Psychopharmacology

Mood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.

The challenges of identifying patients at risk for alcohol withdrawal have been found to be mitigated by the development of a Risk Stratification Questionnaire, now being adopted by the VA regionally throughout New England. More in this video.

Keys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the disorder's biopsychosocial underpinnings. Here, Stephen V. Sobel, MD, focuses on treatment options.

Keys to the management of panic disorder include appropriate use of psychotropic medication and psychotherapy predicated on an understanding of the biopsychosocial underpinnings. More in this podcast.

Why is it important to exercise caution in the treatment of bipolar depression, especially in young women? Take the quiz and learn more.

Bipolar disorder is a longitudinal disorder defined by multiple episodes that may occur years apart. As a result, the proper diagnosis requires careful evaluation of both the current symptoms and the patient’s history.

Despite pharma's retreat and the many challenges in psychiatric drug development -- as detailed here -- the current psychiatric drug pipeline is not totally dry.

Some attorneys have argued that SSRIs cause serious adverse events, capable of compelling defendants to engage in strikingly complex criminal behavior. On close examination, however, these phenomena may be clearly distinguished from criminal behavior.

How can you apply the framework and philosophy of evidence-based medicine to the use of antipsychotic medication? Here to discuss is Leslie L. Citrome, MD, MPH.

For many patients with depression, full symptom remission remains elusive despite multiple trials of antidepressants. This article focuses on psychopharmacological and related interventions.

What if someone with “prescriptive privileges” looked at superficial symptoms only, and ordered antipsychotics without considering the bigger picture?

More than half of all patients with psychiatric disorders report disturbances of sleep and wakefulness. "Sleep disorders are associated with impaired daytime function and predict a heightened future vulnerability to psychiatric disease. They also diminish life span.” Details from an expert here.

This article summarizes efforts to develop neurocognitive enhancement drugs administered individually or as an adjunct to other antipsychotics and cognitive remediation.

Dr Gerard Sanacora discusses novel antidepressant agents with potential clinical relevance for the treatment of major depressive disorder and bipolar disorder.

Some criminal activity can be eliminated by pharmacotherapy for ADHD. Should this information influence clinical practice? The short answer is an un­equivocal “yes.”

If our survey on medical cannabis is any indication, psychiatrists are widely-and deeply-divided on whether and how marijuana should be used in clinical practice. You can read the results here.

Obesity is one of the most common physical health problems in individuals with psychiatric conditions and contributes to excess medical morbidity and mortality. Several classes of psychotropic medications, particularly atypical antipsychotics, cause weight gain. While these issues pose challenges to optimal health, the good news is that there are solutions and emerging strategies.

Hypothyroidism is a common clinical disorder that psychiatrists frequently encounter. However, symptoms of thyroid dysfunction are often vague and nonspecific, which can lead to delayed or missed diagnosis.

For now, it is encouraging to know that psychiatrists remember that they, too, are physicians first who can tap into their medical training to provide comprehensive patient care.

Results of a 10-week prospective study, recently reported at the Annual Meeting of the American Association for Geriatric Psychiatry, offered no conclusive evidence about the mortality risk of elderly patients with Alzheimer disease who were treated with antipsychotics.

The rise in suicides and lethal overdoses of opioid analgesics is probably not coincidental. In most overdose deaths, we have no way of knowing with any degree of certainty whether they were accidental deaths or intentional suicides.

This article reviews some of the most recent findings in genetics and pharmacogenetics of schizophrenia-especially those with clinical implications.

Calling all psychiatrists: we conducted a survey of your opinions about prescribing medical cannabis and invite you to view the results.

Two problems persist in the treatment of severe mental illness that constitute a barrier to effective patient-centered care: excessive reliance on a limited number of antipsychotic medications at the expense of other effective treatments, and the underutilization of other evidence-based treatment options.

Quick . . . name a class of prescription medications that, by most evidence, appears to be overprescribed and abused and the use of which has resulted in an increasing number of emergency department visits. If you said "opioids," you would be right.

Engaging in mindfulness activities either individually or with patients who come to us for brief medication visits can have a profound influence on the therapeutic process.

The extent to which antidepressant use during pregnancy is associated with increased risks of postnatal adaptation syndrome, persistent pulmonary hypertension in the newborn, first-trimester teratogenicity, stillbirth, and infant mortality is explored in 2 recent studies. A close up look here. . .

Drug interactions are more frequent in elderly patients because more medications are taken. In addition, drug interactions may be more serious because of insufficient physiological reserves. When new medications are started or stopped in elderly patients, it is very important to take note of potential interactions with other drugs or foods.

Given the likelihood that insufficient numbers of patients will be available for a randomized controlled trial of MAOIs in refractory depression or atypical depression, we must still rely on consensus guidelines and expert opinion.