Julie Gentile, MD
Professor of psychiatry at the Boonshoft School of Medicine, Wright State University. Project director for Ohio’s Coordinating Center of Excellence in Mental Illness & Intellectual Disability.
Dr. Gentile has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.David Dixon, DO
Clinical chief resident, Wright State University, Department of Psychiatry.
Dr. Dixon has disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Prescribing psychotropic medications in patients with intellectual disability (ID) requires certain nuances in approach that may be unfamiliar to some psychiatrists. In this article, we’ll discuss some aspects of assessment and treatment that you may find useful when you encounter and work with such patients.
Julie Gentile, MD
Professor of psychiatry at the Boonshoft School of Medicine, Wright State University. Project director for Ohio’s Coordinating Center of Excellence in Mental Illness & Intellectual Disability
Dr. Gentile has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Psychotherapy is all about communicating, yet people with intellectual disability often have significant limitations in their communication skills, depending on their level of cognitive functioning. Is it possible for us to help these patients? If so, how? Julie Gentile, MD (www.juliegentile.com) has been looking at these questions for 20 years.
Julie F. Brown, PhD, MSW.
Director of the Skills System at Justice Resource Institute and an adjunct faculty at the Trauma Center at JRI in Brookline, MA.
Dr. Brown has disclosed that she consults with agencies about implementing the Skills System Therapy Technique. Dr. Carlat has reviewed this article and has found no evidence of bias in this educational activity.
Patients with intellectual disability often have difficulty controlling their emotions, which is what leads to so-called “challenging behaviors.” These behaviors include a range of aggressive and impulsive interactions, such as assault to self or others, stealing, fire-setting, sexual offenses, and other problematic situations.
Taylor Walker Noriega, PharmD candidate (2018)Ms. Noriega has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Ketamine has become increasingly popular as an off-label medication for rapid onset treatment of refractory depression. Recently, the American Psychiatric Association convened a task force to review the data and come up with some recommendations.
The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.
Michael Posternak, MD
Psychiatrist in private practice in Boston, MA
Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
How do you start a new patient on antidepressant treatment? We do this countless times in our practices, and reviewing the topic may feel a bit like returning to residency. However, it’s important to revisit our standard operating procedures from time to time to ensure we’re thinking carefully about our decisions during our busy days.
Michael Gitlin, MD
Director of the Outpatient Mood Disorder Program at UCLA, as well as author of The Psychotherapist’s Guide to Psychopharmacology (Free Press)
Dr. Gitlin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
You’ve tried different SSRIs and then some, but your patient either can’t tolerate what you’ve prescribed or simply hasn’t experienced a lift in mood. Now what? Dr. Gitlin has some ideas.
Jonathan E. Becker, DO
Assistant professor of clinical psychiatry and behavioral sciences at Vanderbilt University School of Medicine
Dr. Becker has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Your patient has now failed four antidepressant medications, both alone and as cocktails. What else can you pull out of your bag of tricks? Dr. Becker suggests considering transcranial magnetic stimulation (TMS), which he maintains is underutilized. “Many of my colleagues right down the hall from me still don’t think of TMS for treatment or don’t know who to refer for it,” he says. “I think it should be more readily considered for a lot of patients out there.”
For a look at how TMS works, how effective it is, how it compares with electroconvulsive therapy (ECT), whether some brands of TMS machines are better than others, and what you have to do to make sure your patient’s health insurance plan picks up the tab, we spoke with Dr. Becker, who prescribes this treatment for some of his patients.