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Understanding Cannabis in Psychiatry: Pharmacology and Synthetic Cannabinoids

Dr. Paul Morrison   Clinical Senior Lecturer Institute of Psychiatry King’s College London   NHS Consultant Psychiatrist The Maudsley Hospital, London     This presentation discusses cannabinoid pharmacology and synthetic cannabinoids. The endocannabinoid system consists of: CB1 and CB2 receptors, anandamide, 2‐arachidonoylglycerol (2-AG). Regarding synthetic cannabinoids, they are CB1 full agonists and their effect is…

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Antipsychotics News: Cariprazine, Risperidone and New Drug Applications

Author: Flavio Guzman, MD Editor Psychopharmacology Institute Dr. Guzman has no conflicts of interest to disclose. Cariprazine for Negative Symptoms of Schizophrenia: The FDA Refuses to Review Supplemental New Drug Application (sNDA) The FDA has refused Allergan’s request to review a Supplemental New Drug Application (sNDA) to expand the approved uses to include negative symptoms of schizophrenia…

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Buprenorphine for Opioid Use Disorder: Mechanism of Action

By Joji Suzuki, MD Director, Division of Addiction Psychiatry Department of Psychiatry Brigham and Women’s Hospital Assistant Professor of Psychiatry Harvard Medical School This presentation reviews the mechanism of action of buprenorphine in the treatment of opioid use disorders. Dr. Suzuki explains how partial agonism and high affinity for mu opioid receptors increases the risk of…

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Comments on the 2017 VA/DoD Practice Guideline for the Management of PTSD

By: David Osser, MD; Flavio Guzman, MD In June 2017, the U.S. Department of Veterans Affairs and the Department of Defense published a new edition of the Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. After we published a video lecture (Faculty: David Osser, MD , Harvard Medical School) on…

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Prazosin for PTSD-Related Nightmares: Rationale and Dosing Strategies for Men and Women

David N. Osser, MD Associate Professor of Psychiatry Harvard Medical School Brockton Division of the VA Boston Healthcare System In this video, Dr. David Osser explains the rationale behind the recommendation of using prazosin as first-line treatment for PTSD-related nightmares and disturbed arousals. He also gives practical advice on different dosing strategies for men and…

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Buprenorphine Formulations: A Practical Summary for Clinicians

Joji Suzuki, MD Director, Division of Addiction Psychiatry Department of Psychiatry, Brigham and Women’s Hospital Assistant Professor of Psychiatry, Harvard Medical School This presentation discusses current buprenorphine formulations available for the treatment of opioid use disorder and the rationale for the buprenorphine/naloxone combination. One important concept to remember is that the combination tablet containing both…

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The Neurobiology of Behavioral and Psychological Symptoms of Dementia: An Illustrated Update

Author: Rajesh Tampi, MD Behavioral and psychological symptoms of dementia (BPSD) include a heterogeneous range of psychological reactions, psychiatric symptoms and behaviors. This presentation discusses the neurobiology of BPSD by addressing anatomical, biochemical and functional changes associated with this group of symptoms. BPSD tends to occur because of a complex interaction between anatomical, functional, and…

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Psychopharmacology of Sleep and Wakefulness: Understanding Neurotransmitters and Pathways in Clinical Practice

Author: Flavio Guzman, MD This tutorial integrates neurotransmitters involved in sleep and arousal with the pharmacology of specific psychotropic agents. We review neurotransmitters that promote wakefulness (dopamine, norepinephrine, serotonin, acetylcholine, histamine, orexin/hypocretin) and summarize how current drugs influence each system. We also discuss neurotransmitters that promote sleep (adenosine, GABA, melatonin). This is an integration between…

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Fluvoxamine Essentials: Mechanism of Action, Indications, Pharmacokinetics and Dosing

Author: Flavio Guzman, MD Besides being a SERT inhibitor, fluvoxamine is an agonist at sigma 1 receptors. The drug is approved in the US for the treatment of OCD but not depression. This is interesting as this is a widely used antidepressant in other countries. Fluvoxamine has the potential for drug-drug interactions through inhibition of…

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Cannabis and Mental Health: 2017 Report of the National Academy of Sciences, Engineering and Medicine

Author: Flavio Guzman, MD The National Academies of Sciences, Engineering, and Medicine published a report on the health effects of cannabis and cannabinoids. Here we reproduce the key points of the mental health chapter. You can access the full publication here. Psychosis and schizophrenia Cannabis use is likely to increase the risk of developing schizophrenia…

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