In this newsletter, we include an ABC framework for addressing a successful vaccination, share the clinical essentials of drug-induced movement disorders, and address a few clinical tips on diagnosing and managing bulimia nervosa. We also comment on 2 article reviews for our Quick Takes: A review on the use of electroconvulsive therapy for mania and a systematic review and meta-analysis on the impact of smoking behavior on clozapine blood levels.
The ABCs of Successful Vaccinations: A Role for Psychiatry
Psychiatrists may be well-positioned to help increase vaccine uptake among psychiatric patients, as they are a trusted source of medical information and well-versed in using motivational interviewing tools, which can help manage vaccine hesitancy.
The ABCs include:
- A = Attitudes toward vaccination
- B = Barriers to vaccination
- C = Completed vaccination series.
“Attitudes toward vaccination is an area in which psychiatrists can potentially move patients from hesitancy to vaccine confidence and acceptance.”
Some of the recommendations for addressing attitudes toward vaccination include:
- Express confidence in the vaccine.
- Use presumptive language.
- Ask about any impediments to getting vaccinated.
- Assist with scheduling a vaccine appointment.
The Centers for Disease Control and Prevention offers an online toolkit to help clinicians discuss vaccinations with their patients, which is linked here.
These pearls were published on March 18, 2021, and you can find them in Current Psychiatry. Learn more.
Drug-Induced Movement Disorders: The Clinical Essentials, With Gregory Pontone, M.D.
In this interview, Dr. Gregory Pontone reviews the 4 different drug-induced movement disorders, including their phenomenology and available treatments. He also shares practical tips for initiating these treatments and how long to continue them.
Interview highlights include the following:
- Propranolol is the first-line treatment for akathisia, and the dose will be dependent on each population.
- Anticholinergics for drug-induced extrapyramidal symptoms will be required for as long as the patient is on the primary agent causing the side effect.
- Vesicular monoamine transporter 2 inhibitors are useful for tardive syndromes.
Learn more and earn 0.5 CME credits here.
The Psychopharmacology of Feeding and Eating Disorders
In this presentation, Dr. Timothy Brewerton discusses the prevalence, neurobiology, and psychopharmacology of feeding and eating disorders. He also discusses research regarding several treatment options for feeding and eating disorders.
Bulimia Nervosa (BN): Diagnosis and Treatment Overview
- Objective binge eating is defined by not only eating a large amount of food in a discrete time period but a subjective sense of lack of control over eating.
- The presence of compensatory behavior distinguishes BN from binge eating disorder.
- The mainstay of treatment of BN is antidepressants, especially fluoxetine at higher doses (e.g., 60 mg/day to 80 mg/day).
- Other agents, such as topiramate and ondansetron, have also been found effective. Learn more and earn 1.0 CME credits here.
Quick Takes: Informing Your Practice
Electroconvulsive Therapy (ECT) in Mania: A Review of 80 Years of Clinical Experience
- ECT is an option for the treatment of severe mania and catatonia. Its efficacy is clear. Obstacles include obtaining adequate informed consent. Learn more.
Impact of Smoking Behavior on Clozapine Blood Levels—A Systematic Review and Meta-Analysis
- Cigarette smoking lowers clozapine blood levels by about 30% (range: 20%–50%). When using medications metabolized by CYP1A2, pay attention to cigarette smoking, and be prepared to adjust dosing if your patients change their behavior. Learn more.
Listen to or read the full volume, and earn 0.5 CME credits here.
Reference
Freudenreich, O., Van Alphen, M.U., Lim, C. (2021). The ABCs of successful vaccinations: A role for psychiatry. Current Psychiatry. 20(3):48-49
