Section - Quick Takes

01. Antipsychotic Drugs and Risk of Acute Pancreatitis

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

Scott R. Beach, M.D.

Associate Professor of Psychiatry - Harvard Medical School - Massachusetts General Hospital

Key Points

The study indicates no significant increase in pancreatitis risk for patients on second-generation antipsychotics.
A slight increase in pancreatitis risk is associated with past use of certain first-generation antipsychotics, warranting careful consideration in historical drug use.
Despite initial concerns, routine pancreatic enzyme checks for patients on antipsychotics aren't mandated, but awareness of risk factors should be maintained.

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As a community psychiatrist encountering a young patient with first-episode psychosis, I am faced with a conundrum. This individual has risk factors for pancreatitis: A family history, heavy alcohol consumption, and previous gallstones. From my residency, I recall a purported link between antipsychotics and pancreatitis. The pressing questions are: Should the prescription of an antipsychotic be a concern? Does the choice of antipsychotic matter? Is there a need for any specific blood work?

I’m Scott Beach for the Psychopharmacology Institute, and this is Quick Takes.

A recent study, appearing in the journal Acta Psychiatrica Scandinavica , might offer some guidance and reassurance. This nationwide case-control research, unprecedented in scale, involved the Swedish registry and included individuals hospitalized for the first episode of pancreatitis over 14 years. Remarkably, each subject was matched with 10 control individuals, resulting in a substantial sample of over 50,000 cases and 500,000 controls.

The research delved

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02. Clozapine and Its Augmentation with ECT in Ultra-Treatment-Resistant Schizophrenia

Learning Objectives:

Evaluate the risk of pancreatitis among patients being treated with antipsychotic medication.
Evaluate the effectiveness of ECT in conjunction with clozapine therapy for ultra–treatment-resistant schizophrenia.
Discuss the implications of benzodiazepine prescriptions on short-term suicide risk.
Discuss the potential use, efficacy, and limitations of Silexan as a treatment option for long COVID symptoms.
Identify patient profiles that may benefit from trazodone, considering factors like history of substance abuse, presence of comorbid psychiatric conditions, contraindications, and potential drug–drug interactions.

Original Release Date: December 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: December 1, 2026

Expert: Scott Beach, M.D., Paul Zarkowski, M.D., Carlos Schenck, M.D. Oliver Freudenreich, M.D.

Medical Editor: Melissa Mariano, 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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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.