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Here are the clinical summaries that have been sent out so far:
1. How to reduce risk of priapism due to trazodone
2. You may need to prescribe an iron supplement
3. These three MUST be taken with food
4. You may be giving the wrong dose of stimulant (discussion of equivalent doses of stimulants)
5. Which antibiotics could cause serious problems in your patients?
6. Important detail when prescribing temazepam (some practical tips regarding hypnotics)
7. This blood test is very helpful in patients on buprenorphine
8. Lithium and antihypertensives: Be careful!
9. Correct dose and duration of l-methylfolate
10. These are the patients in whom we should consider lithium
11. Mirtazapine and renal transplant
12. When patients demand a sleeping pill
13. List of options for hypnotics with lower addiction potential
14. What to do about fatigue/somnolence
15. Can you solve this clinical puzzle?
16. Will buprenorphine show up in a urine drug screen?
17. One website to inform them all
18. Oxcarbazepine versus Carbamazepine: Three Pros and One Con
19. How to identify hyponatremia due to psychotropic medications
20. How should we manage hyponatremia?
21. Your patient may be taking a psychiatric medication by another brand name
22. Extended-release preparations come in many forms
23. Some extended-release capsules are OK to open and some are not
24. Warning: Hydroxyzine (Vistaril, Atarax) can be dangerous
25. Should we routinely prefer extended-release preparations? Part 1
26. Should we routinely prefer extended-release preparations? Part 2
27. Which MAOI should I pick?
28. An easy way to significantly reduce discontinuation of medications
29. Does vortioxetine work for GAD?
30. What to do about antidepressants in persons with renal disease?
31. What are the side effects, doctor?
32. Watch out for dry mouth
33. How to manage dry mouth: level one (the simplest measures)
34. How to manage dry mouth–Level 2 and 3 measures
35. What to do about rash/itching with transdermal selegiline?
36. Oral contraceptives and lamotrigine: Part 1
37. Oral contraceptives and lamotrigine: Part 2
38. A case of tardive dyskinesia on an antidepressant: Part 1
39. A case of tardive dyskinesia on an antidepressant: Part 2
40. When to measure serum levels of mood stabilizers: Part 1
41. When to measure serum levels of mood stabilizers: Part 2
42. Which psychotropic medication should be taken WITHOUT food?
43. Managing loss of appetite due to stimulant medications-Part 1
44. Managing loss of appetite due to stimulant medications-Part 2
45. Brain zaps-Part 1 (Clinical features)
46. Brain zaps-Part 2 (Assessment and Management)
47. Which CYP 450 isoenzyme metabolizes which medication?
48. Drug holidays for sexual dysfunction
49. How to know if the BUN and creatinine are elevated due to dehydration
50. 365 Advanced Topics in Psychopharmacology: Quiz 1
51. Should we prescribe medications for weight loss?
52. Some issues about phentermine-topiramate (Qsymia) for weight loss
53. How does bariatric surgery affect dissolution of psychotropic medications?
54. Bariatric surgery and extended-release preparations
55. Can hypnotics be used in persons with sleep apnea?
56. Is your patient taking a psychotropic drug with another brand name?
57. Vortioxetine and sexual dysfunction: How to read a clinical trial
58. Finding out the price, comparing prices, and getting a lower price
59. What do the es-, the levo-, and the dex- mean in drug names?
60. Serum folate is not the right test to order
61. What if lamotrigine is missed for three or more days?
62. Lithium: in how many doses per day and at what time?
63. Let’s not miss orthostatic hypotension
64. How to correctly measure and interpret orthostatic blood pressure and pulse
65. Simple tips to manage orthostatic hypotension
66. Should we prescribe dexmethylphenidate (Focalin) rather than methylphenidate (Ritalin)?
67. How does dexmethylphenidate XR (Focalin XR) deliver the drug?
68. Pros and cons of dexmethylphenidate XR versus methylphenidate ER
69. Is it true that mirtazapine (Remeron) can cause agranulocytosis?
70. Should we use gabapentin for bipolar disorder or not?
71. Which omega-3 fatty acids to recommend–Part One
72. Exactly which omega-3 product to recommend
73. Are the clozapine-norclozapi
74. Doesn’t escitalopram cause QTc prolongation?
75. Which psychotropic medications to continue or stop during surgery?
76. How to systematically examine a person with akathisia
77. Watch out for herbal-psychotropic drug interactions
78. Drug interactions with St. John’s Wort
79. How to tell if a rash is benign or possible Stevens-Johnson Syndrome
80. How is high-dose vitamin C important in prescribing medications?
81. We often don’t identify rapid cycling but should
82. Essential facts about bupropion and seizures
83. Bupropion versus bupropion: Seizure risk with different preparations and doses
84. Should we prescribe Forfivo XL 450 mg?
85. HLA testing in psychopharmacology: Part one
86. HLA testing in psychopharmacology: Part two
87. Oxcarbazepine? Lamotrigine? HLA testing and psychopharmacology: Part three
88 How likely is your patient to carry higher-risk HLA antigens?
89. Tips on using gabapentin for anxiety disorders
90. 7 things to know about divalproex and hair loss
91. Gabapentin versus pregabalin: potential for misuse
92. Be careful with medications that have a long half-life
93. TEN psychotropic medications with a long half-life
94. Higher than usual doses of SSRIs for OCD?
95. For which medications do you ALWAYS do an ECG?
96. Six medications for which big changes are needed in CYP poor metabolizers
97. One exit door or many?
98. Are antidepressants addictive?
99. Management of antidepressant discontinuation (withdrawal) syndrome: Part one
100. Management of antidepressant discontinuation (withdrawal) syndrome: Part two
101. How exactly to add fluoxetine to manage antidepressant discontinuation (withdrawal) syndrome
102. How to really slowly taper an antidepressant: Part one
103. How to look up whether a drug can cause QTc prolongation or torsades
104. A puzzling case of acute dyskinesia
105. Don’t cause unplanned pregnancy
106. Hepatic Function Tests: Part one–Overview
107. Four strange things about levels of AST and ALT
108. Remember: L is for Liver
109. Is the elevated plasma ammonia a false positive?
110. What is pramipexole and why should we care?
111. Should we consider pramipexole for treating mood disorders?
112. Tips on using pramipexole: Part one
113. Tips on using pramipexole: Part two
114. Potential adverse effects of pramipexole
115. Should clomipramine be a first-line treatment for OCD?
116. Six tips about using SSRIs for OCD
117. OCD: If the initial medication does not work?
118. How to do a drug interaction search in one minute
119. Antipsychotics for OCD: What and for whom
120. Antipsychotics for OCD: How much and for how long
121. Don’t miss bruxism in your patients
122. How to manage antidepressant-induc
123. An antidote to treat antidepressant-induced bruxism
124. CYP450 update about newer medications
125. Are lower doses of lithium helpful?
126. Do you regularly prescribe metformin for metabolic adverse effects?
127. Metformin: Who are the best candidates?
128. Potential adverse effects of metformin: Part one
129. Part 2: Metformin can cause B12 deficiency
130. A potentially fatal adverse effect of metformin
131. Tips on prescribing metformin
132. Warning-this could happen if we are not careful (Restarting lamotrigine)
133. What dose should you switch to?
134. Antipsychotic dose equivalents: The Table
135. 365 Advanced Topics in Psychopharmacology: Quiz 2
136. Pros and cons of the two extended-release injections of aripiprazole
137. Warning–the patient may faint after the very first dose
138. How to minimize risk of syncope with prazosin
139. How to choose a cholinesterase inhibitor
140. How to manage MAO-inhibitor-induced insomnia
141. The bottom line on medications for Alzheimer’s disease
142. What about vascular dementia?
143. What about other dementias?
144. Are you specifying these?
145. What is “anxious distress” and why does it matter?
146. VMAT2 inhibitor? What’s that?
147. Which VMAT2 inhibitor should we prefer?
148. In older adults, avoid medications with anticholinergic activity
149. Which medications have significant anticholinergic activity?
150. How exactly to evaluate anticholinergic burden
151. Can lamotrigine levels predict adverse effects?
152. How to get the benefits of split treatment
153. Tips for managing split treatment
154. Three commonly held fallacies about the AIMS
155. How to reduce risk in split treatment
156. How often should the AIMS examination be done?
157. THREE activating procedures in AIMS and what to look for
158. Should we combine methylphenidate and guanfacine?
159. Do side effects of methylphenidate and guanfacine cancel each other out?
160. Tips on using clonazepam ODT (wafers)
161. Six differences between guanfacine and clonidine: Part one
162. Six differences between guanfacine and clonidine: Part two
163. When NOT to use antidepressants in bipolar depression
164. Which antidepressants have greater or lesser risk in bipolar depression?
165. Dose equivalents for antidepressants
166. Excoriation (skin picking) disorder
167. Key clinical features of Excoriation (skin picking) disorder
168. How to treat excoriation (skin picking) disorder: Part one
169. How to treat excoriation (skin picking) disorder: Part two (a)
How to treat excoriation (skin picking) disorder: Part two (b)
170. Clozapine-induced hypersalivation is a big deal
171. Treatment of medication-induced hypersalivation: Part one
172. Treatment of medication-induced hypersalivation: Part two
173. Treatment of medication-induced hypersalivation: Part three
174. 365 Advanced Topics in Psychopharmacology: Quiz 3
175. Don’t do it
176. Pharmacogenetics part one: 5-HTTLPR
177. Pharmacogenetics part two: 5-HTTLPR polymorphisms
178. Can 5-HTTLPR polymorphisms predict if an SSRI will work?
179. 5-HTTLPR polymorphisms and antidepressant efficacy: part two
180. 5-HTTLPR polymorphisms do predict side effects with SSRIs
181. Significance of 5-HTTLPR polymorphisms: A summary
182. Serotonin 2A receptor gene polymorphisms predict antidepressant side effects
183. HTR2C polymorphisms and weight gain: Part one
184. HTR2C polymorphisms and weight gain: Part two
185. What is P-glycoprotein (ABCB1 transporter)?
186. Antidepressants and P-glycoprotein
187. ABCB1 predicts adverse effects with SSRIs
188. Understanding lithium-induced polyuria and diabetes insipidus
189. Evaluating the patient with polyuria: part one
190. Evaluating the patient with polyuria: part two
191. Evaluating the patient with polyuria: part three
192. How to manage lithium-induced polyuria/ diabetes insipidus: part one
193. How to manage lithium-induced polyuria/ diabetes insipidus: part two
194. How to manage lithium-induced polyuria/ diabetes insipidus: part three
195. Are we missing Body Dysmorphic Disorder?
196. Body Dysmorphic Disorder: Pharmacological treatment (part one)
197. Body Dysmorphic Disorder: Pharmacological treatment (part two)
198. Body Dysmorphic Disorder: Pharmacological treatment (part three)
199. My genetic testing showed I need a high dose of a stimulant: Part one
200. My genetic testing showed I need a high dose of a stimulant: Part two
201. How to measure serum prolactin?
202. If prolactin is elevated, ask these questions
203. Elevated prolactin: Next steps
204. Is the extended-release preparation of lithium carbonate better?
205. Pimavanserin (Nuplazid®): A new antipsychotic (Part one)
206. Pimavanserin (Nuplazid®): A new antipsychotic (Part two) (A)
Pimavanserin (Nuplazid®): A new antipsychotic (Part two) (B)
