly has its drawbacks, but given its effectiveness for mood disorders and suicidality, consider using it more frequently in your patients.

Suggested Articles

  • Differentiating Psychotic Disorders: Does It Matter? May 7, 2020 How do we understand the range of psychotic disorders in children and adolescents and how…
  • Cultural Issues in Child and Adolescent Psychiatry August 5, 2020 Read our interview with Dr. Andres Pumariega, MD. Professor and Chief, Division of Child and…

Powered by Contextual Related Posts

Share this page!
Subscribe
Register for free content

Register For Free Articles

Register to receive free email newsletters with concise, practical advice for busy clinicians. You will also have access to select article content on the website and you will receive notifications of new books and special discount offers.




Courses and Book CME
Psychiatry Practice Boosters, Third Edition (2021)
The Medication Fact Book for Psychiatric Practice, Fifth Edition (2020)
2021 Carlat Psychiatry Report Self-Assessment Course
2020 Carlat Psychiatry Report Self-Assessment Course
The Child Medication Fact Book for Psychiatric Practice (2018)
Issue Archives

2019

  • Depression (May)
  • Adult ADHD (November/December)
  • Mental Health Apps (October)
  • How to Talk about Medication (September)
  • Side Effects Part II (August)
  • Side Effects Part I (June/July)
  • Sleep (April)
  • Parenting, Pregnancy, and Prevention (March)
  • Dark and Light Therapy (February)
  • Deprescribing (January)

2018

  • Drug Metabolism (November/December)
  • Working With Transgender Patients (October)
  • Emergency Psychiatry (September)
  • Treatment-Resistant Depression (July/August)
  • Neurobiology (June)
  • Anxiety (May)
  • Neurofeedback (April)
  • Antipsychotics Update (March)
  • Working With Families (February)
  • Bipolar Disorder (January)

2017

  • PTSD (December)
  • Retirement (November)
  • Intellectual Disability (September/October)
  • Antidepressants (July/August)
  • Personality Disorders (June)
  • Dementia (May)
  • Cognitive Behavior Therapy Techniques (April)
  • Pharmacogenetics (March)
  • Treating Psychosis (February)
  • Adult ADHD (January)

2016

  • Complementary and Alternative Medicine in Psychiatry (November/December)
  • Side Effects (October)
  • Pain Management (September)
  • Medication in Pregnancy (July/August)
  • Psychoanalysis in Modern Psychiatry (June)
  • Correctional Psychiatry (May)
  • Antidepressant Roundup (April)
  • Burnout (March)
  • Private Practice (February)
  • Bipolar Disorder (January)

2015

  • Psychiatry and General Medicine (November/December)
  • Biomarkers in Psychiatry (May)
  • Telepsychiatry (October)
  • Sleep Disorders (September)
  • Interventional Psychiatry (July/August)
  • Eating Disorders (June)
  • Psychotherapy Updates (April)
  • Topics in Geriatric Psychiatry (March)
  • Antipsychotics Update (February)
  • Risk Management (January)

2014

  • Bipolar Disorder (November/December)
  • Pharmacogenetics (October)
  • Keeping up in Psychiatry (September)
  • Research in Psychiatry (July/August)
  • Marijuana (June)
  • Psychiatric Diagnosis (May)
  • Issues in Psychopharmacology (April)
  • Schizophrenia (March)
  • Women’s Psychiatry (February)
  • Ethics in Psychiatry (January)

2013

  • Military Psychiatry (December)
  • Depression (November)
  • Treatment of Dementia (October)
  • Anxiety Disorders (September)
  • Natural and Alternative Treatments in Psychiatry (July/August)
  • Autism Spectrum Disorder (June)
  • Practice Tips (May)
  • Substance Abuse (April)
  • Medicolegal Topics (March)
  • End of Life Care (February)
  • Antipsychotic Update (January)

