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Patient Education
What is the ONE website that is BEST for all your patient education needs?
FDA-approved “Medication Guides” for patients
Patient handouts: Potential side effects of psychiatric medications
Patient handouts from Simple and Practical
What are the BEST books on each topic related to psychiatry/ mental health?
ADHD Medications
ADHD medications—General topics
Tips for prescribing ADHD medications
Tips for managing abuse potential of medications for ADHD
Important interactions when using two medications for ADHD
How should ADHD be treated in persons with stimulant (including cocaine) use disorder
Stimulants
Stimulants: General
Also see: ADHD medications—General topics
What are the closest alternatives when forced to switch a stimulant?
A dozen tips to manage loss of appetite due to a stimulant (in adults)
Converting stimulants: Equivalent doses
Pros and cons of short-acting preparations of psychostimulants
Tips for managing abuse potential of medications for ADHD
Stimulant medications and irritability in children with ADHD
Stimulants for ADHD with a history of a substance use disorder?
Don’t change the stimulant medication without first asking about this
What if you refuse an early refill of a stimulant medication?
What to look for in stimulant withdrawal (including a physical sign that is little known)
Stimulant “holidays” (breaks) in adults with ADHD?
How to get full-day coverage with stimulants
Do stimulants need to be titrated up again after an interruption?
Do we need to worry about stimulant medications as our patients become older adults?
Clinical recommendations: What to do about stimulant medications in older adults
Can patients with ADHD develop tolerance to stimulant medications?
Can psychostimulant medications cause or worsen Raynaud’s phenomenon?
What can we do about the shortage of stimulant medications?
Laws about prescriptions for psychostimulants
Are stimulants useful after traumatic brain injury?
What to do about stimulant medications for surgery or other procedures under anesthesia
Laws about prescriptions for psychostimulants
How are methylphenidate and amphetamines metabolized?
Four kinds of atypical responses to stimulant medications
Can I take my medication with me when I travel to another country?
What to do about medications when traveling to Japan
Amphetamine preparations
Amphetamine preparations: Index and links
Pros and cons of dextroamphetamine versus levoamphetamine.
Eight tips for reducing the risk of abuse/diversion of stimulants
Ketogenic diet and amphetamines
Vitamin C if on a stimulant?
Does lisdexamfetamine really have lower abuse potential?
Converting from OROS methylphenidate to amphetamine is a two-step process
Amphetamine (Dynavel-XR®) extended-release oral suspension: Basic information
Amphetamine extended-release orally disintegrating tablets (Adzenys XR-ODT): Basic information
What is the maximum dose of mixed amphetamine salts?
Do psychostimulant medications cause clinically significant increases in blood pressure?
How exactly should blood pressure be monitored in persons on stimulants
How to manage stimulant-induced hypertension
When prescribing an amphetamine, warn patients about anti-acid medications
Dextroamphetamine (Dexedrine®): Basic Information
Lisdexamfetamine (Vyvanse®): Basic Information
Mixed amphetamine salts (Adderall®, Adderall XR®): Basic Information
Mixed salts of a single-entity amphetamine product (Mydayis®): Basic information
Triple-bead preparation of mixed amphetamine salts (Mydayis®)
Should we ever prescribe methamphetamine (Desoxyn®)?
Methylphenidate/ Dexmethylphenidate Preparations
Methylphenidate preparations
Methylphenidate/ dexmethylphenidate preparations: Index and links
How to choose between generic, long-acting methylphenidate/ dexmethylphenidate preparations
OROS methylphenidate extended-release (Concerta®): Basic information
Converting from OROS methylphenidate to amphetamine is a two-step process
Methylphenidate (Ritalin, Ritalin SR®, Ritalin LA®): Basic information
A psychostimulant preparation that is taken in the *evening* (Jornay PM®)
Dexmethylphenidate preparations
Methylphenidate/ dexmethylphenidate preparations: Index and links
How to choose between generic, long-acting methylphenidate/ dexmethylphenidate preparations
Should we prescribe dexmethylphenidate (Focalin) rather than methylphenidate (Ritalin)?
Dexmethylphenidate (Focalin®, Focalin XR®): Basic Information
Does serdexmethylphenidate+dexmethylphenidate (Azstarys®) have significant advantages?