207. Pimavanserin (Nuplazid) Part three: Potential serious adverse effects
208. Pimavanserin (Nuplazid) Part four: The how to
209. What does Transcranial Magnetic Stimulation (TMS) work for?
210. What percentage of patients with MDD responds to TMS?
211. Who is more likely to respond to TMS?
212. How much is the risk of a seizure with TMS?
213. Lithium and psoriasis
214. Which TCA should we recommend first?
215. Tips on thyroid function testing: Part one
216. Tips on thyroid function testing: Part two
217. Tips on thyroid function testing: Part three
218. Orally disintegrating tablets (ODTs) can be useful
219. Psychotropic medications are sometimes given sublingually
220. Important instructions to give for sublingual medications
221. Complementary and alternative medicines (CAM) for depressive disorders
222. Complementary and Alternative Medications for MDD: Summary
223. S-adenosylmethionine (SAMe) for depressive disorders: Part one
224. S-adenosylmethionine (SAMe) for depressive disorders: Part two
225. S-adenosylmethionine (SAMe) for depressive disorders: Part three
226. MAO inhibitors can affect vitamin B6: Part one
227. MAO inhibitors can affect vitamin B6: Part two
228. Ketamine infusions for major depression: Part one
229. Ketamine infusions for major depression: Part two
230. Ketamine infusions for major depression: Part three
231. Ketamine infusions for major depression: Part four
232. Lithium-induced benign tremor: Introduction
233. Lithium-induced benign tremor: Evaluation
234. How to treat lithium-induced benign tremor
235. Which beta blockers to use for lithium-induced benign tremors
236. Is lamotrigine safe for use in pregnancy? Part one
237. Is lamotrigine safe for use in pregnancy? Part two
238. Is lamotrigine safe for use in pregnancy? Part three
239 (a). Is lamotrigine safe for use in pregnancy? Part four
(b). Pregnancy registries
240. Don’t ignore atomoxetine for ADHD in adults
241. Does atomoxetine improve executive functioning?
242. Eight advantages of prescribing atomoxetine
243. How to prescribe atomoxetine for ADHD in adults
244. Atomoxetine: Are we giving enough and for long enough?
245. How to add valproate to lamotrigine
246. Important interactions when using two medications for ADHD
247. 365 Advanced Topics in Psychopharmacology: Quiz 4
248. Was the hypomania or mania “antidepressant-indu
249. Do you prescribe bupropion for ADHD in adults?
250. Is it important to taper gabapentin?
251. Cardiovascular Risk Screening Form
252. Smoking can seriously affect some psychotropic medications
253. Smoking and psychotropic medications: Part two
254. Smoking and psychotropic medications: Part three
255. Can we use topiramate to treat medication-induced weight gain?
256. Is TD less likely with second-generation (“atypical”) antipsychotics?
257. We have to choose one of two types of TCAs
258. Two types of tricyclic antidepressants (TCAs): Part two
259. Management of tardive dyskinesia: First-line options
260. Systematic management of tardive dyskinesia: Part two
261. Systematic management of tardive dyskinesia: Part three
262. Systematic management of tardive dyskinesia: Part four
263. Is lurasidone useful for longer-term treatment of bipolar disorder?
264. Bipolar disorder with comorbid panic disorder: Part one
265: Bipolar disorder with comorbid panic disorder: Part two
266: Bipolar disorder with comorbid panic disorder: Part three
267. False positive urine drug screens: Part one
268. The urine drug screen is positive but the patient denies using the substance
269. Next step to rule out a false positive
270. Dose adjustment for second-generation antipsychotics based on drug interactions
271. Check for this before prescribing an antidepressant for bipolar depression
272. The dose of quetiapine is NOT the same for each disorder
273. How to not delay treatment of acute mania
274. Does loading dose of valproate have pros and (usually) no cons?
275. Order genetic testing for a patient on atomoxetine?
276. Do CYP2D6 PM’s have more side effects on atomoxetine?
277. When and how to check the clomipramine level
278. Changing between the different forms of long-acting injectable aripiprazole
279. An alert from a colleague (psychotropic medication induced glaucoma)
280. Psychotropic medication and glaucoma: Part one
281. Keep an “eye” out for these high risk patients
282. 365 Advanced Topics in Psychopharmacology: Quiz 5
283. Once-a-day preparation of mixed amphetamine salts
284. A triple-bead preparation of mixed amphetamine salts
285. Potential disadvantages of the triple-bead preparation of mixed amphetamine salts
286. Conclusions and verdict
287. Should we give high-dose SSRI for panic disorder?
288. We need to learn more about difficult-to-treat panic disorder
289. One of our Member’s urine was positive for PCP
290. Would you ever use bupropion to treat panic disorder?
291. Do you prescribe beta blockers for panic disorder?
292. Which beta blocker and for how long?
293. How common is ADHD in persons with bipolar disorder?
294. How to treat ADHD in persons with bipolar disorder
295. Best books about adult ADHD for patients and/or families
Best books on adult ADHD for clinicians
296. How to assess outcome in panic disorder and not leave the patient only partially treated
297. Who is at higher risk of bleeding with antidepressants?
298. Antidepressants and bleeding: When do we need to ask additional questions?
299. Antidepressants and bleeding: What should we ask?
300. Should we recommend ultrabrief pulse ECT?
301. The final verdict on ultrabrief pulse ECT
302. Insomnia? Ask about medications
303. Pros and cons of ramelteon (Rozerem) as a hypnotic
304. Pros and cons of ramelteon (Rozerem) as a hypnotic: Part two
305. Best medicines for sleep in elderly patients?
306. Which brand and preparation of melatonin to recommend?
307. Best medicines for sleep in elderly patients? Part two
308. Best medicines for sleep in elderly patients? Part three
309. Best medicines for sleep in elderly patients? Part four
310. Sleep medications to avoid in older adults
311. 365 Advanced Topics in Psychopharmacology: Quiz 6
312. Does oxcarbazepine work for bipolar disorder?
313. My opinion about using oxcarbazepine for bipolar disorder
314. How to start, titrate, and dose oxcarbazepine (Trileptal®)
315. How to diagnose Premenstrual Dysphoric Disorder (PMDD): Part one
316. How to diagnose Premenstrual Dysphoric Disorder (PMDD): Part two
317. How to treat Premenstrual Dysphoric Disorder (PMDD): Part one
318. How to treat Premenstrual Dysphoric Disorder (PMDD): Part two
319. Five ways in which an SSRI can be given for PMDD
320. Next steps in the management of premenstrual dysphoric disorder (PMDD)
321. Management of premenstrual dysphoric disorder: third-line options
322. Equivalence of risperidone oral and long-acting injection (RLAI; Risperdal Consta®)
323. Have you ever prescribed or recommended disulfiram?
324. How does disulfiram work?
325. In what situations could disulfiram be particularly helpful?
326. What exactly happens if alcohol is used by a person on disulfiram?
327. Instructions for patients who are prescribed disulfiram (Antabuse)
328. Disulfiram (Antabuse): How much and for how long?
329. Whom is disulfiram (Antabuse) contraindicated for?
330. What are the potential side effects of disulfiram?
331. Cannabis or cannabinoids for PTSD?
332. What happened to polysubstance dependence?
333. Can a simple intervention reduce risk of delirium in our elderly patients?
334. Does melatonin work for reducing the risk of delirium in our elderly patients?
335. Melatonin to reduce risk of delirium: For whom and exactly how?
336. Tips on using lithium for bipolar disorder during pregnancy: Part one
337. Teratogenic risk with lithium — how much, which malformations, dose-dependent?
338. Other (non-teratogenic) risks of using lithium during pregnancy
339. How to manage dosing of lithium during pregnancy
340. How should lithium dosing be managed at the time of delivery and postpartum?
341. Three characteristics of a seasonal pattern: Part one
342. Three characteristics of a seasonal pattern: Part two
343. Summary of key facts about clozapine and seizures: Part one
344. Summary of key facts about clozapine and seizures: Part two
345. Summary of key facts about clozapine and seizures: Part three
346. 365 Advanced Topics in Psychopharmacology: Quiz 7
347. Choosing the right device for bright light therapy: Part one
348. What kind of light?
349. Final suggestions about bright light therapy devices
350. How our patients should do bright light therapy
351. At what time of the day should bright light therapy be done?
352. Important details about how exactly to do bright light therapy
353. Citalopram for agitation in Alzheimer’s disease
354. Citalopram for agitation in Alzheimer’s disease: Part two
355. Citalopram for agitation in Alzheimer’s disease: Part three
356. Citalopram for agitation in Alzheimer’s disease: Part four
357. What to do with meds if a person is on TMS
358. How to examine a person with tremor: Part one
359. How to examine a person with tremor: Part two
360. How to examine a person with tremor: Part three
361. Tips on how to rule out other causes of tremors
362. 365 Advanced Topics in Psychopharmacology: Quiz 8
363. Where to look up information on meds and lactation
364. We should be able to identify POTS in our patients
365. Important clinical features of POTS and how to diagnose it
366. Differential diagnosis and management of POTS
367. High blood pressure has been redefined in 2017
368. Blood pressure measurements vary. What should we do?
369. Which iron supplement should we recommend? Part one
370. Which iron supplement should we recommend? Part two
371. How to improve the tolerability of an iron supplement
372. How to improve the absorption of iron
373. 365 Advanced Topics in Psychopharmacology: Quiz 9
374. Another very serious side effect of clozapine that we should know about
375. How should we screen for clozapine-induced myocarditis?
376. Diagnosing clozapine-induced myocarditis and what to do next
377. Why mental health clinicians need to learn about Polycystic Ovarian Syndrome PCOS
378. Clinical features of PCOS: Part one
379. Clinical features of PCOS: Part two
380. Clinical features of PCOS: Part three. Hyperandrogenism
381. Clinical features of PCOS: Part four
382. Polycystic Ovarian Syndrome (PCOS): Diagnostic evaluation: Part one
383. Polycystic Ovarian Syndrome (PCOS): Diagnostic evaluation: Part two
384. Management of PCOS
385. Misleading interpretation of pharmacogenomic testing results: Part one
386. Misleading interpretation of pharmacogenomic testing results: Part two
387. 365 Advanced Topics in Psychopharmacology: Quiz 10
388. A greatly underutilized treatment option for bipolar depression that we should all know about
389. How to do bright light therapy differently for bipolar depression
390. What all these terms mean: Cannabis, marijuana, hemp, THC, CBD, dronabinol, and so on
391. What if you refuse an early refill of a stimulant medication?
392. What to look for in stimulant withdrawal (including a physical sign that is little known)
393. Acne is a potential side effect of lithium
394. How to know that the acne may be due to the lithium
395. What to do about caffeine
396. How much caffeine is too much?
397. Let’s educate ourselves about the caffeine content of different beverages
398. How much caffeine do coffee and tea contain?
399. Which three soft drinks have ZERO caffeine?
400. Are your patients drinking so-called “energy” drinks?
401. What do you call a cow that has been sterilized?
402. Some cases of unexpected side effects related to stimulants and antipsychotics
403. Be careful if a person is on both a stimulant and an antipsychotic
404. A perfect storm
405. What could happen when changing from an antipsychotic to a stimulant?
406. Going from an antipsychotic to a stimulant
407. Can persons on psychotropic medications donate blood?
408. It is very important for learning to intermittently test yourself (Quiz 11)
409. What is “Mild Neurocognitive Disorder”? Part one
410. What is “Mild Neurocognitive Disorder”? Part two
411. What is “Mild Neurocognitive Disorder”? Part three
412. Seizure risk if atomoxetine and bupropion are used together?
413. Why use the MoCA instead of other tests?
414. An overview of the items on the MoCA: Part one
415. An overview of the items on the MoCA: Part two
416. How exactly to administer the MoCA: Part one
417. How exactly to administer the MoCA: Part two
418. How to score the MoCA
419. Six arguments against the Mini-Mental State Exam
420. Antidepressants can injure the liver, some more than others
421. Antidepressant-induced liver injury: Part two
422. Antidepressant-induced liver injury: Part three
423. Antidepressant-induc
424. Antidepressant-induc
425. True or False? (Quiz 12)
426. When treating major depression, follow these three steps
427. S is for Sleep
428. Does improving sleep improve depression too?
429. A is for Anxiety
430. Should we consider a benzodiazepine for persons with major depressive disorder?
431. Benzodiazapine for persons with major depressive disorder?
432. How to do relapse prevention in bipolar disorder: Part one