2012

  • Screening Tools and Tips (December)
  • Medical Comorbidities (November)
  • Devices in Psychiatry (October)
  • Eating Disorders (September)
  • Bipolar Disorder (July/August)
  • Risk Management (June)
  • Antidepressant Roundup 2012 (May)
  • Gender and Sexuality (April)
  • Personality Disorders (March)
  • ADHD (February)
  • Natural Treatments in Psychiatry (January)

2011

  • Electronic Medical Records (December)
  • Insomnia (November)
  • Psychotherapy (October)
  • Alcoholism (September)
  • Anxiety Disorders (July/August)
  • Schizophrenia (June)
  • Managing Side Effects (May)
  • Antidepressant Roundup 2011 (April)
  • DSM-5 and Diagnostic Issues (March)
  • Drug-Drug Interactions (February)
  • Bipolar Disorder (January)

2010

  • Hospital Psychiatry (December)
  • Psychiatric Medication in Pregnancy (November)
  • Maintenance of Certification (October)
  • The Neuroscience of Psychotherapy (September)
  • Treatment of Depression (July/August)
  • Email and the Internet in Psychiatry (June)
  • Substance Abuse (May)
  • The Diagnosis and Treatment of Dementia (April)
  • Ethics in Psychiatry (March)
  • Natural Treatments in Psychiatry (February)
  • ADHD (January)

2009

  • Treating Schizophrenia (December)
  • Treatment for Anxiety Disorders (November)
  • The Latest on Antidepressants (October)
  • Topics in Neuropsychiatry (September)
  • The Interface of Medicine and Psychiatry (July/August)
  • Generic Medications in Psychiatry (June)
  • The Treatment of Eating Disorders (May)
  • Healthcare Policy and Psychiatry (April)
  • Antipsychotic Roundup 2009 (March)
  • Psychiatric Medication in Pregnancy and Lactation (February)
  • Transcranial Magnetic Stimulation (January)

2008

  • Treating Fibromyalgia and Pain in Psychiatry (December)
  • Issues in Child Psychiatry (November)
  • Improving Psychiatric Practice (October)
  • Treating Personality Disorders (September)
  • Bipolar Disorder (July/August)
  • Antipsychotic Roundup 2008 (June)
  • Atypical Antipsychotics in Clinical Practice (February)
  • Neuropsychological Testing (May)
  • Psychiatric Medications: Effects and Side Effects (April)
  • Update on Substance Abuse (March)
  • Anticonvulsants in Psychiatry (February)
  • Brain Devices in Psychiatry (January)

2007

  • The Treatment of Insomnia (December)
  • Avoiding Malpractice in Psychiatry (November)
  • Update on Eating Disorders (October)
  • Complex Psychopharmacology (September)
  • Laboratory Testing in Psychiatry (August)
  • Psychotherapy in Psychiatry (July)
  • Posttraumatic Stress Disorder (June)
  • Topics in Geriatric Psychiatry 2007 (May)
  • Pregnancy and Menopause in Psychiatry (Apil)
  • Antipsychotic Roundup 2007 (March)
  • Understanding Psychiatric Research (February)
  • Antidepressant Round-up 2007 (January)

2006

  • Technology and Psychiatric Practice (December)
  • The Use of MAOIs (November)
  • Medication Treatment of Depression (January)
  • Seasonal Affective Disorder (October)
  • Treatment of ADHD (September)
  • Topics in Bipolar Disorder (August)
  • Neurotransmitters in Psychiatry (July)
  • Treating Substance Abuse (June)
  • The STAR*D Antidepressant Trial (May)
  • Natural Treatments in Psychiatry (April)
  • Medication Treatment of Anxiety (March)
  • Panic Disorder: Making Treatment Work (March)
  • Antipsychotic Roundup 2006 (February)
  • Antidepressant Roundup 2006 (January)

2005

  • Self-Help Books and Psychiatry (December)
  • Genetics and Psychiatry (November)
  • Pregnancy and Psychiatric Treatment (October)
  • Benzodiazepines and Hypnotics in Psychiatry (September)
  • Geriatric Psychiatry Update (August)
  • Chart Documentation in Psychiatry (July)
  • The Treatment of Bipolar Disorder (June)
  • Weight Loss and Smoking Cessation in Psychiatry (May)
  • Treating ADHD (April)
  • Drug Industry Influence in Psychiatry (March)
  • Atypical Antipsychotics 2005 (February)
  • Antidepressant Roundup 2005 (January)