Combining stimulants with other medications
Combine a stimulant and atomoxetine?
Going from atomoxetine to an antipsychotic
Combining guanfacine and stimulants for ADHD
Can stimulant and antipsychotic medications be used together?
Changing from an antipsychotic to a stimulant
When a stimulant and an antipsychotic are used together and then the stimulant is stopped
Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined?
Can stimulant medications be used along with buprenorphine or methadone?
Norepinephrine reuptake inhibitors
Atomoxetine
Atomoxetine (Strattera®): Basic Information
Don’t ignore atomoxetine for ADHD in adults
Order genetic testing for a patient on atomoxetine?
Seizure risk if atomoxetine and bupropion are used together?
Combine a stimulant and atomoxetine?
It makes a big difference—atomoxetine once a day or twice a day?
What can we do for somnolence/ sedation on atomoxetine?
Viloxazine extended-release (Qelbree™)
Viloxazine extended-release capsules (Qelbree®): Basic information
Alpha-2 agonists
Clonidine
Clonidine (Kapvay®) extended-release tablets: Basic Information
Guanfacine versus clonidine for ADHD
Guanfacine
Other medications for ADHD
Agitation Medications
Anti-Addiction Medications
Acamprosate
Benzodiazepines for alcohol withdrawal
Which benzodiazepines for alcohol withdrawal syndrome (AWS)?
Benzodiazepine regimens for preventing or treating alcohol withdrawal
Buprenorphine
Buprenorphine (Subutex® and Suboxone®): Basic Information
Clinical pearls on prescribing buprenorphine (Suboxone®)
Clinical pearls about prescribing buprenorphine: Part Two
Disulfiram
How to use disulfiram to help with alcoholism
Disulfiram: A shortcut to sobriety?
How common is liver toxicity with disulfiram and when does it occur?
When and how often should hepatic function tests be done in patients on disulfiram?
Naloxone
Special issues in using naloxone for overdoses involving fentanyl
YouTube video on how to use Evzio®
Naltrexone
Naltrexone (Revia®, Vivitrol®): Basic Information
Tips on using naltrexone for alcohol use disorder
How high can we go with naltrexone for alcohol use disorder?
What if a patient on naltrexone is in acute pain?
Does naltrexone cause insomnia OR does it cause sleepiness?
Naltrexone extended-release injectable (Vivitrol®)
Naltrexone (Revia®, Vivitrol®): Basic Information
Tips on using naltrexone extended-release injectable (Vivitrol®)
Could extended-release naltrexone injection work for alcohol use disorder even if oral naltrexone did not?
How to order, store, and administer naltrexone extended-release injection (Vivitrol®)
Find a Vivitrol® prescriber
Low-dose naltrexone (LDN)
What is low-dose naltrexone (LDN) and should it be used for anything?
Nicotine replacement therapy
A practical guide to nicotine replacement therapy (NRT)
How exactly should nicotine patches be used?
How exactly should nicotine gum be used?
How exactly should nicotine lozenges be used?
How exactly should nicotine oral inhalers be used?
How exactly should nicotine nasal spray be used?
Thiamine (for prevention of Wernicke-Korsakoff syndrome)
Varenicline
Varenicline (Chantix®): Basic Information
Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders?
A practical guide to using varenicline (Chantix®) for tobacco (smoking) cessation
Other
How to learn addiction psychiatry
A practical guide to the management of tobacco use disorder
Do electronic cigarettes (e-cigarettes) work for smoking cessation?
What “authorities” say about e-cigarettes for tobacco use disorder
What are electronic cigarettes (e-cigarettes)?
Clinical Institute Withdrawal Assessment for Alcohol, revised (CIWA-Ar)
Bupropion for cocaine use disorder?
APA Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder
Should we consider gabapentin for alcohol use disorder?
Antiamyloid antibodies
Antiamyloid antibodies—General articles
New, “disease-modifying” treatments for Alzheimer’s disease
Why amyloid-β and amyloid plaques are so important
Antiamyloid antibodies—Lecanemab
Untangling exactly whom lecanemab (Leqembi®) is FDA-approved for
How well does lecanemab (Leqembi®) work?
