Dr Osser is associate professor of psychiatry at Harvard Medical School and Co-Director, US Department of Veterans Affairs National Bipolar Disorder Telehealth Program.
Role of Lithium in 2023 in Bipolar I Mania and Depression
What is the current role of lithium?
Psychopharmacologic Treatment of Bipolar II Depression
What is the best evidence-based medication treatment for acute bipolar II depression?
Use of Antipsychotics: Risks of Tardive Dyskinesia
"This study served as a sobering reminder of the significant frequency of this disfiguring and sometimes disabling adverse effect, which can be irreversible."
Lithium: Cardiac Adverse Effects and When to Get an ECG
When should you monitor electrocardiograms in patients taking lithium?
Lithium and Suicide Prevention: More Thoughts on Recent VA Study
"Despite this new study and the need for further research, the best recommendation at this time regarding lithium in patients with bipolar disorder who are suicidal would be to consider it a worthwhile option."
Drug-Drug Interactions in Patients with Bipolar Disorder
Up to 20% of patients with bipolar disorder have 4 or more medications, so it is important to be aware of these common drug-drug interactions.
Lithium Levels—What Increases and Decreases Them?
Here are a few reminders to help avoid both toxicity and loss of effectiveness.
Bipolar Disorder: Sorting Out Comorbidities
Because patients with bipolar disorder often have underlying comorbidities, a thorough diagnosis is imperative.
Chronic Kidney Disease and Lithium—A New Perspective
Mania With Psychosis vs Schizophrenia vs Schizoaffective Disorder, Bipolar Type
Have you had difficulty with differential diagnosis when patients have manic symptoms and psychosis? One doctor discusses the related DSM-5 criteria changes and some of their implications for psychopharmacology.
Lithium Neurotoxicity: The SILENT Syndrome
This infrequent, but important, toxic effect of lithium deserves increased awareness.
Sorting Out Comorbidities
Bipolar Depression: How Not to Miss the Diagnosis
Major depressive episode and bipolar disorders: same DSM-5 diagnostic criteria, but very different disorders.
Medication Decisions for Women of Childbearing Potential
Bipolar disorder and pregnancy: what considerations need to be kept in mind?
Shining a Spotlight on Bright Light for Acute Bipolar Depression
A rare robust finding from a study on bipolar depression.
Tips for Lithium Dosing for Optimal Renal Safety
Higher lithium levels are associated with a greater risk of long-term kidney harm and more frequent depressive episodes. This bipolar update reviews ways to minimize renal side effects.
Prazosin: The Best Medication for Comorbid PTSD?
Why does prazosin appear to be the safest and most effective medication for select patients with comorbid PTSD?
Comorbid PTSD: Update on the Role of Prazosin
Prazosin appears to be effective and perhaps the best medication for selected patients, including those with bipolar disorder.
Addressing Smoking: Is Varenicline the Answer?
Many patients with bipolar and other psychiatric disorders believe it is better to wait to address cigarette and other nicotine use. Here is why that is not necessarily the case.
COVID-19 Pandemic’s Effects on Assessment & Psychopharmacological Management
As we learn about the effect of COVID-19 on patients with bipolar and other psychiatric disorders, clinicians should be prepared to ask questions to uncover new syndromic behaviors.
ADHD in Patients With Bipolar Disorder: Genetics, Diagnosis, and Treatment
Although clinicians and patients may wish otherwise, the comorbidity of ADHD and bipolar disorder needs to be considered.
4 New Algorithms to Help Improve Practice
Dr Osser discusses 4 new algorithms to help improve your practice.
Addressing Pain in Patients With Bipolar Disorder
The psychiatric prescribing clinician may be called upon to treat pain comorbid with bipolar disorder.
Reappraising a Preference for Valproate
David Osser, MD, comments on the low priority of valproate for treating patients with bipolar disorder.
Oxcarbazepine: Does It Have a Role in Bipolar Disorder?
Oxcarbazepine might be considered for patients who you want to treat with carbamazepine for mania (as monotherapy or adjunct) but for whom it would be unsafe or who have been unable to tolerate it.
Topiramate in Bipolar Disorder and Comorbidities: The Myths and the Evidence
There are some off-label proposed uses for topiramate in comorbidities that are common in patients with bipolar disorder. What does the evidence say?
Valproic Acid: Overused in Bipolar Disorder?
Valproate/divalproex appears to be considerably overused in the US; the use of lithium, second-generation antipsychotics, and carbamazepine should be more prominent in treatment decisions for patients with bipolar mania.
The Case Against Antidepressants for Bipolar Depression: Findings from STEP-BD
Do you prescribe antidepressants for your patients with bipolar depression? If so, think again, and consider results from these studies.
Cannabis: Patients With Bipolar Should Avoid Use
Regardless of whatever short-term benefit patients perceive from cannabis, the evidence points clearly to an association between usage and worsening course of bipolar disorder over time.
The Neuroprotective Effects of Lithium
Do you need help persuading patients to try lithium?
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