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.
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Does ADHD bring creative strengths? Can stimulants dampen creative thought? New research suggests they can, but the effect varies by patient.
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Last October, we published a table on mood stabilizer side effects that raised an understandable alarm among astute readers. The table, which was based on a 2020 meta-analysis, suggested that aripiprazole (Abilify) has a greater chance of causing weight gain than quetiapine (Seroquel). What the table failed to specify was that the figures were based on long-term maintenance studies.
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SSRIs are often used to reduce irritability, but questions about they can cause violence have loomed over these antidepressants since the early 1990’s. This new study, with 700,000 patients followed over 7 years, suggests they can.
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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.
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CBT for Benzo Withdrawal. Medications have largely proven unsuccessful for benzodiazepine withdrawal, but CBT looked promising in this meta-analysis of three randomized controlled trials. Compared to gradual tapering without CBT, the addition of this psychotherapy allowed an extra 1 in 3 patients to successfully come off their benzodiazepine. A therapist...
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Buspirone (Buspar) is approved for generalized anxiety disorder, but its efficacy there is often questioned. Here we find out how it stacks up against the benzos and SSRIs, and explore its off-label potential in depression, sexual dysfunction, alcoholism, traumatic brain injury, and premenstrual dysphoric disorder.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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