Psychopharmacology_tips - Articles - Page 2

Mirtazapine Augmentation: Running Low on Rocket Fuel

August 30, 2019

Thomas Jordan, MD and Chris Aiken, MD. Dr. Jordan and Dr. Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dubbed “California Rocket Fuel” by Stephen Stahl, the combination of venlafaxine and mirtazapine seemed to hit all the right receptors. The hype may have gotten a little ahead of the evidence on this one, however, as three new studies reveal.

A New Contraindication for Ambien and the Z-Hypnotics

August 30, 2019

Chris Aiken, MD Talia Puzantian, PharmD, BCPP

Chris Aiken, MD Talia Puzantian, PharmD, BCPP Dr. Aiken and Dr. Puzantian have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The FDA rarely issues absolute contraindications, but that’s where their language is tilting in a new warning on Z-Hypnotics. We look at the data behind their decision and offer six tips for safer prescribing of sleep medications.

Is Paxil the Best SSRI for Anxiety?

August 30, 2019

Chris Aiken, MD

Chris Aiken, MD Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Paxil built its reputation as the best SSRI for anxiety, but the data suggests the opposite.

l-Methylfolate for Depression: Costly Mistake or Good Thinking?

August 1, 2019

Folic acid and l-methylfolate are two versions of the same vitamin. Both are popular for antidepressant augmentation, but one is a expensive prescription. We compared them side-by-side and found that one has a slight advantage.

Medication Side Effects Part II: Weight Gain, Akathisia, Hair Loss, and Orthostasis

August 1, 2019

Rajnish Mago, MD

Rajnish Mago, MD

Editor-in-Chief of Simple and Practical Mental Health and author of Side Effects of Psychiatric Medications: Prevention, Assessment, and Management Dr. Mago has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Mago reveals his top strategies for common side effects. Featuring safe-dosing of metformin, vitamins for hair loss, and special stockings for orthostasis.

Opioid Treatment Options

November 8, 2018

Opioid use disorder (OUD) treatment can be tricky, in part because it doesn’t respond well to detox and counseling-only approaches. The overwhelming majority of people relapse after such attempts, or even become more vulnerable to overdose because of decreased tolerance after detoxing.

New Stimulants: From Remixed Amphetamines to Bedtime Ritalin

November 1, 2018

Chris Aiken, MD

Chris Aiken, MD Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

You may have noticed that a confusing array of new stimulants has been approved in the last few years. Since 2012, there have been five new amphetamines and two new methylphenidates. What are these preparations? Are any of them worth prescribing to your patients?

Harnessing Beneficial Drug Interactions

November 1, 2018

Rehan Aziz, MD and Chris Aiken, MD

Rehan Aziz, MD Associate Professor of Psychiatry and Neurology at Rutgers Robert Wood Johnson School of Medicine. Dr. Aziz has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity. Chris Aiken, MD Editor-in-Chief, The Carlat Psychiatry Report. Dr. Aiken has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

It’s nice when we can get our patients better with a single medication, but that’s not always possible. Sometimes the right combination of meds can do the trick, but studies of polypharmacy are scarce. In this article we dig through that research, small and limited as it is, to highlight a few useful combinations where the drug interaction can benefit your patient.

EXPERT Q&A

Effects of Drug Interactions

November 1, 2018

Neil Sandson, MD

Neil Sandson, MD.
Clinical Associate Professor, Department of Psychiatry at University of Maryland School of Medicine

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

When it comes to computer alerts for drug interactions, the two issues to pay attention to are toxicity and loss of efficacy. Toxicity is the bigger concern, particularly if the drug has a “narrow therapeutic index,” where modest differences in the level can have dangerous effects.

How Ethnicity Influences Medication Response

October 1, 2018

Donna Lisi, PharmD. and Chris Aiken, MD.

Donna Lisi, PharmD. Contributing writer to the Carlat Psychiatry Report newsletters. Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Drs. Lisi and Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

From cultural expectations to genetic variations, ethnicity has a strong effect on medication response. In this article, we’ll review five areas where ethnic groups can differ in their biological response to psychiatric medications.