In this newsletter, we include information about the recent declaration of a national emergency in child and adolescent mental health.
We also share practical tips on how to manage dosage and side effects of lithium, key points from a presentation on medicinal cannabis and the psychiatric patient, and our practical research summaries (Quick Takes).
National Emergency in Youth Mental Health
On October 19, 2021, 3 organizations––the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association––published a joint statement about a national emergency in the mental health of children and adolescents.
The reason for this declaration is throughout the COVID-19 pandemic, children and families have experienced enormous adversity and disruption. More than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted.
Between March and October 2020, emergency department visits for mental health emergencies increased 24% for kids aged 5 to 11 and 30% for children 12 to 17.
Thus, there is an urgent need to improve access to care across mental health promotion, prevention, and treatment. This statement also raises an urgent need:
- For better access to telemedicine to provide mental health care to all populations.
- For the adoption of effective and financially sustainable models of integrated mental health care in primary care.
- To reduce the risk of suicide through prevention programs in schools, primary care, and community settings.
- To address the ongoing challenges of the acute care needs of children and adolescents.
- To promote and pay for trauma-informed care services that support relational health and family resilience.
- To intensify the efforts to recruit underrepresented populations into mental health professions.
- To approach the impact of the public health crisis on the well-being of health professionals. You can read more here.
Lithium: How to Manage Dosage and Side Effects and Persuade Patients to Take It, With David Osser, M.D.
In this interview, Dr. David Osser discusses the use of lithium for clinical practice. This includes practical insights on lithium dosing and monitoring strategies. He also discusses important drug–drug interactions, lithium’s effects on other systems, and management of adverse effects.
Interview highlights include the following:
- Lithium has neuroprotective effects, which can be maximized if started early in the course of managing patients with bipolar disorder.
- When titrating lithium doses, it is best to consider factors such as dose timing, medication formulation, and intake of other medications that could affect its clearance.
- Laboratory tests that should be requested for patients taking lithium include lithium levels, renal parameters, and thyroid function tests.
Learn more and earn 0.75 CME credits here.
Medicinal Cannabis and the Psychiatric Patient: Clinical Harm vs Novel Treatment
In this presentation, Dr. Diana Martinez discusses the impact of cannabis use among young adults and explores the evidence for the use of medicinal cannabis among patients with psychiatric disorders. The different forms of cannabis are discussed in terms of their therapeutic and side effects, allowing clinicians to weigh the risk–benefit ratio of cannabis use for patients.
Cannabis and Cognition
- Cannabis can be associated with acute cognitive changes.
- Acute cannabis intoxication results in impaired concentration, impaired attention, impulsivity, and decreases in working memory.
- In adults, most of the effects wear off with abstinence.
- Impulsivity and long-term impairment in decision making is seen in people with heavy cannabis.
- In adolescents, cannabis use is more closely associated with cognitive problems.
- Cannabis use should be avoided in younger people.
Learn more and earn 0.75 CME credits here.
Quick Takes: Informing Your Practice
Six-Month Neurological and Psychiatric Outcomes in 236,379 Survivors of COVID-19
- COVID-19 infection is associated with new-onset neurological illness, such as stroke and myoneural junction or muscle diseases, but at relatively low absolute rates (e.g., less than 1%). Rates for new-onset anxiety and mood disorders are higher, at 7% and 8%, respectively. Learn more.
Agitation and Dementia: Prevention and Treatment Strategies in Acute and Chronic Conditions
- In patients with dementia, after aggressive use of activity therapies for the prevention of agitation, you might be forced to use acute haloperidol. But if time allows, before that, consider citalopram: Its efficacy for chronic agitation has been found to be equal to that of antipsychotics in randomized trials. Learn more.
Listen to or read the full volume, and earn 0.5 CME credits here.
Listen to Our Podcast: Psychopharm Updates
Don’t miss out on the latest updates in psychopharmacology! Each episode of our podcast showcases one of our products on a regular basis: Video lectures, Quick Takes, and Expert Consultations. We update our feed every 5 days.
References
American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry and Children’s Hospital Association. (2021, October 19). AAP-AACAP-CHA Declaration of a National Emergency in Child and Adolescent Mental Health. American Academy of Pediatrics.