2004

  • Sexual Dysfunction (December)
  • Suicide Prevention (November)
  • To Sleep, To Awake (October)
  • Women’s Issues in Psychiatry (September)
  • OCD: An Update (August)
  • Chronic Pain and Psychiatry (July)
  • Neuroimaging in Psychiatry (June)
  • Natural Medications in Psychiatry (May)
  • Posttraumatic Stress Disorder (April)
  • Treatment of Alcoholism (March)
  • Battle of the Atypicals (February)
  • Antidepressant Roundup, 2004 (January)

2003

  • Research Methods in Psychiatry (December)
  • Antidepressants in Children (November)
  • The Treatment of Dementia (October)
  • Bipolar Disorder, Part II: The Novel Anticonvulsants (September)
  • Bipolar Disorder: The Basics (August)
  • Drug-Drug Interactions in Psychiatry (July)
  • Managing Antidepressant Side Effects (June)
  • Antidepressants in Pregnancy and Lactation (May)
  • ADHD: Medication Options (April)
  • Panic Disorder: Making Treatment Work (March)
  • Atypical Antipsychotics in Clinical Practice (February)
  • Medication Treatment of Depression (January)

2019

  • Autism in Children and Adolescents (November/December)
  • Depression in Children and Adolescents (May/June/July/August)
  • Substance Use in Children and Adolescents (September/October)
  • Trauma in Children and Adolescents (March/April)
  • Anxiety in Children and Adolescents (January/February)

2018

  • Psychotropic Risks in Children and Adolescents (May/June)
  • ADHD in Children and Adolescents (November/December)
  • Depression in Children and Adolescents (September/October)
  • Autism in Children and Adolescents (July/August)
  • Anxiety in Children and Adolescents (March/April)
  • Suicide in Children and Adolescents (January/February)

2017

  • Adolescents (November/December)
  • ADHD in Children and Adolescents (September/October)
  • Psychosis in Children and Adolescents (August)
  • PANDAS, PANS, and Related Disorders (June/July)
  • Marijuana in Children and Adolescents (May)
  • Tourette’s and Other Tic Disorders in Children and Adolescents (March/April)
  • Autism in Children and Adolescents (January/February)

2016

  • Gender Dysphoria in Children and Adolescents (November/December)
  • Technology Issues With Children and Adolescents (September/October)
  • Mood Dysregulation in Children and Adolescents (July/August)
  • Eating Disorders in Children and Adolescents (May/June)
  • Conduct Disorder in Children and Adolescents (April)
  • Sleep Disorders in Children and Adolescents (March)
  • ADHD in Children and Adolescents (January/February)

2015

  • Antidepressant Use in Children (November/December)
  • Foster Care and Child Psychiatry (September/October)
  • Autism (July/August)
  • Trauma (May/June)
  • Anxiety Disorders (April)
  • Schools and Psychiatry (March)
  • Emergency Psychiatry in Children (January/February)

2014

  • Antipsychotics in Children (December)
  • ADHD (November)
  • Gender and Sexuality (September/October)
  • Psychotic Symptoms (Summer)
  • Medication Side Effects (May)
  • Food and Mood (April)
  • Learning and Developmental Disabilities (February)

2013

  • Complex Practice Issues (December)
  • Diet and Nutrition (November)
  • Child Psychiatry in DSM-5 (August/September)
  • Medication Side Effects and Interactions (June/July)
  • Problematic Technology (March/April)
  • Autism Spectrum Disorders (January/February)

2012

  • Bipolar Disorder (December)
  • Substance Abuse (October/November)
  • Transitional Age Youth (July/August)
  • Rating Scales (May/June)
  • Eating Disorders (March/April)
  • Behavioral Disorders (February)

