In this very special newsletter issue, we include practical tips on how to deal with the COVID-19 pandemic. We also share the latest information on TMS, key points from a presentation on postpartum mood disorders, and our practical research summaries (Quick Takes).
COVID-19: Recommendations and Tools for Mental Health Clinicians
Recommendations
These recommendations are based on the Center for the Study of Traumatic Stress Guide for Clinicians. We have included additional resources for your convenience.
- Stay informed, and educate your patients.
- Sources of reliable information:
- CDC
- WHO
- If you use WhatsApp, text “Hi” to this number: +41 79893 1892
- A chatbot will reply with updates.
- Educate
- Patient education plays a critical role in mitigating emotional distress.
- WHO document for the community: download PDF.
- Patient education plays a critical role in mitigating emotional distress.
- Sources of reliable information:
- Limit media exposure.
- Gather the information you need, and then turn the media off.
- Advise your patients to do the same.
- Take care of yourself and your loved ones.
- You are not invulnerable to experiencing your own emotional distress during outbreaks.
- This distress can be compounded by caring for sick and distressed patients.
Apps and Tools
| App Name | Comments |
| Sanvello |
Smartphone app Meditation, daily mood tracking, and coping tools Free premium access through the COVID-19 crisis |
| Headspace |
Smartphone app Guided meditations, animations, articles, and videos Headspace is offering all US healthcare professionals who work in public health settings free access to Headspace Plus through 2020. |
| Calm |
Web app. Paid service, they are offering free meditations and other resources. |
FDA Breakthrough Device Designation for TMS for Bipolar Depression
- The NeuroStar Advanced Therapy (Neuronetics Inc.) transcranial magnetic stimulation (TMS) system is the first device to receive the FDA’s breakthrough device designation for the treatment of bipolar depression.
- Breakthrough designation is a process that will expedite the FDA review of the NeuroStar Advanced Therapy clinical trial program. (1)
- If approved for bipolar depression, it could provide an option for those patients who do not respond to medications.
A Practical Update on TMS in Psychiatry With Dr. Simon Kung
In this interview with Dr. Simon Kung, he discusses the background of TMS and how to use it for clinical treatment. Dr. Kung talks about TMS for depression, GAD, and OCD; efficacy; side effects; and relapse rates. He also leaves the door open for possible future uses.
Interview Highlights:
- For unipolar depression, TMS is about as efficacious as antidepressants and has a similar relapse rate as ECT.
- TMS was FDA approved for OCD in 2018.
- In open-label studies, the response rate for bipolar depression is comparable to that of unipolar depression, but more studies are needed.
Learn more and earn 0.5 CME credits here
Postpartum Mood Disorders
Dr. Marlene Freeman discusses postpartum depression, bipolar disorder, and psychosis. She guides clinicians on the importance of a correct diagnosis, risk factors, prevention, and appropriate pharmacologic and nonpharmacologic treatment for postpartum and breastfeeding women.
You can earn 1.5 CME credits here
Treatment Strategies for Postpartum Bipolar Disorder
- Valproic acid is highly teratogenic and associated with longer-term neurodevelopmental problems.
- Because the risk of major malformations occurs early in pregnancy and many pregnancies are unplanned, it should be avoided in girls and women of reproductive age.
- Although lithium has an association with cardiovascular defects after first-trimester exposure, the absolute risk is small, and continuing lithium may be appropriate for women who respond well to it. Learn more
Quick Takes: Informing Your Practice
What Is the Real Risk of Antipsychotic Use and Pneumonia?
- There is a causal association between antipsychotic use and pneumonia; however, the absolute risk is low. Learn more
Benzodiazepine Practicalities
- Theoretically, benzodiazepines could be prescribed up to 2 weeks of regular use with very low risk of tolerance, dependence, and withdrawal. Learn more
Listen to or read the full volume, and earn 0.5 CME credits here
Reference
1.- Brooks, M. (2020, March 6). TMS device receives breakthrough status for bipolar depression. Retrieved from https://www.medscape.com/viewarticle/926364?src=soc_fb_200311_mscpedt_news_mdscp_bipolar&faf=1