433. How to do relapse prevention in bipolar disorder: Part two
434. Five websites for information about psychotropic medications and pregnancy
435. Tips on getting the most out of attending live meetings (conferences, congresses)
436. Tips on meeting people at conferences
437. Tips on attending the sessions and for after the meeting
438. Are you using a questionnaire to assess sexual functioning?
439. Which questionnaire should we use to assess sexual functioning?
440. Important instructions while giving the CSFQ to the patient: Part one
441. Important instructions while giving the CSFQ to the patient: Part two
442. How to score the CSFQ
443. How to interpret the CSFQ total and subscale scores
444. How common are benign and serious rashes with lamotrigine?
445. Do you recommend dermatological precautions when starting lamotrigine?
446. Valproate-induced pancreatitis: Part one
447. Valproate-induced pancreatitis: Part two
448. Valproate-induced pancreatitis: Part three
449. Correct answers in just ONE OR TWO SENTENCES each (Quiz 13)
450. Hypnotic if waking up in the middle of the night? Part one
451. Hypnotic if waking up in the middle of the night? Part two
452. Hypnotic if waking up in the middle of the night? Part three
453. Pros and cons of dextroamphetamine versus levoamphetamine. Part one
454. Pros and cons of dextroamphetamine versus levoamphetamine. Part two
455. Can we combine metformin and topiramate to produce weight loss? Part one
456. Can we combine metformin and topiramate to produce weight loss? Part two
457. Three quick questions with short answers provided
458. Tips on using naltrexone for alcohol use disorder: Part one
459. Tips on using naltrexone for alcohol use disorder: Part two
460. Tips on using naltrexone for alcohol use disorder: Part three
461. What is cannabidiol (CBD)? Part one
462. What is cannabidiol (CBD)? Part two
463. Can melatonin increase blood sugar? Part one
464. Can melatonin increase blood sugar? Part two
465. Cannabidiol (CBD): Clinical experience. Part one
466. Cannabidiol (CBD): Clinical experience. Part two
467. Laws about prescriptions for psychostimulants. Part one
468. Laws about prescriptions for psychostimulants. Part two
469. Laws about prescriptions for psychostimulants. Part three
470. Why neuropsychiatric symptoms in dementia are important
471. Should we prescribe valproate for neuropsychiatric symptoms in persons with dementia?
472. Carbamazepine for neuropsychiatric symptoms in persons with dementia? Part one
473. Carbamazepine for neuropsychiatric symptoms in persons with dementia? Part two
474. Gabapentin for neuropsychiatric symptoms of dementia? Part one
475. Gabapentin for neuropsychiatric symptoms of dementia? Part two
476. What are the BEST books for adults with ADHD and their loved ones?
477. Do psychotropic medications affect intrauterine devices (IUDs)? Part one
478. Do psychotropic medications affect intrauterine devices (IUDs)? Part two
479. Why I don’t usually prescribe paroxetine. Part one
480. Why I don’t usually prescribe paroxetine. Part two
481. Why I don’t usually prescribe paroxetine. Part three
482. How to assess persons who are “sensitive to medications.” Part one
483. How to assess persons who are “sensitive to medications.” Part two
484. How to manage a person who is “sensitive to medications”
485. How to start patients on “ridiculously” low doses
486. Final tips on managing patients who are “sensitive to medications”
487. For how long are substances detected in a urine drug screen (UDS)? Part one
488. For how long are substances detected in a urine drug screen (UDS)? Part two
489. What is estimated GFR (eGFR)?
490. Which medications are mostly excreted unchanged and why is this important? Part one
491. Which medications are mostly excreted unchanged and why is this important? Part two
492. We must do more to treat obesity
493. An overview of medications for treatment of obesity
494. Some issues regarding medications for weight loss
495. Medications for treatment of obesity: For how long and next steps
496. Be very careful when switching from one MAO inhibitor to another
497. Two types of MAO and of MAO inhibitors: Part one
498. Two types of MAO and of MAO inhibitors: Part two
499. Two types of MAO and of MAO inhibitors: Part three
500. Can I have cheese or pizza?
501. How about some Chinese food?
502. Tips about the MAO inhibitor diet: Part one
503. Tips about the MAO inhibitor diet: Part two: General principles
504. Tips about the MAO inhibitor diet: Part three: Patient handouts
505. Tips about the MAO inhibitor diet: Part four: Educating patients about the MAOI diet
506. Important instructions regarding MAO inhibitors and other medications
507. What do the stages of chronic kidney disease mean?
508. Bupropion in persons with renal impairment: Part one
509. Bupropion in persons with renal impairment: Part two
510. Tips on Premenstrual Dysphoric Disorder: Part one
511. Tips on Premenstrual Dysphoric Disorder: Part two
512. Tips on Premenstrual Dysphoric Disorder: Part three
513. Tips on Premenstrual Dysphoric Disorder: Part four
514. Tips on Premenstrual Dysphoric Disorder: Part five
515. Correct answers given in 2 to 3 sentences only (Quiz 15)
516. Tips on dealing with “slips” in recovery: Part one
517. Tips on dealing with “slips” in recovery: Part two
518. Tips on using acamprosate for alcohol use disorder: Part one
519. Tips on using acamprosate for alcohol use disorder: Part two
520. Tips on using acamprosate for alcohol use disorder: Part three
521. Tips on using acamprosate for alcohol use disorder: Part four
522. Can oral contraceptives cause or worsen depression? Part one
523. Can oral contraceptives cause or worsen depression? Part two
524. Can oral contraceptives cause or worsen depression? Part three
525. Omega-3 fatty acids for vegetarian and vegan patients: Part one
526. Omega-3 fatty acids for vegetarian and vegan patients: Part two
527. Which psychotropic medications does cannabis affect? Part one
528. Which psychotropic medications does cannabis affect? Part two
529. Medications from Canadian pharmacies? Part one
530. Medications from Canadian pharmacies? Part two
531. Medications from Canadian pharmacies? Part three
532. Stimulant medications and irritability in children with ADHD: Part one
533. Stimulant medications and irritability in children with ADHD: Part two
534. THREE-question quiz with correct answers in THREE sentences or less (Quiz 16)
535. Transdermal testosterone for hypoactive sexual desire disorder in postmenopausal women: Part one
536. Transdermal testosterone for hypoactive sexual desire disorder in postmenopausal women: Part two
537. Transdermal testosterone for hypoactive sexual desire disorder in postmenopausal women: Part three
538. Which laboratory tests in men with erectile dysfunction?
539. How to reduce the risk of erectile dysfunction–Part one
540. How to reduce the risk of erectile dysfunction–Part two
541. Which PDE-5 inhibitor for erectile dysfunction? Part one
542. Which PDE-5 inhibitor for erectile dysfunction? Part two
543. Which PDE-5 inhibitor for erectile dysfunction? Part three
544. Which PDE-5 inhibitor for erectile dysfunction? Part four
545. Which laboratory tests for persons taking valproate? Part one
546. Which laboratory tests for persons taking valproate? Part two
547. Different preparations of valproate–Part one
548. Different preparations of valproate–Part two
549. Different preparations of valproate–Part three
550. How to differentiate between bipolar I and II, mania and hypomania
551. How to treat bipolar II depression
552. How to treat bipolar disorder with comorbid anxiety
553. How to treat bipolar disorder with comorbid ADHD
554. What to do when a person on lamotrigine develops a rash
555. Carbamazepine/oxcarbazepine for maintenance therapy in bipolar disorders?
556. Second-generation antipsychotics as first-line treatment for bipolar disorders?
557. Long-acting injectable antipsychotics for bipolar disorder?
558. Some options for refractory bipolar depression
559. Tips on managing perimenopausal symptoms. Part one
560. Tips on managing perimenopausal symptoms. Part two
561. Tips on managing perimenopausal symptoms. Part three
562. Tips on managing perimenopausal symptoms. Part four
563. Three quick questions (Quiz 17)
564. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part one
565. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part two
566. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part three
567. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part four
568. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part five
569. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part six
570. Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders? Part seven
571. How to refer your patient for TMS. Part one
572. How to refer your patient for TMS. Part two
573. How to refer your patient for TMS. Part three
574. How to refer your patient for TMS. Part four
575. How to identify bipolar disorder. Part one
576. How to identify bipolar disorder. Part two
577. How to identify bipolar disorder. Part three
578. How to identify bipolar disorder. Part four
579. Cognitive domains that we need to evaluate: Complex attention. Part one
580. Cognitive domains that we need to evaluate: Complex attention. Part two
581. Cognitive domains that we need to evaluate: Complex attention. Part three
582. Cognitive domains that we need to evaluate: Complex attention. Part four
583. Cognitive domains: Executive function. Part one
584. Cognitive domains: Executive function. Part two
585. Cognitive domains: Executive function. Part three
586. Cognitive domains: Executive function. Part four
587. How exactly to add aripiprazole for hyperprolactinemia
588. Cognitive domains: Learning and memory. Part one
589. Cognitive domains: Learning and memory. Part two
590. Cognitive domains: Learning and memory. Part three
591. Cognitive domains: Learning and memory. Part four
592. Cognitive domains: Learning and memory. Part five
593. Cognitive domains: Learning and memory. Part six
594. Cognitive domains: Learning and memory. Part seven
595. Cognitive domains: Learning and memory. Part eight
596. Cognitive domains: Learning and memory. Part nine
597. Amphetamine stopped working after keto diet started. Part one
598. Amphetamine stopped working after keto diet started. Part two
599. Clinicians’ guide to screening tests in mental health. Part one
600. Clinicians’ guide to screening tests in mental health. Part two
601. Clinicians’ guide to screening tests in mental health. Part three
602. Clinicians’ guide to screening tests in mental health. Part four
603. Clinicians’ guide to screening tests in mental health. Part five
604. Clinicians’ guide to screening tests in mental health. Part six
605. Clinicians’ guide to screening tests in mental health. Part seven
606. The patient who “demands” TWO antipsychotics
607. Why cut-off scores on screening tests matter to clinicians. Part one
608. Why cut-off scores on screening tests matter to clinicians. Part two
609. Why cut-off scores on screening tests matter to clinicians. Part three
610. Why cut-off scores on screening tests matter to clinicians. Part four
611. The Mood Disorders Questionnaire is being used inappropriately. Part one
612. The Mood Disorders Questionnaire is being used inappropriately. Part two
613. Don’t use screening questionnaires for bipolar disorder
614. Is mirtazapine LESS sedating at higher doses? Part one
615. Is mirtazapine LESS sedating at higher doses? Part two
616. Avoid these three antipsychotics in women with breast cancer
617. Is a beta blocker causing erectile dysfunction in your patient?
618. A beta blocker that may even *improve* erectile dysfunction
619. The pros and cons of the beta blocker nebivolol
620. Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors? Part one
621. Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors? Part two
622. Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors? Part three
623. Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors? Part four
624. Cognitive domains: Language. Part one
625. Cognitive domains: Language. Part two
626. Cognitive domains: Language. Part three
627. Cognitive domains: Language. Part four: Testing Fluency in the MoCA
628. Two types of verbal fluency and how to evaluate them
629. Understanding abnormalities of language: Aphasias
630. Advanced tips on evaluating verbal fluency clinically. Part one
631. When should we consider letter and semantic fluency to be impaired?
632. More tips about evaluating verbal fluency
633. Do you assess semantic advantage in your patients?
634. A phonemic “advantage” is not an advantage–it is a bad sign
635. Why is borderline personality disorder often missed?
636. Why has it been difficult to screen for borderline personality disorder?
637. What would it take to quickly screen for borderline personality disorder?
638. One criterion to screen them all, One criterion to find them
639. How exactly to ask about affective instability
640. What the presence of affective instability does NOT mean
641. In whom is screening for borderline personality disorder most useful?
