Unbiased and Practical Psychopharmacology Updates For Prescribers

Recent articles and videos

Lamotrigine Is Not Slow: Comments About Its Efficacy in Bipolar Depression

James Phelps, MD Director Mood Disorders Program Samaritan Mental Health, Corvallis, OR. Dr. Phelps has no conflicts of interest to disclose. Lamotrigine has a reputation for being slow because of its long titration period. Lamotrigine was just as fast as the olanzapine/fluoxetine combination (OFC) in a trial sponsored by the manufacturer of OFC, Eli Lilly.…

Lamotrigine Interactions: Practical Recommendations on Divalproex, Carbamazepine and Oral Contraceptives Use

James Phelps, MD Director Mood Disorders Program Samaritan Mental Health, Corvallis, OR.   There are two drug interactions with lamotrigine that must be managed with special care. When lamotrigine is added to divalproex and when lamotrigine is used with carbamazepine. If the patient is already on divalproex and you are adding lamotrigine, cut lamotrigine dose…

Antipsychotic-Induced Dystonia: Diagnosis and Management

Michael D. Jibson, MD, PhD Professor of Psychiatry Director of Residency Education University of Michigan   Acute dystonic reactions are associated with antipsychotic use, especially with high-potency first-generation antipsychotics. About 90% of these reactions occur either in the first four days of treatment or after an increase in dose. Risk factors include large muscle mass,…

Antipsychotics for Agitation: Differences Between Tablets, Orally Disintegrating Tablets and Sublingual Formulations

Michael D. Jibson, MD, PhD Professor of Psychiatry Director of Residency Education University of Michigan This presentation discusses how to prescribe oral antipsychotics for acute agitation (standard tablets, orally disintegrating tablets, and a sublingual formulation). Orally disintegrating antipsychotics (Abilify Discmelt, Zyprexa Zydis, Risperdal M-Tab) are not absorbed transmucosally, they have to be swallowed. Orally disintegrating…

Managing Geriatric Bipolar Disorder: Use of Lithium and Anticonvulsants

Sandra A. Jacobson, M.D. Research Associate Professor University of Arizona College of Medicine-Phoenix This presentation discusses selected concepts on the use of mood stabilizers in the elderly. Lithium serum levels are kept low (0.4 and 0.8 mEq/L), even for the treatment of mania in elders. Lithium should be dosed on a once nightly basis with…

Geriatric Psychopharmacology: How Pharmacokinetic and Pharmacodynamic Changes Affect Prescribing

Sandra A. Jacobson, M.D. Research Associate Professor University of Arizona College of Medicine-Phoenix   In terms of pharmacokinetic changes, aging slows hepatic metabolism. However, liver function tests are poorly correlated with drug metabolizing activity. Normal aging does not affect glucuronidation reactions, but it does affect oxidation reactions. Psychotropics metabolized by glucuronidation are preferred in the…

Treatment-Resistant Depression: Augmentation with Second-Generation Antipsychotics (Aripiprazole vs Quetiapine)

Prof. Philip Cowen Professor of Psychopharmacology Department of Psychiatry University of Oxford, UK This presentation compares advantages and disadvantages of using quetiapine vs. aripiprazole as augmentation for treatment-resistant depression. It also addresses the common question of when to augment (antidepressant + SGA) vs. when to switch (prescribing a different antidepressant). Combination and Augmentation: Clarifying Concepts…

Inflammation and Depression: Use of Anti-Inflammatory Agents and The Role of Inflammatory Markers (CRP)

Prof. Philip Cowen Professor of Psychopharmacology Department of Psychiatry University of Oxford, UK This presentation summarizes recent findings on the role of inflammation in depression. A study suggests patients with elevated levels of inflammatory markers (C-reactive protein) have a differential response to a specific antidepressant. The efficacy of celecoxib and infliximab in treatment-resistant depression is…

2018 APA Alcohol Use Disorder Guideline: Summary of Recommendations

By Flavio Guzman, MD Editor Psychopharmacology Institute The American Psychiatric Association (APA) released a new practice guideline on the treatment of alcohol use disorder. We reproduce below a summary of selected recommendations on pharmacotherapy. Pharmacotherapies for Alcohol Use Disorder Naltrexone or Acamprosate APA recommends (1B) that naltrexone or acamprosate be offered to patients with moderate…

2017 in Review: New Drugs, Formulations and Clinical Guidelines

Author: Flavio Guzman, MD Dr. Guzman has no conflicts of interest to disclose. In this article, we look back at the most clinically relevant news of 2017 in the field of psychopharmacology. In terms of new drugs, two medications were approved for the treatment of tardive dyskinesia: valbenazine (Ingrezza) and  deutetrabenazine (Austedo). This publication also summarizes…

PDF: LAI Antipsychotics

Screenshot 2017 01 07 12.39.54

Free PDF Download

  • New formulations (Aristada, Invega Trinza)
  • Practical dosing tables
Powered by ConvertKit