Section - CAP Smart Takes

01. Pharmacologic and Nonpharmacologic Interventions for Persistent Irritability

Published on February 1, 2023 Certification expiration date: February 1, 2026

David R. Rosenberg, M.D.

Chair of the Department of Psychiatry & Behavioral Neuroscience - Wayne State University School of Medicine

Key Points

Antipsychotics had the most significant effect in decreasing irritability compared with all other medications and nonpharmacologic interventions.
Target specific symptoms with pharmacologic and nonpharmacologic interventions before combining medications.
Combining medication and therapy can have the best results.

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Text version

Hi! David Rosenberg here for the Psychopharmacology Institute. In this CAP—or Child and Adolescent Psychiatry—Smart Take, we will look at the effectiveness of pharmacologic and nonpharmacologic interventions alone or in combination for preschool children through adolescence with ASD, ADHD, disruptive behavior disorders, disruptive mood dysregulation disorder, and severe mood dysregulation with persistent irritability.

This article conducted a systematic review and meta-analysis, analyzing over 100 studies. As expected, considerable heterogeneity was seen; however, large effects were still seen. This is a huge issue and critical analysis, as persistent irritability is one of the most common reasons for referral to mental health providers. The good news is that large beneficial effects were found for these conditions with pharmacologic and nonpharmacologic interventions. An additional benefit was seen with combined pharmacologic and nonpharmacologic interventions; the combination was superior to either treatment alone. Antipsychotics, perhaps not surprisingly, had the largest beneficial effect in decreasing irritability

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02. Viloxazine Effect on Learning and School Problems in Youth With ADHD

Learning Objectives:

Recognize that pharmacologic and nonpharmacologic interventions have large beneficial effects when combined.
Identify that viloxazine ER can significantly reduce learning and school problems and clinical ADHD symptoms.
Acknowledge that antipsychotic and antidepressant prescriptions remained high in September 2020 and had not decreased or returned to prepandemic levels.
Understand that lisdexamfetamine was well tolerated in preschool children with ADHD, with no new safety signals observed.
Recognize that a web-based pediatric drug information system can help prevent prescribing errors.

Original Release Date: February 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: February 1, 2026

Expert: David Rosenberg, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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Participants must complete the activity online during the valid credit period that is noted above.

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Complete the Post Activity Evaluation for providing the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
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Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.