642. Which diagnoses suggest that we should screen for borderline personality disorder?
643. What is pregabalin (Lyrica) and what does it do?
644. Does pregabalin work for generalized anxiety disorder (GAD)?
645. How well does pregabalin work for GADand how does it compare to other medications?
646. Can pregabalin (Lyrica) be added to a serotonergic antidepressant after partial response?
647. What dose of pregabalin should we titrate to for GAD?
648. Which contraceptive after oral-contraceptive-associated depression? Part one
649. Which contraceptive after oral-contraceptive-associated depression? Part two
650. How to judge the quality of a journal. Part one
651. How to judge the quality of a journal. Part two
652. How to judge the quality of a journal. Part three: Journal Impact Factor
653. Three quick questions for you about screening tests (Quiz 18)
654. What is N-acetylcysteine (NAC)?
655. N-acetylcysteine (NAC) for trichotillomania? Part one
656. N-acetylcysteine (NAC) for trichotillomania? Part two
657. N-acetylcysteine (NAC) for Excoriation (skin picking) disorder?
658. Before we recommend NAC, we should know this
659. Tips on how exactly to prescribe NAC
660. Tips on how exactly to prescribe NAC. Part two
661. This is the problem with nicotine replacement treatment
662. Are e-cigarettes effective for smoking cessation?
663. Can e-cigarettes be a stepping stone to quitting cigarettes in the future?
664. Are e-cigarettes recommended for treating tobacco use disorder?
665. Are e-cigarettes recommended for treating tobacco use disorder? Part two
666. What are electronic cigarettes (e-cigarettes)?
667. Three generations of electronic cigarettes (e-cigarettes)
669. More about e-cigarettes and related products
669. Switching to e-cigarettes may increase medication levels. Part one
670. Switching to e-cigarettes may increase medication levels. Part two
671. Thyroid hormones for psychopharmacologists: What’s what
672. Pros and Cons of T3 and T4. Part one
673. Pros and Cons of T3 and T4. Part two
674. No reliable evidence for addition of thyroid hormone to an SSRI
675. What is a failed study?
676. Why do clinical trials sometimes have both a placebo and an active control arm?
677. Summing up: Positive, negative, and failed studies
678. Liothyronine (T3) with an antidepressant: How much? Part one
679. Liothyronine (T3) with an antidepressant: How much? Part two
680. Liothyronine (T3) with an antidepressant: For how long?
681. Can mirtazapine be started at 30 mg per day?
682. Bipolar disorder with rapid cycling: In what percentage of your patients?
683. Who is more likely to develop rapid cycling?
684. Risk factors for rapid cycling: Caveats and what we can do
685. What to do if a patient has bipolar disorder with rapid cycling
686. Which medications for bipolar disorder with rapid cycling?
687. More on what we don’t know about treatment of rapid cycling in bipolar disorder
688. Summing up rapid cycling
689. Why isn’t bupropion the most frequently prescribed antidepressant?
690. Lamotrigine: No additional benefit at 400 mg per day?
691. Is lamotrigine 400 mg per day no more effective than 200 mg per day?
692. Should we consider amantadine for antipsychotic-induced parkinsonism?
693. Advantages and disadvantages of amantadine
694. Some key things about the pharmacology of amantadine
695. How to test for B vitamins in patients with cognitive impairment
696. How to interpret vitamin B12 level and serum methylmalonic acid levels
697. Testing serum or RBC folate levels in patients with cognitive impairment
698. Why homocysteine is important and should be measured
699. Just three quick questions with brief answers (Quiz 19)
700. Shocking data on weight gain and metabolic side effects in adolescents on olanzapine
701. The bottom line on metabolic side effects of olanzapine in adolescents
702. Does weight gain with second-generation antipsychotics continue even after six months?
703. A psychopharmyth about weight gain with second-generation antipsychotics
704. Sundowning in patients with dementia is important!
705. Sundowning or Delirium?
706. Does melatonin work for sundowning in dementia?
707. Lithium-induced hypercalcemia and hyperparathyroidism are common
708. Clinical features of hyperparathyroidism
709. How to screen for lithium-induced hyperparathyroidism
710. Measuring serum calcium and calculating corrected serum calcium
711. How to calculate the corrected serum calcium: a real-life example
712. Corrected serum calcium: The bottom line
713. Summing up: What labs to do and when to screen for lithium-induced hyperparathyroidism
714. Monitoring for metabolic side effects in children and adolescents on a second-generation (atypical) antipsychotic
715. Is measuring BMI at four weeks useful?
716. A simple, free questionnaire for Adult Autism Spectrum Disorder
717. How to score and interpret the Adult Autism Spectrum Quotient (AQ)
718. How to screen adults for autism spectrum disorder
719. Is vortioxetine more efficacious than other antidepressants?
720. Should patients with celiac disease worry about gluten in medications?
721. Part 2: Should patients with celiac disease worry about gluten in medications?
722. What else can cause Steven-Johnson Syndrome (SJS)/ Toxic Epidermal Necrolysis (TEN)?
723. Do past infections increase the risk of Stevens-Johnson Syndrome (SJS)/ Toxic Epidermal Necrolysis (TEN)?
724. Vitamin B6 for lithium-induced benign tremor?
725. Vitamin B6 for lithium-induced benign tremor? Part two
726. How common is liver toxicity with disulfiram and when does it occur?
727. When and how often should hepatic function tests be done in patients on disulfiram?
728. Prescription Drug Monitoring Programs (PDMPs)
729. Tips on using the Prescription Drug Monitoring Program
730. L-theanine for anxiety or stress?
731. How is L-theanine used for anxiety and stress responses?
732. What is a “standard” drink?
733. How much alcohol intake is “normal”?
734. What are Binge drinking and Heavy drinking?
735. Summarizing: More than low risk, Binge, and Heavy drinking
736. We should screen every patient for possible alcohol use disorder
737. How exactly to screen patients for possible alcohol use disorder. Part one
738. How exactly to screen patients for possible alcohol use disorder. Part two
739. A mnemonic to help diagnose Restless Legs Syndrome
740. Advanced tips about the urges to move in RLS
741. Important details about Rest, Getting up, and Evenings in RLS
742. E and S: Advanced tips on the diagnostic clinical features of restless legs syndrome (RLS)
743. DSM-5 criteria for restless legs syndrome (RLS): A simple explanation and mnemonic. Part one
744. DSM-5 criteria for restless legs syndrome (RLS): A simple explanation and mnemonic. Part two
745. What is vitamin D? Part one
746. What is vitamin D? Part two
747. Which test to order for vitamin D status
748. How should we define vitamin D insufficiency or deficiency?
749. When and how to treat vitamin D insufficiency or deficiency
750. Quick! Are these statements True or False? (Quiz 20)
751. What is Lewy body dementia?
752. How is neurocognitive disorder with Lewy bodies different from that due to Parkinson’s disease?
753. Why we must be able to recognize Neurocognitive disorder with Lewy bodies
754. Diagnostic criteria for Neurocognitive disorder with Lewy bodies explained
755. How to identify fluctuating cognition
756. How variability in NCD with Lewy bodies differs from that in Alzheimer’s disease
757. We need to differentiate between Neurocognitive disorder with Lewy bodies and delirium
758. How to differentiate NCD with Lewy bodies from delirium
759. NCD with Lewy bodies versus delirium
760. What kinds of psychotic symptoms are present in neurocognitive disorder with Lewy bodies?
761. Explaining spontaneous parkinsonism in Neurocognitive disorder with Lewy bodies
762. REM sleep behavior disorder is important in diagnosing NCD with Lewy bodies
763. How to identify REM sleep behavior disorder in our patients with dementia
764. Marked sensitivity to side effects of antipsychotics in NCD with Lewy bodies
765. What to do about marked sensitivity to side effects of antipsychotics in NCD with Lewy bodies
766. Three benzodiazepines are safer in the elderly and in liver disease
767. Which benzodiazepines for alcohol withdrawal syndrome (AWS)?
768. Three different approaches to using benzodiazepines for alcohol withdrawal
769. Use the CIWA-Ar to monitor the severity of alcohol withdrawal and to guide treatment
770. How to do symptom-triggered treatment for alcohol withdrawal
771. Fixed-dose regimens for alcohol withdrawal and their advantages
772. Fixed-dose regimens for alcohol withdrawal: Disadvantages and examples
773. A table with key facts about commonly used benzodiazepines
774. We are missing most cases of sleep apnea
775. The STOP-Bang questionnaire and where to get it for free
776. How to monitor for metabolic side effects in adults on second-generation antipsychotics
777. Important points about monitoring for metabolic side effects of second-generation antipsychotics
778. Elevated vitamin B12 levels are common and could be very serious
779. What serious illnesses may be causing an elevated vitamin B12
780. Functional vitamin B12 deficiency can occur even with a high vitamin B12 level
781. How common are the different types of thyroid problems that lithium can cause? (a) Introduction
How common are the different types of thyroid problems that lithium can cause? (b) Incidence
782. How should lithium-induced hypothyroidism be evaluated?
783. When and how to check antithyroid antibodies in a patient on lithium
784. How to manage lithium-induced hypothyroidism. Part one
785. How to manage lithium-induced hypothyroidism. Part two
786. Past ECT treatment should not be assumed to have been adequate
787. Which factors related to ECT technique are important for adequate treatment?
788. Which factors related to ECT technique are important for adequate treatment? Part two
789. More about adequacy of ECT treatment
790. Mirtazapine is a treatment option for antipsychotic-induced akathisia
791. Mirtazapine for treating akathisia: Two possible clinically-important points
792. Mirtazapine may also CAUSE akathisia
793. True or False? (Quiz 21)
794. What is melatonin and what does it do?
795. Melatonin for insomnia–advantages, efficacy, effects, and a mind-blowing statistic
796. What dose of melatonin to start with and where to get low dose preparations (a)
What dose of melatonin to start with and where to get low dose preparations (b)
797. Beyond insomnia and sleep apnea: Another type of sleep disorder
798. Many patients with insomnia actually have Delayed Sleep Phase Disorder
799. Pull from both ends to treat Delayed Sleep Phase Disorder
800. Pulling at the other end: Bright light therapy in the morning
801. More on how exactly to treat Delayed Sleep Phase Disorder
802. Next steps in treating Delayed Sleep Phase Disorder
803. How to diagnose SIADH
804. What is BEN and why does it matter to mental health clinicians?
805. E-cigarettes or conventional nicotine-replacement products? Which is more effective?
806. More on e-cigarettes, “smoking replacement,” and “harm reduction”
807. Five reasons why many clinicians sometimes combine a stimulant and atomoxetine
808. Cyproheptadine as-needed to reverse antidepressant-induced sexual dysfunction?
809. How exactly to use cyproheptadine for antidepressant-induced sexual dysfunction
810. Will mirtazapine increase the risk of QT prolongation? (Member’s case)
811. Can mirtazapine cause QT prolongation and ventricular arrhythmias?
812. Bottom line regarding mirtazapine and QT prolongation
813. Do you give thiamine routinely for the prevention of Wernicke-Korsakoff syndrome?
814. Problems regarding how thiamine is being prescribed
815. Thiamine for prevention: How much? By what route? How many times a day?
816. THIS is how we should prescribe thiamine to prevent Wernicke-Korsakoff syndrome
817. Can I drink while on the antidepressant?
818. It is not a problem but don’t do it???
819. Six types of abnormal reactions to alcohol that may occur in persons taking an antidepressant
820. Two cases where stopping estrogen led to worsening of psychosis
821. Starting or stopping an oral contraceptive (or other estrogen) in a patient on clozapine
822. How is clozapine metabolized?
823. Estrogen and estrogen-containing oral contraceptives affect clozapine levels
824. What does estrogen have to do with schizophrenia??
825. Adjunctive estrogen for schizophrenia?
826. Should we not insist on fasting before getting labs for metabolic monitoring?
827. Should we go ahead and get a non-fasting lipid profile?
828. Easily find patient assistance programs for patients who can’t afford a particular medication
829. Stimulants for ADHD with a history of a substance use disorder?
830. Does this person really have ADHD?
831. History of ADHD: Learn more about what we are looking for
832. Neuropsychological testing for diagnosing ADHD?
833. What is the (limited) role of neuropsychological testing in ADHD or suspected ADHD?
834. Other possible uses of neuropsychological testing in ADHD
835. Can medication X cause side effect Y?
836. “Not a known and common side effect”
