Psychopharmacology Updates for Prescribers

A practical guide to adjusting addiction pharmacotherapy in patients with significant medical comorbidities. Dr. Sevarino provides evidence-based dosing modifications for naltrexone, buprenorphine, methadone, and disulfiram across liver disease, renal impairment, cardiovascular disease, respiratory conditions, and infectious comorbidities, with integrated care frameworks for complex cases.

When should you taper a benzodiazepine, and how slowly? Does semaglutide reverse metabolic risk in schizophrenia patients on clozapine or olanzapine? Is EPA effective for TRD? Can brief psychotherapy enable safe antidepressant discontinuation? Is a ketogenic diet effective for depression and other psychiatric conditions?

This guide provides a comprehensive overview of buspirone, a 5-HT1A partial agonist approved for generalized anxiety disorder, covering its non-GABAergic mechanism, pharmacokinetics, significant CYP3A4 drug interactions, dosing strategies, side effects, various special population considerations, and clinical positioning as a non-sedating anxiolytic without significant dependence risk.

A guide to management of treatment-resistant OCD, covering proper diagnostic criteria, evidence-based SSRI dosing protocols, systematic augmentation strategies, and advanced interventions such as TMS, DBS, and ablative surgery for refractory cases.

A discussion on catatonia assessment and management, covering diagnostic approaches including the Bush-Francis scale, differentiating catatonia from psychosis and deception, lorazepam challenge protocols, treatment strategies including benzodiazepines and ECT, and relapse prevention.

When should you consider high-dose olanzapine instead of clozapine for treatment-resistant schizophrenia? How effective is aripiprazole augmentation versus switching strategies in older adults with depression? Can GLP-1 receptor agonists elevate lithium levels? Should inflammatory markers guide antidepressant selection? Is adjunctive propranolol effective for panic disorder?

This guide provides a comprehensive review of trazodone, a serotonin antagonist and reuptake inhibitor (SARI) FDA-approved for depression but predominantly prescribed off-label for insomnia, covering its dose-dependent pharmacology, clinical uses, drug interactions, side effects including priapism and QT prolongation, and special population considerations.

A discussion on lithium dosing and side effect management in bipolar disorder, covering therapeutic levels, renal protection strategies, weight gain mechanisms, nephrogenic diabetes insipidus, cognitive effects, tremor differentiation, and dermatologic complications with practical solutions for clinical challenges.

A comprehensive series on bipolar depression covering subtypes, assessment tools, and evidence-based treatments. Topics include lithium, lamotrigine, atypical antipsychotics, and off-label options like pramipexole and light therapy.