Drug Classes

Summary of Newly Approved Antipsychotics

By Flavio Guzman, MD Two new second-generation antipsychotics were approved in 2015: brexpiprazole (Rexulti) and cariprazine (Vraylar). Like aripiprazole (Abilify), they are both D2 partial agonists and are associated with risk of akathisia. Aripiprazole, brexpiprazole and cariprazine are FDA-approved for the treatment of schizophrenia. Aripiprazole and cariprazine are approved for the treatment of manic episodes in…

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Reviewing Antipsychotic Adverse Effects with Prof. Mark Taylor

Professor Mark Taylor is a consultant psychiatrist at the NHS in the UK. He is also Associate Professor at the University of Queensland in Brisbane Australia. He is the coauthor of a paper published in the Journal of Psychopharmacology: “First do no harm.” A systematic review of the prevalence and management of antipsychotic adverse effects”.…

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Aripiprazole Lauroxil Extended-Release Injectable (ARISTADA)

By Flavio Guzman, MD Prescribing information highlights To be administered by intramuscular injection in the deltoid (441 mg dose only) or gluteal (441 mg, 662 mg or 882 mg) muscle by a healthcare professional. For patients naïve to aripiprazole, establish tolerability with oral aripiprazole prior to initiating treatment with ARISTADA. ARISTADA can be initiated at…

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Methylphenidate for ADHD: Mechanism of Action and Formulations

Author: Flavio Guzman, MD Dr. Guzman has no conflicts of interest to disclose Methylphenidate is a CNS stimulant approved for the treatment of narcolepsy and attention deficit hyperactivity disorder (ADHD). Methylphenidate inhibits the reuptake of dopamine and norepinephrine, increased dopaminergic and noradrenergic activity in the prefrontal cortex may explain its efficacy in ADHD. There are many formulations available,…

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Pharmacotherapy of Treatment-Resistant OCD: Augmentation Strategies

Treatment of obsessive compulsive disorder is often challenging. Treatment resistance is quite common, between 40 to 60% of patients do not show and adequate response to first-line treatments. We invited Dr. David Veale to comment on his meta-analysis published in BMC Psychiatry : “Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review…

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Valproate in Psychiatry: Approved Indications and Off-Label Uses

By Flavio Guzman, MD . This brief article summarizes the clinical uses of valproate in psychiatry. We discuss FDA-approved indications as well as off-label uses. Instead of an exhaustive review, this is a practical summary for clinicians. The term valproate includes a number of formulations, such as: Valproid acid Divalproex sodium Divalproex sodium extended release…

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FDA Warning: Ziprasidone Associated with DRESS Syndrome

The FDA has issued a warning (December 11, 2014) that the second generation antipsychotic ziprasidone (Geodon and others) is associated with a rare but serious skin condition known as Drug Reaction with Eosinophilia (DRESS)and Systemic Symptoms . Excerpts from the FDA website: A new warning has been added to the Geodon drug label to describe…

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Side Effects of Antidepressants: Interview with Dr. Rajnish Mago

In this expert interview we discuss side effects of antidepressants. Our guest today is Dr. Rajnish Mago. Dr. Mago currently serves as Director of the Mood Disorders Program at the Thomas Jefferson University Hospital in Philadelphia, Pennsylvania. He is Associate Professor of Psychiatry at the Jefferson Medical College. He recently published the high-yield book “Side…

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Citalopram and Escitalopram: A Summary of Key Differences and Similarities

Author: Flavio Guzman, MD Psychiatrist Pharmacology Department University of Mendoza Argentina Citalopram (Celexa) and escitalopram (Lexapro) are two commonly prescribed SSRIs used for the treatment of depression and anxiety disorders. This brief multimedia tutorial explores the differences and similiarities between these two SSRIs. Introduction: Basic Concepts Let me highlight some useful points before getting into more…

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Venlafaxine and Desvenlafaxine: Differences and Similarities

Author: Flavio Guzman, MD Venlafaxine (Effexor) is an SNRI that is metabolized to O-desmethylvenlafaxine or desvenlafaxine. In 2008 this active metabolite was approved as antidepressant (Pristiq). In this multimedia tutorial we discuss what the two drugs have in common and their differences, we also explore mechanisms of action, indications, pharmacokinetics, adverse effects and dosing guidelines.…

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