837. The Prescribing Information has useful information for prescribers
838. Can buspirone cause dyskinesia or parkinsonism?
839. How to search PubMed efficiently for possible adverse effects
840. How to search PubMed efficiently for possible adverse effects–Part 2
841. I didn’t know about this, did you?
842. Clinical features of cannabinoid hyperemesis syndrome
843. More clinical features of cannabinoid hyperemesis syndrome
844. An ingredient from hot peppers is used as a treatment for cannabinoid hyperemesis syndrome
845. How exactly to use capsaicin for cannabinoid hyperemesis syndrome
846. Acute treatment of cannabinoid hyperemesis syndrome: General measures
847. Acute treatment of cannabinoid hyperemesis syndrome: Specific measures
848. Final words on cannabinoid hyperemesis syndrome
849. How often should we check an ECG? Part one
850. How often should we check an ECG? Part two
851. How often should we check an ECG? Part three
852. How often should we check an ECG? Part four
853. True or False? (Quiz 22)
854. What is the optimal serum valproic acid (valproate) level? Part one
855. What is the optimal serum valproic acid (valproate) level? Part two
856. Bupropion for cocaine use disorder? What’s the evidence?
857. Bupropion for cocaine use disorder? What’s the bottom-line?
858. Agitation in Alzheimer’s disease: First, assess for modifiable causes
859. Valproate or quetiapine for agitation in Alzheimer’s disease: Yes or No?
860. Medications for agitation in Alzheimer’s disease: Part one
861. Antipsychotic in a patient with tardive dyskinesia?
862. FDA-cleared is not the same as FDA-approved
863. The FDA has a class system for medical devices
864. Are TMS and Alpha-Stim FDA “approved” or FDA “cleared”?
865. Initial steps in managing lithium-induced hypercalcemia/ hyperparathyroidism
866. Surgery for lithium-induced hyperparathyroidism
867. There is a medication for treating lithium-induced hyperparathyroidism
868. How psychotropic medications cause blurred vision: Part one
869. How psychotropic medications cause blurred vision: Part two
870. How to evaluate blurred vision apparently due to a psychotropic medication
871. Managing diarrhea due to mood stabilizers
872. How to find a cognitive therapist
873. How to measure neck circumference
874. Why do we need an “Apnea-Hypopnea Index”?
875. Apnea-Hypopnea Index for diagnosing obstructive sleep apnea and rating its severity
876. Understanding the proper place of Apnea-Hypopnea Index
877. Does dose reduction work for neuroleptic-induced parkinsonism?
878. Can isotretinoin cause depression or suicidality?
879. Why we can’t easily dismiss the risk of depression or suicidality with isotretinoin
880. What exactly is a “therapeutic window” for nortriptyline?
881. Nortriptyline level: At what dose and after how many days?
882. The timing of nortriptyline trough levels
883. What to do with the nortriptyline level
884. True or False?
885. Do you think that valproate causes PCOS?
886. Valproate and PCOS: What should we do before starting valproate
887. Valproate and PCOS: What we should do during treatment
888. How to find a facility that provides TMS
889. Nausea due to psychotropic medications is more important than we might think
890. Two simple strategies to reduce the risk of nausea
891. It makes a big difference—atomoxetine once a day or twice a day?
892. What dose of aripiprazole as an adjunct for OCD?
893. How to dose aripiprazole as an adjunct for OCD
894. Elevated alkaline phosphatase with normal AST and ALT
895. Metformin for antipsychotic-induced weight gain in children and adolescents?
896. Important tips on using metformin in children and adolescents
897. When and what to do about clozapine and olanzapine after smoking cessation
898. Add clomipramine to an SSRI for OCD?
899. Could it have been a type II error?
900. Adding clomipramine to an SSRI for OCD: Were the treatments adequate?
901. Concerns about combining clomipramine and SSRIs
902. If combining with clomipramine, which SSRIs should we worry the most about?
903. How exactly to add clomipramine to an SSRI
904. What monitoring should be done if clomipramine is added to an SSRI?
905. How to make sleep hygiene interventions more efficient and effective
906. The ONE most effective part of CBT-I that all of us should learn to implement
907. How exactly to do sleep restriction therapy. Part one
908. How exactly to do sleep restriction therapy. Part two
909. How exactly to do sleep restriction therapy. Part three
910. How exactly to do sleep restriction therapy. Part four
911. Can adding buspirone to a serotonergic antidepressant cause serotonin syndrome?
912. Be especially careful when combining buspirone with these two antidepressants
913. Does intermittent use of an antidepressant work for premature ejaculation?
914. Is as-needed treatment of premature ejaculation with a serotonergic antidepressant as effective and as acceptable?
915. Important factors for deciding on as-needed antidepressant for premature ejaculation
916. How do antidepressants increase the risk of bleeding?
917. Which antidepressants in persons at increased risk of bleeding?
918. True or False? (Quiz 24)
919. Dose equivalents for long-acting injectable second-generation antipsychotics
920. How dose equivalents for LAI second-generation antipsychotics were calculated
921. Dose equivalents of LAI second-generation antipsychotics
922. How to diagnose atypical features
923. Four things to look for if atypical features are present
924. A mnemonic for medications metabolized by CYP3A4
925. Another mnemonic—plants and CYP3A4
926. Are oral, irreversible MAOIs the first-line treatment for major depression with atypical features?
927. Atypical depression: Oral irreversible MAOIs or SSRIs?
928. Bupropion first-line for major depressive disorder with atypical features?
929. Stimulants in a patient receiving ketamine/ esketamine?
930. What to do about stimulants during ketamine/esketamine treatment
931. What to do about stimulants after ketamine/esketamine treatment
932. Why is migraine important for mental health clinicians?
933. The four phases of migraine
934. Prodromal phase of migraine
935. Clinical features of the migraine aura
936. The mechanism of migraine aura explains its clinical features
937. Common characteristics of migraine headache
938. Associated symptoms during the headache phase of migraine (a)
Associated symptoms during the headache phase of migraine (b)
939. Diagnostic criteria for migraine
940. Diagnostic subtypes of migraine
941. Three simple questions help to PIN the diagnosis of migraine
942. Recommend an “aura diary”
943. Where can patients get kosher vitamins and supplements?
944. Complementary and alternative medicines (CAM): Specific kosher products
945. Vitamins and minerals: Specific kosher products
946. Naltrexone-bupropion in a patient on clomipramine?
947. Links to 5 free templates for sleep diaries
948. Some tips on using sleep diaries
949. True or False? (Quiz 25)
950. How to change from gabapentin (Neurontin(R)) to pregabalin (Lyrica(R))
951. Switching between gabapentin and pregabalin: Potential side effects and an illustrative case
952. “Fingerprint” metabolites that uniquely identify substances in a urine drug screen