2011

  • Treatment of Anxiety Disorders (December)
  • Trauma (November)
  • Bullying and School Issues (October)
  • Hidden Medical Disorders (August)
  • OCD and Tic Disorders (June)
  • Suicide and Non-Suicidal Self Injury (April)
  • Sleep Disorders (March)
  • ADHD (January)

2010

  • Use of Antipsychotics in Children and Adolescents (December)
  • Learning and Developmental Disabilities (October)
  • Major Depression (September)
  • Treating Children and Families (July)
  • The Explosive Child (May)

2019

  • Dual Diagnosis in Addiction Medicine (May/June)
  • Medical Issues in Addiction Practice (November/December)
  • Alcohol Addiction (September/October)
  • Legal Issues in Addiction Medicine (July/August)
  • Traumatic Brain Injury and Addiction (March/April)
  • Board Certification in Addiction Medicine (January/February)

2018

  • Opioid Addiction (November/December)
  • Addiction in Older Adults (October)
  • Sleep Disorders and Addiction (September)
  • Adolescent Addiction (July/August)
  • Pain and Addiction (May/June)
  • Cannabis and Addiction (March/April)
  • Stigma and Addiction (January/February)

2017

  • Pregnancy and Addiction (November/December)
  • Detox (Sepember/October)
  • Dual Diagnosis (August)
  • Alternatives to 12-Step Programs (June/July)
  • Recovery (May)
  • Psychiatric Uses of Street Drugs (March/April)
  • Sex Addiction (January/February)

2016

  • Prescription Drug Monitoring Programs (PDMPs) (November/December)
  • Addiction in Health Care Professionals (September/October)
  • Dialectical Behavior Therapy in Addiction (August)
  • Motivational Interviewing (June/July)
  • Benzodiazepines (May)
  • Opioid Addiction (March/April)
  • Families and Substance Abuse (January/February)

2015

  • The Twelve Steps (November/December)
  • Designer Drugs (September/October)
  • Residential Treatment Programs Decoded (July/August)
  • Nicotine and E-Cigarettes (June)
  • Drug Screening (April/May)
  • Integrating Therapy and Medications for Alcoholism (March)
  • Detoxification Protocols (January/February)

2014

  • Behavioral Addictions (December)
  • Risk and Reimbursement (November)
  • Stimulant Abuse (September/October)
  • Self-Help Programs (June)
  • Opioid Addiction (May)
  • Coping with Bad Outcomes (March)
  • Change Management in Addiction Treatment (January/February)

2013

  • Cocaine Addiction (December)
  • Relapse Prevention (November)
  • Cannabis Addiction (August/September)
  • Addiction in DSM-5 (June/July)
Editor-in-Chief

Joshua D. Feder, MD

A National Merit Scholar, Dr. Feder studied engineering and mathematics at Boston University, then continued in medicine on a Naval scholarship. He completed psychiatry residency at Naval Regional Medical Center in San Diego, served during the first gulf war and completed a child and adolescent psychiatry fellowship at Tripler Army Medical Center in Honolulu, and eventually became Chief of Child Psychiatry and a faculty member at the Uniformed Services University of the Health Sciences at the National Naval Medical Center in Bethesda, MD. Dr. Feder is now in active clinical practice in Solana Beach, California, serves as an adjunct professor at Fielding Graduate University, and participates in clinical research at UCSD School of Medicine. Dr. Feder is also active in developing technology to help people with autism and related challenges and serves as a senior consultant to the International Network for Peace Building with Young Children. In 2018 he co-authored the Child Medication Fact Book for Psychiatric Practice.

Full Editorial Information

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Subscriptions
  • Books
  • Online Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Child Psychiatry Report

Contact

  • info@thecarlatreport.com
  • 866-348-9279
  • PO Box 626, Newburyport MA 01950

Follow Us

© 2021 Carlat Publishing, LLC and Affiliates, All Rights Reserved.

Please see our Privacy Policy and the Hardware/Software Requirements to view our website.

×