Section - Quick Takes

01. Insomnia Symptoms and the Risk of Stroke in the Health and Retirement Study

Published on February 1, 2024 Certification expiration date: February 1, 2027

Carlos H. Schenck, M.D.

Professor & Senior Staff Psychiatrist at the Hennepin County Medical Center (HCMC) - University of Minnesota

Key Points

The study demonstrates a dose–response relationship between the number of insomnia symptoms and an increased risk of stroke, particularly in individuals over 50 years old with no prior history of stroke.
Comorbidities, such as depression, diabetes mellitus, hypertension, and heart disease, alongside insomnia symptoms, contribute to an elevated stroke risk. This is compounded by associated endocrine and metabolic dysregulation, inflammation, vasoconstriction, and stress.

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Hello. I am Carlos H. Schenck, MD, professor of psychiatry at the University of Minnesota Medical School, specializing in sleep medicine and outpatient psychiatry. I am here to provide a Quick Take on an important new study, titled “Association Between Insomnia Symptoms and Trajectory with the Risk of Stroke in the Health and Retirement Study”. This is the first prospective study examining insomnia as a risk factor for stroke and the first to explore mediation factors associated with this risk.

The study involved 31,126 individuals aged over 50, with an average age of 61 years; 57% were female. None had a history of stroke prior to the study. Over the 9-year period, more than 2,000 strokes were recorded. Insomnia symptoms tracked included difficulty falling asleep, staying asleep, waking up too early, and experiencing nonrestorative sleep. The findings were significant: The risk of stroke escalated with an increase in the number

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02. Long-Term Efficacy of Antipsychotic Drugs in Adults With Schizophrenia

Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate the association between insomnia symptoms and increased stroke risk.
Interpret the findings of a network meta-analysis on the long-term efficacy of antipsychotics, focusing on the efficacy of olanzapine compared with other drugs.
Assess the safety and efficacy of haloperidol for managing delirium in hospitalized patients.
Identify the potential benefits and risks of medical cannabis in the treatment of Parkinson's disease.
Evaluate the need for brain imaging in new psychosis cases, considering factors beyond age and apparent neurologic signs.

Original Release Date: February 1, 2024

Review and Re-release Date: March 1, 2024

Expiration Date: February 1, 2027

Experts: Scott Beach, M.D., Carlos Schenck, M.D., Oliver Freudenreich, M.D., Gregory Pontone, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

Oliver Freudenreich declares the following interests:

- Alkermes: Research grant, consultant honoraria

- Janssen: Research grant, consultant honoraria

- Otsuka: Research grant

- Karuna: Research grant, consultant honoraria

- Neurocrine: Consultant honoraria

- Vida: Consultant honoraria

- American Psychiatric Association: Consultant honoraria

- Medscape: Honoraria

- Elsevier: Honoraria

- Wolters-Kluwer: Royalties

- UpToDate: Royalties, honoraria

Gregory Pontone declares the following interests:

- Acadia Pharmaceuticals: Consultant

- GE Healthcare: Consultant

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other 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

Instructions for Participation and Credit:

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

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
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.