953. Which TCAs are the most effective ones for MDD?
954. TCA versus TCA for MDD: How BIG were the differences?
955. Which TCAs to consider as first-line options
956. Are any of your patients on topiramate?
957. How to monitor serum bicarbonate for possible metabolic acidosis
958. What is the anion gap and how can we easily calculate it from the lab results?
959. How we can easily calculate the anion gap
960. Important clinical tips on using the anion gap
961. Two types of metabolic acidosis: Examples
962. Some antidepressants may have clinically important interactions with tramadol (Ultram(R))
963. Serious problems that can occur when an antidepressant is combined with tramadol
964. More clinical tips on tramadol and antidepressants
965. Is fluvoxamine more effective for OCD than other SSRIs?
966. What did other sources find about fluvoxamine versus other SSRIs for OCD?
967. Another one bites the dust!
968. Clinical tips on managing Parkinson’s disease psychosis: Part one
969. Clinical tips on managing Parkinson’s disease psychosis: Part two
970. Clinical tips on managing Parkinson’s disease psychosis: Part three
971. Is tardive dyskinesia reversible if the antipsychotic is stopped?
972. Is tardive dyskinesia reversible? Part two
973. Final conclusions on “Is tardive dyskinesia reversible?”
974. Does bupropion treat antidepressant-induced sexual dysfunction? Part one
975. Does bupropion treat antidepressant-induced sexual dysfunction? Part two
976. Does bupropion treat antidepressant-induced sexual dysfunction? Part three
977. Does bupropion treat antidepressant-induced sexual dysfunction? Part four
978. How often does antidepressant-induc
979. MAO inhibitors (MAOIs) and contraindicated medications: How long do we have to wait?
980. How long do we have to wait? Part 2
981. Combination therapy (mood stabilizer plus antipsychotic) for acute mania? Part one
982. Combination therapy (mood stabilizer plus antipsychotic) for acute mania? Part two
983. Combination therapy (mood stabilizer plus antipsychotic) for acute mania? Part three
984. Our advice on combination therapy (mood stabilizer plus antipsychotic) for acute mania
985. Why is dextromethorphan combined with a CYP 2D6 inhibitor?
986. Does new-onset psychosis late in life predict the onset of dementia?
987. Alzheimer’s disease often travels in “mixed company” for acute mania?
988. Behavioral symptoms in dementia that are unlikely to improve with an antipsychotic
989. Avoid these mistakes in using antipsychotics for psychosis in dementia
990. Minimizing caffeine may be helpful in bipolar disorder
991. Four issues about caffeine and bipolar disorder
992. Serious dangers to avoid if it is essential to physically restrain a pregnant woman
993. What to do if it is essential to physically restrain a pregnant woman
994. True or False? (Quiz 26)
995. Why we must identify and characterize psychotic features in manic episodes. Part one
996. Two types of psychotic symptoms in mania
997. Do psychotic symptoms in mania affect the prognosis?
998. Psychotic symptoms in mania affect the treatment plan
999. What to do about cognitive complaints in brief outpatient visits
1000. First, which cognitive domains are impaired and to what extent?
1001. In difficult-to-treat patients, always focus on more evaluation before more treatment trials
1002. Unusually severe difficulties tolerating an antidepressant?
1003. Quetiapine monotherapy for generalized anxiety disorder (GAD)?
1004. How well does quetiapine XR monotherapy for GAD work?
1005. Bottom line on quetiapine monotherapy for GAD
1006. Elevated triglycerides are common in mental health patients
1007. Non-medication management of elevated triglycerides
1008. Do you recommend omega-3 fatty acids for hypertriglyceridemia?
1009. Omega-3 fatty acids to lower serum triglycerides can make a HUGE difference
1010. How to elicit what our patients really think about their diagnosis
1011. How to discuss relapse prevention strategies to improve outcomes in bipolar disorder
1012: Specific strategies for relapse prevention in bipolar disorders
1013. A key strategy for for preventing relapse and aborting manic episodes: Part one
1014. A key strategy for for preventing relapse and aborting manic episodes: Part two
1015. Does divalproex (valproate) work for bipolar depression? Part one
1016. Bottom line on the efficacy of divalproex for bipolar depression
1017. Important tips on using divalproex for bipolar depression
1018. Tranylcypromine: Third-line for bipolar depression
1019. True or False? (Quiz 27)
1020. Clock drawing: A simple, brief, but very useful clinical test
1021. How to administer the Clock Drawing Test
1022. More things the Clock Drawing Test can tell us
1023. Stimulus-bound behavior and semantic processing difficulty identified by the Clock Drawing Test
1024. How visual field defects may be identified on the clock drawing test
1025. What errors to look for in the Clock Drawing Test
1026. Final conclusions about the Clock Drawing Test
1027. Do you try to avoid SNRIs in bipolar depression?
1028. Greater risk of switching to mania/hypomania with SNRIs?
1029. Essential details about the Increased risk of switching with SNRIs
1030. Bottom line and Action items regarding SNRIs in bipolar depression
1031. Is ondansetron (brand name Zofran) associated with an increased risk of QT prolongation?
1032. Useful information and guidance about QT prolongation with ondansetron
1033. What if ondansetron is combined with a psychotropic medication?
1034. Final recommendations regarding ondansetron and QT prolongation
1035. How to switch from oral or transdermal selegiline to another MAO inhibitor
1036. What is khat and why is it important in mental health?
1037. Why it is important for all of us to screen for eating disorders
1038. A simple 5-item screen for eating disorders is nothing to SCOFF at
1039. How well does the SCOFF do in screening for eating disorders?
1040. SCOFF: Verbally or in writing? In other languages?
1041. Important additional tips on screening for eating disorders
1042. Here’s a screening questionnaire specifically for binge-eating disorder
1043. How to convert from alprazolam immediate-release to extended-release
1044. Potential advantages of alprazolam extended-release
1045. Does alprazolam extended-release have a lower addictive/ abuse potential?
1046. My recommendations regarding alprazolam extended-release
1047. Does hydroxyzine have advantages over diphenhydramine?
1048. Hydoxyzine versus diphenhydramine: Bottomline and Clinical Recommendations
1049. Bradycardia in a patient with bipolar disorder
1050. Lithium can cause certain benign changes in the ECG, but…
1051. Lithium and ECG changes: What to look for
1052. Six general principles about lithium’s effects on the ECG
1053. Clinical recommendations regarding lithium and ECGs
1054. True or False? (Quiz 28)
1055. Is sertraline safe to use during breastfeeding?
1056. Tips on psychotropic medications during breastfeeding
1057. Tips on breastfeeding while on a psychotropic medication
1058. Strategies to reduce the infant’s medication exposure during breastfeeding
1059. How to monitor a newborn being breastfed by a mother on a psychotropic medication
1060. Can I take my medication with me when I travel to another country?
1061. Can I take my medication with me when I travel to another country? Part two
1062. Headache DURING sex. Really?
1063. Headache during sexual activity? Could be serious!
1064. More clinical features of primary headaches associated with sexual activity
1065. Are we identifying comorbid diagnoses in bipolar disorders?
1066. How common is comorbid OCD in bipolar disorders?
1067. Which patients with bipolar disorders are more likely to also have comorbid OCD?
1068. Serotonergic antidepressants for comorbid OCD in bipolar disorder?
1069. Other options for OCD comorbid with bipolar disorder
1070. Clinical recommendations for OCD comorbid with bipolar disorder: Part one
1071. Clinical recommendations for OCD comorbid with bipolar disorder: Part two
1072. Cannabidiol (CBD) for schizophrenia or other psychotic disorders? Part one
1073. Cannabidiol in schizophrenia? What did randomized, double-blind clinical trials find?
1074. Clinical trials of cannabidiol for schizophrenia: What to make of them (part one)
1075. Clinical trials of cannabidiol for schizophrenia: What to make of them (part two)
1076. With cannabidiol, keep possible drug interactions in mind
1077. Bottom line on cannabidiol in schizophrenia
1078. How to find treatment facilities for substance use disorders (addictions)
1079. True or False? (Quiz 29)
1080. Is this medication “weight-neutral”?
1081. How to identify potentially significant side effects hidden behind “misleading means”
1082. Another case of “misleading means”
1083. Two more tips on what to look at in evaluating risks with a medication
1084. General approach to treating women during pregnancy and lactation
1085. Two general principles and three models of treatment during pregnancy and lactation
1086. Some questions to ask in evaluating a patient with blurred vision
1087. Questions to ask to try to rule out some other causes of blurred vision
1088. Does quetiapine work for insomnia?
1089. How quetiapine saved the day
1090. When might we consider quetiapine for insomnia?
1091. Addressing two concerns about off-label use of quetiapine for insomnia
1092. Even low-dose quetiapine carries some risks
1093. Quetiapine for insomnia? Bottom line and Clinical recommmendations
1094. BOTH a bipolar disorder AND a substance use disorder: More common that we may realize
1095. Comorbid bipolar disorder and substance use disorder: What, who, and so what
1096. Bipolar disorder or substance use? Tips on clarifying the diagnosis
1097. Bipolar disorder or substance use? More tips on clarifying the diagnosis
1098. Tips on treating comorbid bipolar disorder and substance use disorder. Part one
1099. General tips on treating comorbid bipolar disorder and substance use disorder. Part two
1100. Tips on treating alcohol use disorder in persons with a bipolar disorder. Part one
1101. Tips on treating alcohol use disorder in persons with a bipolar disorder. Part two
1102. Clinical recommendations on treating alcohol use disorder in persons with a bipolar disorder
1103. A systematic evaluation of bright light therapy devices. Part one
1104. A systematic evaluation of bright light therapy devices. Part two
1105. Bright light therapy devices that passed the test
1106. Which large light box to recommend. Part one
1107. Which large light box to recommend. Part two
1108. Consider smaller light boxes? If so, which one? Part one
1109. Consider smaller light boxes? If so, which one? Part two
1110. How to easily search for drug interactions with cannabidiol
1111. True or False? (Quiz 30)
1112. What is performance anxiety (“stage fright”) and why is it important?
1113. Why consider a beta-blocker for performance anxiety?
1114. When and when not to consider a beta-blocker for performance anxiety
1115. Which beta-blocker for disabling performance anxiety with physical/autonomic symptoms?
1116. Final tips about beta-blockers for physical symptoms in performance anxiety
1117. When and how to prescribe lithium citrate oral solution
1118. Some interesting facts about boxed warnings (so-called “black box warnings”)
1119. What to do about boxed warnings. Part one
1120. What to do about boxed warnings. Part two
1121. SSRIs for OCD: How high can we go?
1122. Reducing the cost of medications by using higher strength pills. Part one
1123. Reducing the cost of medications by using higher strength pills. Part two
1124. Using a Canadian pharmacy can reduce the cost of some medications
1125. A simple way to significantly reduce the cost of l-methylfolate (Deplin(R))
1126. Online resources for complementary and alternative medicines or products
1127. Elevated serum creatinine in young man on lithium
1128. Can creatine supplementation lead to elevated serum creatinine?
1129. Creatine supplementation: What happened with my patient
1130. Two types of creatine supplements
1131. Clinical recommendations about creatine supplements and serum creatinine
1132. What serum creatinine is and why it is important
1133. Factors that can affect serum creatinine. Part one
1134. Factors that can affect serum creatinine. Part two
1135. Factors that can affect serum creatinine. Part three
1136. True or False? (Quiz 31)
1137. Patients on high doses of controlled substances
1138. General tips on engaging patients in dose reduction
1139. Tips on reducing patients’ anxiety about medication dose reduction
1140. How to frame the need for reduction in the dose of a controlled substance
1141. Valproate-induced hyperammonemia
1142. Evaluation of hyperammonemia in patients on valproate
1143. How to manage valproate-induced hyperammonemia: Part one
1144. How to manage valproate-induced hyperammonemia: Part two
1145. Key points to know about L-carnitine
1146. Levels of seriousness in drug interaction search results
1147. Drug interaction search (checker) tools: Free options (Part one)
1148. Drug interaction search (checker) tools: Free options (Part two)
1149. Which antidepressants in patients with a history of, or at higher risk for, bleeding? Part one
1150. Which antidepressants in patients with a history of, or at higher risk for, bleeding? Part two
1151. Stimulant “holidays” (breaks) in adults with ADHD? Part one: Tolerance
1152. Stimulant “holidays” (breaks) in adults with ADHD? Part two
1153. Stimulant “holidays” (breaks) in adults with ADHD? Part three
1154. How significant are interactions between lithium and antihypertensives?
1155. Factors affecting the severity of the interaction between antihypertensives and lithium
1156. Clinical recommendations on thiazide diuretics in persons on lithium
1157. What does “treatment-resistant depression” in the indication for esketamine (Spravato(R)) mean? Part one
1158. What does “treatment-resistant depression” in the indication for esketamine (Spravato(R)) mean? Part two
1159. How well does esketamine work for treatment-resistant depression? Part one
1160. How well does esketamine work for treatment-resistant depression? Part two
1161. Does esketamine work rapidly as intravenous ketamine does?
1162. Does esketamine work rapidly as intravenous ketamine does? Part two
1163. True or False? (Quiz 32)
1164. Common and other side effects of esketamine nasal spray (Spravato(R))
1165. Dissociative and perceptual changes are esketamine’s commonest psychological side effects
1166. What exactly are “dissociative or perceptual changes” that may occur with esketamine?
1167. How serious are the dissociative and perceptual side effects of esketamine?
1168. What do WE need to be do about dissociative and perceptual changes?
1169. Are we identifying and treating anxiety disorders in persons with bipolar disorders?
1170. Pharmacological treatment of anxiety disorders in persons with bipolar disorders. Part one
1171. Pharmacological treatment of anxiety disorders in persons with bipolar disorders. Part two
1172. Are you using a self-rated scale in persons with OCD?
1173. Use this self-rating scale for OCD
1174. The Obsessive-Compulsive Inventory-Revised (OCI-R)
1175. There are many ways in which we can use the OCI-R
1176. How to score and interpret the OCI-R
1177. How to use the OCI-R for screening
1178. “Rescue measures” for orthostatic hypotension
1179. Abdominal binders: Simple but effective for orthostatic hypotension
1180. How exactly to use an abdominal binder
1181. How exactly to recommend increased salt intake for orthostatic hypotension
1182. Grapefruit or its juice can interact with psychotropic medications
1183. More tips on the interaction between grapefruit and psychotropic medications
1184. Can grapefruit be entered into an interaction checker?
1185. Does paliperidone HAVE to be taken with food?
1186. Medications to be taken consistently either with or without food
1187. Caffeine can significantly change serum clozapine levels
1188. More on caffeine’s effect on clozapine levels
1189. We need to warn patients on fluvoxamine about caffeine
1190. When cigarette smokers stop smoking…
1191. Why we need ICD-10 codes other than those for mental disorders
1192. ICD-10 codes for mental health clinicians
1193. True or False? (Quiz 33)
1194. Ropinirole off-label for treatment-resistant depression?
1195. When to consider off-label ropinirole for “treatment-resistant depression”
1196. Ropinirole can have some serious side effects
1197. Potential drug interactions with ropinirole
1198. How is bipolar depression different from unipolar depression?
1199. How is bipolar depression different from unipolar depression? Part two
1200. How is bipolar depression different from unipolar depression? three
1201. Do stimulant medications work for major depressive disorder?
1202. The bottom line on stimulants for treatment-resistant depression
1203. Should we use automated blood pressure instruments?
1204. Automated blood pressure measurement can be BETTER
1205. How to correctly measure blood pressure. Part one
1206. How to correctly measure blood pressure. Part two
1207. How to correctly measure blood pressure. Part three
1208. How to correctly measure blood pressure. Part four
1209. How to correctly measure blood pressure. Part five
1210. When should we consider ECT for major depressive disorder?
1211. How well does ECT work for major depressive disorder?
1212. Comparing different types of ECT
1213. What type of ECT should patients receive and how often?
1214. Some issues in the practice of ECT for major depressive disorder
1215. An alarm that makes you PROVE that you are really awake!
1216. Clozapine-induced constipation can be very serious
1217. Evaluation and management of clozapine-induced constipation
1218. Basic (level 1) strategies for clozapine-induced constipation
1219. Intermediate (level 2) strategies for clozapine-induced constipation
1220. Advanced (level 3) strategies for clozapine-induced constipation: Part one
1221. Advanced (level 3) strategies for clozapine-induced constipation: Part two
1222. FDA’s warning about clozapine-induced constipation
1223. Why warfarin is important for psychopharmacologists
1224. Best and worse choices of psychotropic medications in a patient on warfarin
1225. Best antidepressants for a patient on warfarin
1226. Clinical recommendations for psychotropic medications in patients on warfarin
1227. Generic medications lead to HUGE savings
1228. Do you worry about generic medications?
1229. Generic medications: When should we be more concerned?
1230. Clinical recommendations about generics
1231. The educational story of generic bupropion extended-release. Part one
