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EXPERT Q&A

QT Intervals in Psychiatric Practice

October 1, 2022

Victoria Hendrick, MD and Paul Barkopoulos, MD.

Paul Barkopoulos, MD. Clinical Assistant Professor, Psychiatry & Biobehavioral Sciences, UCLA David Geffen School of Medicine and Olive View UCLA Medical Center, Los Angeles, CA.

Victoria Hendrick, MD. Editor-in-Chief, The Carlat Hospital Psychiatry Report; Chief, Inpatient Psychiatry, Olive View UCLA Medical Center.

Dr. Barkopoulos and Dr. Hendrick, authors for this educational activity, have no relevant financial relationship(s) with ineligible companies to disclose.

Several psychiatric medications prolong the QTc interval and place patients at risk of the dreaded torsade de pointes. Some patients are particularly vulnerable to QTc prolongation: the elderly, patients with heart disease and electrolyte imbalances, and patients taking certain medications, like thioridazine and ziprasidone. We provide a step-by-step guide so that you can keep your patients safe from this cardiovascular side effect.

Uncommon Tips: Which Is Better—Citalopram or Escitalopram?

June 1, 2022

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief, The Carlat Psychiatry Report. Dr. Aiken has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Citalopram and escitalopram are very similar drugs, but there are reasons to prefer one over the other.

Citalopram Plus Stimulants for Chronic Irritability?

July 14, 2021

Eric Robbins, MD.

Eric Robbins, MD. Dr. Robbins has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Disruptive Mood Dysregulation Disorder (DMDD) is a challenging syndrome. Some have conceptualized it as a combination of ADHD and ODD. Are there good ways to treat the irritability that do not involve antipsychotics or anti-epileptic drugs? This study explores adding citalopram to stimulants.

SSRIs and Intracerebral Hemorrhage Risk

May 21, 2021

Paul Barkopoulos, MD.

Paul Barkopoulos, MD. Dr. Barkopoulos has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

SSRIs help relieve post-stroke depression but increase the risk of intracerebral hemorrhage. This study gives us tips to reduce this risk.

Can Antidepressants Prolong Survival in Cancer Patients?

May 21, 2021

Paul Barkopoulos, MD.

Paul Barkopoulos, MD. Dr. Barkopoulos has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Antidepressant adherence is linked with increased survival among cancer patients.

EXPERT Q&A

How to Come Off a Psych Med Part 1: Antipsychotics

February 3, 2021

Swapnil Gupta, MD

Swapnil Gupta, MD
Associate professor at Icahn School of Medicine at Mount Sinai. Co-author of Deprescribing in Psychiatry (Oxford, 2019). Dr. Gupta has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

How do you taper off an antipsychotic? Swapnil Gupta gives a practical approach, and discusses dopamine hypersensitivity, a controversial theory that suggests antipsychotic withdrawal can cause dyskinesias, prolactinemia, and rebound psychosis.

How to Select an SSRI

November 12, 2020

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of TCPR. 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.

After digging through 3 decades of research, we can tell you this: There is no such thing as “the best” SSRI. But there are some important differences between them, and this article will show you how to find the right one for your patient.

Mood and Menopause

October 6, 2020

Ruta Nonacs, MD, PhD

Ruta Nonacs, MD, PhD
Ruta Nonacs practices psychiatry at Massachusetts General Hospital’s Perinatal and Reproductive Psychiatry Clinical Research Program. She has published original research on peripartum mood disorders and is the author of A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in Her Childbearing Years (Simon & Schuster). Dr. Nonacs has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Ruta Nonacs names the antidepressants that work best for menopausal depression and when to move to hormonal therapies. And for adolescents and young adults, she tells us which birth control pills are least likely to worsen mood.

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.