pharmacology-tips | CARLAT PUBLISHING

EXPERT Q&A

The Schizophrenia-OCD Overlap

September 28, 2021

Michael Poyurovsky, MD

Ma’ale HaCarmel Mental Health Center, Tirat Carmel, Israel; Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel. Dr. Poyurovsky has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

OCD and schizophrenia often overlap, but treatment of this comorbidity is risky terrain. Dr. Poyurovsky explains when antidepressants should be avoided and details which antipsychotics are more likely to exacerbate OCD and which ones are more likely to help it.

How to Switch Antipsychotics

February 3, 2021

Peter Smith, PsyD.

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

Should you stop the old antipsychotic and start the new? Or gradually cross-taper them? This new meta-analysis compared three titration strategies to find the best way to switch from one antipsychotic to another in schizophrenia.

Keeping Up With Trintellix

October 6, 2020

Michael Posternak, MD.

Michael Posternak, MD. Psychiatrist in private practice, Boston, MA. Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Not satisfied with its claim to improve cognitive features of depression, Trintellix has ventured into new therapeutic arenas. Sometimes with success, sometimes with failure, we review where this novel antidepressant stands in schizophrenia, anxiety, cognitive decline, ADHD, sexual dysfunction, and binge eating disorder.

Mood Stabilizers: What You Don’t Know Can Hurt Them

October 6, 2020

Nicholas Rosenlicht, MD.

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

There are many mood stabilizers to choose from, but which ones are the best tolerated? This meta-analysis looks at how they stack up in terms of weight gain, sedation, and overall discontinuation.

Who Should Get Lithium?

September 3, 2020

Janusz Rybakowski, MD, PhD

Janusz Rybakowski, MD, PhD

Janusz Rybakowski is a pioneer in lithium research who has authored over 500 articles on clinical psychiatry. He is a professor of psychiatry at Poznan University in Poland, former chairman of psychiatry at the Medical Academy Bydgoszcz, and author of an upcoming textbook on lithium. Dr. Rybakowski has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Some patients respond so well to lithium that they rarely need other interventions. Janusz Rybakowski sums up what we know about the optimal lithium responder, how to use this underutilized medication, and what lithium’s antiviral properties mean in the era of COVID-19.

Trazodone: The Forgotten Antidepressant

May 7, 2020

Eugene Rubin, MD

Eugene Rubin, MD Private practice, Bingham Farms, MI. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Trazodone is rarely used as an antidepressant, and that’s a missed opportunity. It lacks the weight gain, sleep disruption, and sexual side effects that so many antidepressants cause. In this article are two important dosing tips that can make it work better.

Optimal Antidepressant Doses in Major Depression

March 9, 2020

Kristen Gardner, PharmD.

Kristen Gardner, PharmD. Dr. Gardner has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

More is not necessarily better in psychopharmacology. Some medications have plateau effect, while others follow a “U-shaped curve,” causing more problems as the dose goes too high. This metaanalysis looked at 77 dose-response trials with antidepressants to quantify their optimal therapeutic window.

An Answer for Psychotic Depression

February 10, 2020

Randall Moore, MD.

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

Research tells us how to start meds, but rarely when to stop them. This study brings some needed answers on discontinuing antipsychotics after recovery from psychotic depression.

Mirtazapine Augmentation: Running Low on Rocket Fuel

August 30, 2019

Thomas Jordan, MD and Chris Aiken, MD.

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.

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.