1232. The educational story of generic bupropion extended-release. Part two
1233. The educational story of generic bupropion extended-release. Part three
1234. The educational story of generic bupropion extended-release:Bottom line
1235. Should trazodone be taken with food or without food?
1236. True or False? (Quiz 34)
1237. Bipolar depression: Factors affecting treatment selection and outcomes. Part one
1238. Bipolar depression: Factors affecting treatment selection and outcomes. Part two
1239. Bipolar depression: Factors affecting treatment selection and outcomes. Part three
1240. Bipolar depression: Factors affecting treatment selection and outcomes. Part four
1241. More on interpreting thyroid function tests. Part one
1242. More on interpreting thyroid function tests. Part two
1243. More on interpreting thyroid function tests. Part three
1244. Serum TSH level is NORMAL but T4 level is low
1245. What causes central hypothyroidism (and can our meds cause it)?
1246. How to find patient assistance programs: An example
1247. Why do some people take lithium orotate?
1248. Does lithium orotate work?
1249. Lithium orotate or lithium carbonate?
1250. In what strengths is lithium orotate available?
1251. Lithium orotate: Clinical recommendations
1252. How common is new-onset hyponatremia during antidepressant treatment?
1253. How common is new-onset hyponatremia during antidepressant treatment? Part two
1254. How should carbamazepine be discontinued? Part one
1255. How should carbamazepine be discontinued? Part two
1256. Dopamine agonist withdrawal syndrome (DAWS)
1257. Two cases of major depression after stopping a dopamine agonist
1258. DAWS is common but very variable
1259. DAWS: Risk factors and Diagnosis
1260. How to prevent DAWS
1261. How to treat DAWS
1262. Can medication A cause side effect X? An example (Part one)
1263. Can medication A cause side effect X? An example (Part two)
1264. How EXACTLY to screen for tardive dyskinesia
1265. How EXACTLY to screen for tardive dyskinesia: Part two
1266. What are MAO-B inhibitors?
1267. What’s the possible serious interaction between MAO-B inhibitors and antidepressants?
1268. What do we know about using an antidepressant with an MAO-B inhibitor?
1269. Bottom line and clinical recommendations on using antidepressants along with MAO-B inhibitors
1270. True or False? (Quiz 35)
1271. Warning! Some antipsychotics can be dangerous in catatonia
1272. Which antipsychotics to prefer in patients with catatonia
1273. What are 504 plans?
1274. How is imipramine palmoate (Tofranil-PM) different from imipramine hydrochloride (Tofranil)?
1275. What to do if renal impairment develops while on lithium. Part one
1276. What to do if renal impairment develops while on lithium. Part two
1277. How often do kidney stones occur on topiramate?
1278. Laboratory findings related to stone formation in patients on topiramate
1279. Factors that increase the risk of urinary stones with topiramate
1280. Atypical sensory processing is common and clinically important
1281. Three types of symptoms of atypical sensory processing
1282. How sensory oversensitivity presents clinically
1283. Sensory under-responsivity and unusual fascination with sensory stimuli
1284. Look for sensory dysregulation in your patients with migraine
1285. What symptoms of sensory dysregulation in persons with migraines?
1286. How long till the glucose levels decrease?
1287. Case reports of antipsychotic-induced severe hyperglycemia
1288. Two patterns of antipsychotic-associated hyperglycemia: Clinical implilcations
1289. After switching to aripiprazole, will the blood sugar improve?
1290. What to do about hyperglycemia if switched to aripiprazole
1291. When are drug interactions with TCAs more serious?
1292. Not all TCAs are created equal
1293. Have any of your patients complained of tinnitus?
1294. Why tinnitus is important for mental health clinicians to learn about
1295. Key things to ask about if a patient complains of tinnitus
1296. Tinnitus in patients on bupropion?
1297. Tinnitus and antidepressants
1298. True or False? (Quiz 36)
1299. Generic alternative to naltrexone/bupropion (Contrave(R))?
1300. Does guanfacine work for ADHD in adults?
1301. How well does guanfacine work for adults with ADHD?
1302. The bottomline on guanfacine for ADHD in adults
1303. Metformin for weight loss unrelated to antipsychotics?
1304. More on weight gain unrelated to antipsychotic medications
1305. Certain herbal products can cause mania/ hypomania/ mixed states
1306. Clinical recommendations: herbal products and substance/medication-induced bipolar disorder
1307. Which antidepressant in a patient on multiple non-psychiatric medications?
1308. A brief introduction to directly-acting oral anticoagulants
1309. Potential interactions between DOACs and psychotropic medications
1310. Which serotonin reuptake inhibitors may have a lower risk of bleeding?
1311. An example of misleading means (averages)
1312. Are you over-diagnosing PTSD?
1313. What kind of trauma can lead to PTSD?
1314. Many ways of experiencing trauma that can lead to PTSD
1315. TCAs other than clomipramine for OCD?
1316. Should we recommend vitamin B12 supplements?
1317. What causes vitamin B12 deficiency in our patients?
1318. Tips on understanding the clinical features of vitamin B12 deficiency
1319. Don’t miss the symptoms and signs of vitamin B12 deficiency
1320. Tips on checking and interpreting vitamin B12 levels
1321. How to confirm vitamin B12 deficiency
1322. Does vitamin E work for tardive dyskinesia? Yes and No
1323. The bottom line on vitamin E for tardive dyskinesia
1324. How much vitamin E do we need?
1325. Warning! High doses of vitamin E can be harmful
1326. Perimenopausal depression may be a special situation
1327. Tips on choosing medication(s) for perimenopausal depression
1328. Add estrogen to an antidepressant after partial/ non-response?
1329. Safety considerations in using estrogen for perimenopausal depression
1330. True or False? (Quiz 37)
1331. Important! Motor threshold in TMS may be affected by medications
1332. Medications that may LOWER the motor threshold in TMS
1333. Order an MRI of brain in first-episode psychosis?
1334. How useful is a brain MRI in first-episode psychosis?
1335. When is a brain MRI indicated in first-episode psychosis?
1336. Does lamotrigine decrease the effectiveness of oral contraceptives?
1337. Clinical recommendations regarding the effect of lamotrigine on oral contraceptive
1338. Converting from OROS methylphenidate to amphetamine is a two-step process
1339. Pilocarpine “mouthwash” to treat medication-induced dry mouth?
1340. How to make pilocarpine mouthwash to treat dry mouth
1341. How to use the topical pilocarpine (mouthwash) for medication-induced dry mouth
1342. Folic acid may counteract the benefit of lamotrigine
1343. How lamotrigine affects folate metabolism
1344. Possible alternatives to folic acid for patients on lamotrigine
1345. Can 5ARIs cause depression or suicidality?
1346. 5ARIs, sexual dysfunction, and depression
1347. 5ARIs, sexual dysfunction, and depression: Bottom line and Clinical recommendations
1348. Diagnose PTSD only if all four categories of symptoms are present
1349. PTSD: Examples of symptoms in the four categories
1350. Ultraviolet A and B: Implications for vitamin D production
1351. Ultraviolet A (UVA) versus ultraviolet B (UVB): Implications for sunscreen use
1352. Lorazepam for catatonia: How much? How long?
1353. Lorazepam for catatonia: How much? How long? (Part 2)
1354. Lorazepam for catatonia: How much? How long? (Part 3)
1355. Lorazepam Challenge Test in catatonia: Part one
1356. Lorazepam Challenge Test in catatonia: Part two
1357. How is ECT used for catatonia? Part one
1358. How is ECT used for catatonia? Part two
1359. A patient with a low vitamin B12 level
1360. Can patients on bupropion drink alcohol? Part one
1361. Can patients on bupropion drink alcohol? Part two
1362. True or False? (Quiz 38)
1363. Two patients where opening medication capsules was helpful
1364. Should we encourage patients to use independent pharmacies?
1365. FDA-approved Medication Guides for patients
1366. QT prolongation with hydroxyzine and diphenhydramine. Part one
1367. QT prolongation with hydroxyzine and diphenhydramine. Part two
1368. Let’s not get mixed up about “mixed features”
1369. Important! Mixed features consist of “non-overlapping” symptoms
1370. Four things to check for before adding the mixed features specifier
1371. Can lamotrigine CAUSE depression?
1372. Lamotrigine can also cause other psychiatric side effects
1373. Are doxepin’s anticholinergic effects dose-dependent?
1374. Why (HIPAA-compliant) emails with patients are invaluable
1375. What kind of email for communicating with patients?
1376. Risk management concerns regarding email with patients
1377. Should we be using gabapentin for alcohol use disorder?
1378. In whom is gabapentin more likely to work for alcohol use disorder?
1379. What dose of gabapentin for alcohol use disorder?
1380. Do modafinil/ armodafinil increase cardiovascular risk?
1381. Recommendations for cardiovascular monitoring with modafinil/ armodafinil
1382. Do benzodiazepines reduce the response to TMS treatment?
1383. Should we reduce or stop benzodiazepines before TMS treatment?
1384. What do you think about these results of iron studies?
1385. What are “iron studies” and why should we care?
1386. Serum ferritin: the best single test for iron deficiency
1387. Could the serum ferritin be normal even if iron deficiency is present?
1388. What cut-off to use for serum ferritin
1389. Pros and cons of other iron studies
1390. Which iron studies to order and exactly how to order them
1391. Case examples: Interpreting iron studies
1392. Instructions to patients
1393. How to interpret the results of iron studies
1394. Are psychiatric medications safe AFTER laser iridotomy for narrow-angle glaucoma?
1395. Conclusion on whether psychiatric medications are safe AFTER laser iridotomy for narrow-angle glaucoma
1396. What is lactose intolerance and what are its symptoms?
1397. Tips on identifying lactose intolerance
1398. Can lactose in pills cause lactose intolerance?
1399. Lactose in medication pills: Clinical recommendations
1400. When a patient has difficulty getting off venlafaxine. Part one
1401. When a patient has difficulty getting off venlafaxine. Part two
1402. All three phases of treatment are very important in major depressive disorder
1403. Continuation treatment of MDD is very important!
1404. Who should get continuation treatment and what should they get?
1405. Continuation treatment for MDD: How much?
1406. How long should continuation treatment for MDD last?
1407. Many patients need PREVENTIVE treatment but most don’t receive it
1408. The main reasons for longer-term preventive treatment in MDD
1409. Other factors suggesting that preventive treatment of MDD is needed
1410. Obstructive sleep apnea is common and massively underdiagnosed (Part 1)
1411. Obstructive sleep apnea is common and massively underdiagnosed (Part 2)
1412. Are we missing the diagnosis of OSAH in our patients with major depressive disorder?
1413. More evidence that obstructive sleep apnea is frequently going undiagnosed
1414. Just screen everyone for OSAH, Ok?
1415. True or False? (Quiz 39)
1416. A mnemonic for symptoms of antidepressant discontinuation syndrome
1417. An expanded mnemonic for all common symptoms of antidepressant discontinuation syndrome
1418. What is medication-induced excessive yawning and why does it matter?
1419. Which medications can cause excessive yawning?
1420. Management of antidepressant-induced excessive yawning
1421. Add aripiprazole to treat clozapine-induced weight gain?
1422. The possible benefits of adding aripiprazole to clozapine
1423. More on aripiprazole to produce weight loss in patients on clozapine or olanzapine
1424. Why C-reactive protein matters to us
1425. Why are there two different tests for C-reactive protein?
1426. Can high sensitivity C-reactive protein help us choose antidepressant treatment?
1427. C-reactive protein: Bottom line and Clinical recommendations
1428. Treating ADHD in persons with stimulant (including cocaine) use disorder. Part one
1429. Treating ADHD in persons with stimulant (including cocaine) use disorder. Part two
1430. Treating ADHD in persons with stimulant (including cocaine) use disorder. Part three
1431. Treating ADHD in persons with stimulant (including cocaine) use disorder. Part four
1432. Treating ADHD in persons with stimulant (including cocaine) use disorder. Part five
1433. Is “low dose” lithium sufficient for antidepressant augmentation in MDD?
1434. The problem of inadequate serum lithium levels in major depressive disorder
1435. Clinical recommendations: How much lithium for augmentation in major depressive disorder?
1436. How long should a trial of lithium augmentation last? Part one
1437. How long should a trial of lithium augmentation last? Part two
1438. For how long should lithium augmentation be continued?
1439. Lamotrigine monotherapy for maintenance treatment in bipolar I disorder? Part one
1440. Lamotrigine monotherapy for maintenance treatment in bipolar I disorder? Part two
1441. Lamotrigine monotherapy for maintenance treatment in bipolar I disorder? Part three
1442. What is kratom and why is it important to know about?
1443. How is kratom used and what are its effects?
1444. What are the potential harms of kratom?
1445. Kratom withdrawal and toxicity
1446. How are kratom withdrawal, dependence, and overdose treated?
1447. Medication prices on Costco.com versus on Goodrx.com
1448. Does exercise work as a treatment for depressive disorders?
1449. For depressive symptoms, aerobic exercise or resistance training?
1450. How MUCH exercise for treating depressive symptoms?
1451. Final tips on exercise as a treatment for depressive symptoms
1452. What is nightmare disorder and why is it important?
1453. Five ways in which nightmares are very different from sleep terrors
1454. Nightmares versus “bad dreams”
1455. Suggestion: We should specifically ask about nightmares when we ask about sleep
1456. When should we separately diagnose nightmare disorder?
1457. PTSD-associated nightmares: Menu of treatment options
1458. Major practice guidelines have downgraded prazosin for PTSD
1459. What did studies of prazosin for PTSD find? And, what changed?
1460. What may have gone wrong
1461. Bottom line: Does prazosin work for PTSD-associated nightmares or not?
1462. Who might respond better to prazosin?
1463. What is the maximum dose of prazosin for PTSD?
1464. How is the dose of prazosin divided and titrated up?
1465. Atomoxetine can cause EITHER insomnia or somnolence/sedation
1466. Could the serum levels of atomoxetine be too high?
1467. Atomoxetine at bedtime or in split doses?
1468. What else can we do for somnolence/ sedation on atomoxetine?
1469. Does modafinil work for ADHD?
1470. Modafinil for ADHD? Bottom line and Clinical recommendations
1471. Non-selective versus “cardioselective” beta-blockers
1472. Beta-blockers in a person with asthma? Part 1
1473. Beta-blockers in a person with asthma? Part 2
1474. Which beta-blockers in persons with diabetes?
1475. Viewpoint: Has the pendulum swung from too far against the use of benzodiazepines? Part one
1476. Viewpoint: Has the pendulum swung from too far against the use of benzodiazepines? Part two
1477. Quiz no. 40
1478. How to identify clinical versus subclinical hypothyroidism or hyperthyroidism
1479. Thyroid function tests: The four commonest combinations
1480. Thyroid function in acute psychiatric conditions
1481. What do you make of these thyroid function test results?
1482. My thoughts on the patients with abnormal thyroid function tests. Part one
1483. A patient with low TSH AND low free T4
1484. What to do about medications in a patient who is NPO
1485. What if a tremor is either unilateral or asymmetrical? Part one
1486. What if a tremor is either unilateral or asymmetrical? Part two
1487. What is the tremor in Parkinson’s disease like?
1488. More on recognizing Parkinson’s disease tremor
1489. How can response to intravenous ketamine be maintained? Part one
1490. How can response to intravenous ketamine be maintained? Part two
1491. How can response to intravenous ketamine be maintained? Part three
1492. How can response to intravenous ketamine be maintained? Part four
1493. Are we missing iron deficiency without anemia?
1494. What symptoms may suggest non-anemic iron deficiency (NAID)?
1495. Let’s ask about one of the commonest causes of iron deficiency
1496. Drug interactions with an herbal product like ashwagandha
1497. Can psychostimulant medications cause Raynaud’s syndrome?
1498. Clinical features of Raynaud’s phenomenon
1499. Important facts about stimulant-induced Raynaud’s phenomenon
1500. Clinical recommendations Raynaud’s syndrome associated with stimulants
1501. What is the maximum dose of mixed amphetamine salts? Part one
1502. What is the maximum dose of mixed amphetamine salts? Part two
1503. What is the maximum dose of mixed amphetamine salts? Part three
1504. What exactly do tics look like?
1505. Four qualities of tics that can help to differentiate them from other movements
1506. How high can we go with naltrexone for alcohol use disorder? Part one
1507. How high can we go with naltrexone for alcohol use disorder? Part two
1508. How high can we go with naltrexone for alcohol use disorder? Part three
1509. How high can we go with naltrexone for alcohol use disorder? Part four
1510. Which laboratory tests in persons with first-episode psychosis? Part one
1511. Which laboratory tests in persons with first-episode psychosis? Part two
1512. Which laboratory tests in persons with first-episode psychosis? Part three
1513. Understanding sleep study results in obstructive sleep apnea
1514. In a sleep study result, what is the Respiratory Disturbance (Distress) Index (RDI)?
1515. Quiz no. 41
1516. What are the alternatives to the oral route? Part one
1517. Tips on giving antidepressants through a feeding tube
1518. Antidepressants: What are the alternatives to the oral route? Part three
1519. Sometimes, a medication may be given rectally
1520. Can antidepressants be given rectally if needed?
1521. Bottom line on antidepressants in patients who are NPO
1522. Clinical case: New onset of acute anxiety and physical symptoms
1523. How does toxicity from anticholinergic medications present clinically?
1524. Clinically-important differences between the various SNRIs? Part one
1525. Reasons to prefer desvenlafaxine (Pristiq®) over venlafaxine (Effexor XR®)
1526. (More) Reasons to prefer desvenlafaxine (Pristiq®) over venlafaxine (Effexor XR®)
1527. How exactly should desvenlafaxine be stopped?
1528. SNRIs differ in the extent of norepinephrine reuptake inhibition
1529. How high do we have to go to get significant norepinephrine reuptake inhibition?
1530. Pros and cons of venlafaxine versus duloxetine. Part one
1531. Pros and cons of venlafaxine versus duloxetine. Part two
1532. How to manage lithium treatment before and after bariatric surgery: Part one
1533. How to manage lithium treatment before and after bariatric surgery: Part two
1534. What are the potential side effects of melatonin? Part one
1535. What are the potential side effects of melatonin? Part two
1536. Can melatonin have negative effects on puberty?
1537. (Relative) contraindications to prazosin for PTSD-associated nightmares
1538. Case: Rising serum creatinine in a patient on lithium. Part one
1539. Case: Rising serum creatinine in a patient on lithium. Part two
1540. Case: Rising serum creatinine in a patient on lithium. Part three
1541. Case: Elevated serum creatinine that remained stable for many years
1542. Which urine drug screen do most workplaces require?
1543. A specific example of a DOT-5-compliant urine drug screen panel
1544. More on workplace urine drug screening
1545. Urinary hesitancy or retention due to atomoxetine is not rare
1546. The “Who” and “When” of atomoxetine-induced urinary hesitancy/ retention
1547. How to manage medication-induced urinary hesitancy/retention. Part one
1548. How to manage medication-induced urinary hesitancy/retention. Part two
1549. How to manage medication-induced urinary hesitancy/retention. Part three
1550. Hypomania or mania? Why do we care?
1551. Ways in which manic and hypomanic episodes are and are not different
1552. Was it really hypomania?
1553. Evaluating for hypomania: How to ask
1554. Tip on documenting a hypomanic episode
1555. A safeguard to reduce overdiagnosis of bipolar II disorder
1556. How to “sell” sleep restriction therapy to persons with insomnia
1557. How exactly to restrict in sleep restriction therapy
1558. How to manage a stimulant “crash” in the evening
1559. Many ways to add up to 15 hours
1560. Lisdexamfetamine (Vyvanse®) for binge-eating disorder
1561. Quiz no. 42
1562. Pros and cons of short-acting preparations of psychostimulants
1563. Expert commentary: Lamotrigine monotherapy for bipolar I disorder?
1564. Why depression in persons with Parkinson’s disease is important
1565. Tips on diagnosing depression in persons with Parkinson’s disease
1566. How to treat depression in persons with Parkinson’s disease. Part one
1567. How to treat depression in persons with Parkinson’s disease. Part two
1568. How to treat depression in persons with Parkinson’s disease. Part three
1569. How long before sexual activity should PDE-5 inhibitors be taken?
1570. Can antidepressants cause urinary incontinence?
1571. Antidepressant-induced urinary incontinence: Clinical features and management
1572. L-methylfolate can sometimes precipitate irritability, agitation, insomnia, or aggressiveness
1573. Key facts about increased blood pressure on venlafaxine
1574. Could extended-release naltrexone injection work even if oral naltrexone did not?
1575. Abstinence from alcohol can be monitored by a urine screening test
1576. Recent alcohol use can be detected by a urine screening and confirmation test
1577. Is urine screening for alcohol metabolites really useful?
1578. Special situations in which urine screening for alcohol metabolites is particularly useful
1579. A strategy for patients who decline every medication option
1580. A strategy for patients who decline every medication option (Part two)
1581. Medication-induced priapism of the clitoris
1582. Management of medication-induced priapism of the clitoris
1583. Can beta-blockers cause depression or is this a myth?
1584. Bottom line on beta-blockers and depression
1585. Watch out for cholinergic rebound syndrome
1586. Cholinergic rebound syndrome: Clinical features and prevention
1587. Anticholinergic to prevent or treat cholinergic rebound
1588. Lithium-induced hair loss
1589. Answers to two key questions about lithium-induced hair loss
1590. How to evaluate suspected medication-induced hair loss
1591. What can be done about lithium-induced hair loss?
1592. It is important to review what we have learned! (Quiz 43)
1593. Is it risky to stop lithium abruptly or rapidly?
1594. Let’s not stop lithium abruptly or rapidly
1595. Excessive daytime sleepiness after remission of major depression
1596. Understanding the diagnostic criteria for autism spectrum disorder
1597. Deficits in social communication and social interaction
1598. Restricted, repetitive patterns of behavior, interests, or activities in autism spectrum disorder
1599. Tips on diagnosing autism spectrum disorder
1600. What is NOT autism spectrum disorder
1601. With or Without? Two big factors in autism spectrum disorder
1602. Does medication-induced hyponatremia change lithium blood levels?
1603. How can duloxetine can be tapered very slowly? Part 1
1604. How can duloxetine can be tapered very slowly? Part 2
1605. How can duloxetine can be tapered very slowly? Part 3
1606. What if a patient on naltrexone is in acute pain? Part 1
1607. What if a patient on naltrexone is in acute pain? Part 2
1608. What if a patient on naltrexone is in acute pain? Part 3
1609. Why is it important to check clozapine levels?
1610. Exactly when to check clozapine levels
1611. What clozapine levels should we aim for?
1612. What clozapine levels should we aim for? Part 2
1613. No to two creative ideas from our Members
1614. Can aripiprazole *worsen* psychosis?
1615. When is aripiprazole more likely to cause worsening of psychosis?
1616. More on possible worsening of psychosis after adding or switching to aripiprazole
1617. Factors to consider in switching from one antidepressant to another. Part 1
1618. Factors to consider in switching from one antidepressant to another. Part 2
1619. Factors to consider in switching from one antidepressant to another. Part 3
1620. Factors to consider in switching from one antidepressant to another. Part 4
1621. Switching antidepressants: Lessons from a difficult case. Part 1
1622. Switching antidepressants: Lessons from a difficult case. Part 2
1623. Switching antidepressants: Lessons from a difficult case. Part 3
1624. Switching antidepressants: Lessons from a difficult case. Part 4
1625. Three quick questions to review some of what we have learned (Quiz 44)
1626. Why we should more often consider splitting tablets
1627. When it is or isn’t OK to split tablets
1628. When it is or isn’t OK to split tablets. Part 2
1629. Tips on how to correctly split tablets and take them
1630. Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined? Part 1
1631. Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined? Part 2
1632. Is brain imaging useful in catatonia?
1633. Functional brain imaging in catatonia and the bottom line
1634. Are stimulants useful after traumatic brain injury?
1635. Tips on using stimulants for post-TBI deficits
1636. Isn’t it risky to prescribe a stimulant after TBI?
1637. Does any atypical antipsychotic have a lower risk of tardive dyskinesia?
1638. Lower risk of TD with quetiapine?
1639. What chronic fatigue syndrome is and what it is not
1640. Chronic fatigue syndrome: A lot more than just fatigue
1641. Diagnostic criteria for chronic fatigue syndrome/ myalgic encephalomyelitis
1642. ME/ CFS is a very serious illness!
1643. General approach to the treatment of ME/ CFS
1644. Stimulants/ wakefulness-promoting agents for ME/ CFS?
1645. Other medications often used in ME/ CFS
1646. ME/ CFS: Understanding their illness and “Activity Pacing”
1647. GET and CBT for ME/ CFS?
1648. Instructions for WHEN and HOW to take iron supplements. Part 1
1649. Instructions for WHEN and HOW to take iron supplements. Part 2
1650. Clinicians are “uninformed, misinformed, and misinforming patients” about gun laws
1651. Federal law about when firearms cannot be sold to someone with mental illness
1652. How involuntary psychiatric hospitalization affects gun ownership
1653. State laws regarding mental illness and gun rights
1654. “Relief from firearm disability”: How patients can get their gun rights back
1655. Answer 3 quick questions to reinforce your learning! (Quiz 45)
1656. What type of suicidal ideation does this patient have?
1657. “Pre-suicidal” and “Passive suicidal” ideation
1658. Three factors to look for in evaluating active suicidal ideation
1659. Dissecting active suicidal ideation into categories
1660. Some medications have a low “therapeutic index”. What’ exactly is that?
1661. More on the therapeutic index and window
1662. Some important points about lithium toxicity
1663. Tips that will help reduce errors related to lithium toxicity
1664. Three simple principles about ECG changes in lithium toxicity
1665. Risks of second-generation (atypical) antipsychotics in pregnancy
1666. Do atypical antipsychotics increase the risk of congenital malformations? Part 1
1667. Conclusions about whether atypical antipsychotics increase the risk of congenital malformations
1668. Gestational diabetes: Do atypical antipsychotics increase the risk? Part 1
1669. Gestational diabetes: Do atypical antipsychotics increase the risk? Part 2
1670. Atypical antipsychotics and various other pregnancy outcomes
1671. Clinical recommendations regarding using antipsychotics during pregnancy. Part 1
1672. Clinical recommendations regarding using antipsychotics during pregnancy. Part 2
1673. Bupropion with a history of seizures in early childhood? Part 1
1674. Bupropion with a history of seizures in early childhood? Part 2
1675. Skin rash on a SSRI can sometimes be serious
1676. SSRI-induced rash that we are more likely to see
1677. Treatment options for SSRI-induced rash
1678. Which preparation of lithium is less likely to harm the kidneys? Part 1
1679. Which preparation of lithium is less likely to harm the kidneys? Part 2
1680. Who’s job is it to check for drug interactions?
1681. Watch out for this new class of diabetes medications!
1682. Anticholinergic medication for antidepressant discontinuation syndrome?
1683. What to do about the risk of arrhythmias with lamotrigine. Part 1
1684. What to do about the risk of arrhythmias with lamotrigine. Part 2
1685. What to do about the risk of arrhythmias with lamotrigine. Part 3
1686. What to do about the risk of arrhythmias with lamotrigine. Part 4
1687. Recommend this medication reminder app to ALL your patients!
1688. Some cool and useful options in the Medisafe app
1689. A few more cool, helpful features in Medisafe
1690. Why we sometimes specifically order a “CBC with differential”
1691. A primer on the Absolute Neutrophil Count (ANC)
1692. Why don’t we routinely prescribe lamotrigine extended-release (Lamictal XR)?
1693. Acute effects of cannabis that we should warn patients about
1694. Potential physical and psychological adverse effects of longer-term cannabis use
1695. What to look for to identify a higher risk of problems with cannabis use
1696. Which medications work for cannabis use disorder? Part 1
1697. Which medications work for cannabis use disorder? Part 2
1698. Does gabapentin work for cannabis use disorder?
1699. Downsides of considering gabapentin for cannabis use disorder
1700. Cannabinoid receptor agonists for cannabis use disorder?
1701. Medications that MAY work for cannabis use disorder
1702. Medications for cannabis use disorder: Bottom line and Clinical recommendations
1703. True or False? (Quiz 46)
1704. The FDA versus NAC
1705. Where can patients still get N-acetylcysteine (NAC)?
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I love the daily emails. They are a joy to read thank you so much for this
Thanks, Jessica, for your kind words!
Raj
Hello Dr. Mago. I have found the subscription to your services so very helpful. I am wondering if you could address the following question on one of your daily emails. I am concerned about the use of valproic acid in patients diagnosed with Non-alcoholic Fatty Liver Disease. My specific example: a patient who has been in remission from very severe bipolar disorder on the combination of olanzapine and valproic acid for a number of years with normal LFTs. In the last month, AST and ALT elevated slightly. No symptoms of GI problems. His PCP sent him for US which showed NAFLD. What is the safety/liability to the patient (relative) to staying on valproic acid in light of this finding with the liver. The patient has other risk factors for NAFLD: obesity, DM, sedentary lifestyle etc.
If you could comment on this in a broad sense it would be most helpful. I am sure that psych providers will be seeing more and more of this syndrome (?) being diagnosed.
Thank you Dr. Mago. Your emails and website are invaluable to my practice!
Elise Wise, Psychiatric Nurse Practitioner, Phoenix, AZ
Thank you for offering this fantastic service as I look forward to reading my daily email. I was hoping you could start a new mini-series on pearls for private practice. I know you covered your recommendation for Lumello as an electronic medical record already but please comment on other facets such as how do you screen your patients? What is your procedure for dismissing patients if they have had repeat no-shows? Etc ….
Any comments on recent NY times article on difficulty patients have when trying to stop antidepressants? I have never had this difficulty so wanting to hear your opinion on this. Thanks
Can you discuss SSRIs as REM sleep suppressants in hypersomnia and narcolepsy? Are their effects really significant?
It would be useful to have a discussion about when the chronic use of benzodiazepines is helpful. Some uses that come to mind include REM behavior disorder, persistent myoclonus especially if nocturnal, persistent intractible anxiety not blocked by SSRI treatment, difficult to manage AM anxiety that may be relieved by a long acting hs benzo, patients with persistent anxiety who do not tolerate SSRIs and patients who arrive with a long history of taking benzos
Thanks for your commment. You bring up a situation that we often face in clinical practice. You have listed some situations in which long-term use of benzodiazepines may be helpful. With regard to the last one — patients who arrrive with a long history of taking benzos — I think that we should always reassess whether they really need to continue to take the medication or, more commonly, can they reduce the dose very gradually.
Is there a way to get CME credit?
At this time, we are unable to offer CME credit. The process for being able to give CME credit is tedious and expensive. You may say that we provide CME, but without the “credit”!
Regarding Gabapentin: In my primary care and rheumatology patient population I have been using Gabapentin for the co-occuring pain, anxiety, and insomnia. Often they have cycles of moods which are kindled by the inflammatory process. Use has been effective in enabling patients to return to work and lifestyles, managing their moods as well as inflammatory pain.
Thank you for your comment! It makes sense to use a medication that can address several of the problems a patient has.
Simple and Practical is so informative and fun to read every day! I too look forward to reading Dr. Mago’s email every morning. His daily mentorship provides necessary guidelines that build clinical confidence and keeps the art of psychopharmacology exciting! Both the physician and patient benefit from our staying truly informed, safe, and effective in practice. Thank you, Dr. Mago!
Thank you so much, Dr. Cotner, for your kind comment! You made my day!
VERY HELPFUL! I CAN BRUSH UP ON MANY TOPICS THAT I HAVE FORGOTTEN.
This service is amazing Dr. Mago. I am looking forward for it everyday, and read it immediately. It is on my starred inbox emails. Thanks