Should we recommend treatment with lecanemab (Leqembi®)?
Lecanemab (Leqembi®) carries an important boxed warning
Antiamyloid antibodies—Donanemab
A brief review of donanemab (Kisunla®) for Alzheimer’s disease
Antianxiety Medications
Also see: “Benzodiazepines” (below)
Beta-blockers
Clinical tips on using a beta-blocker for performance anxiety (“stage fright”)
Beta-blockers for panic disorder?
What are the different types of beta-blockers?
Can beta-blockers cause depression or is this a myth?
CNS side effects of beta-blockers
Beta-blockers can either worsen or improve erectile dysfunction
Which beta-blockers in persons with diabetes?
Are beta-blockers contraindicated in asthma?
Buspirone
Can buspirone cause dyskinesia or parkinsonism?
Serotonin syndrome with a combination of buspirone and a serotonergic antidepressant?
Can buspirone cause increased prolactin or galactorrhea?
Buspirone (Buspar®): Basic Information
Complementary and Alternative Medicine (CAM)
Gabapentin
Gabapentin (Neurontin®) for anxiety disorders?
Gabapentin (Neurontin®): Basic Information
Potential side effects of gabapentin (Neurontin® (handout)
Gabapentin (Neurontin®) or pregabalin (Lyrica®) abuse, dependence, and withdrawal
Is it important to taper gabapentin?
How to change from gabapentin (Neurontin®) to pregabalin (Lyrica®)
Hydroxyzine
Does hydroxyzine have advantages over diphenhydramine?
QT prolongation with hydroxyzine versus diphenhydramine
A complete change in how to use hydroxyzine
Potential side effects handout of hydroxyzine (Vistaril®)
Pregabalin
Pregabalin (Lyrica®): Basic information
Potential side effects handout for pregabalin (Lyrica®)
Pregabalin (Lyrica®): Pharmacological effects
Does pregabalin (Lyrica®) work for generalized anxiety disorder (GAD)?
Pregabalin (Lyrica®) for generalized anxiety disorder (GAD) with partial response to a serotonergic antidepressant?
What dose of pregabalin (Lyrica®) should we use for generalized anxiety disorder (GAD)?
How to change from gabapentin (Neurontin®) to pregabalin (Lyrica®)
Gabapentin (Neurontin®) or pregabalin (Lyrica®) abuse, dependence, and withdrawal
Serotonin reuptake inhibitors
Should we give high-dose SSRIs for panic disorder?
Does vortioxetine work for Generalized Anxiety Disorder (GAD)?
Other
Anticholinergic medications
Should we routinely prescribe an anticholinergic with an antipsychotic?
Important differences between anticholinergic medications
For how long should anticholinergics be given for antipsychotic-induced parkinsonism?
After a few months, try to reduce/ stop anticholinergic medication
How does toxicity from anticholinergic medications present clinically?
Cholinergic rebound syndrome: Why we should NOT stop anticholinergic medications abruptly
An anticholinergic medication for antidepressant discontinuation (withdrawal)?
Topical anticholinergics for localized hyperhidrosis
Antidepressant Medications
General topics about antidepressants
Antidepressant medications: Dose equivalents
Which antidepressants are FDA-approved for use in pediatric patients?
Antidepressants are like antibiotics
Can we increase the levels of all THREE neurotransmitters in major depression?
How and when to titrate up antidepressants
Do any antidepressants come in liquid forms?
Antidepressants: What are the alternatives to the oral route?
Sometimes, a medication may be given rectally
Different and confusing ways in which antidepressants are classified
Pharmacological effects of antidepressants explain the alternative names for their classification
S-adenosylmethionine (SAMe) for depressive disorders: An overview
Which antidepressants are better than the SSRIs?
How to titrate antidepressants: which medications, which patients, how much, how long
Antidepressants: how much and for how long?
Combining antidepressants: Are two better than one?
SSRI/ SNRI plus mirtazapine: What three clinical trials found
Factors to consider in switching from one antidepressant to another
Switching antidepressants: Lessons from a difficult case
Can patients have alcohol while on an antidepressant?
Omega-3 fatty acids for depressive disorders?
Complementary and alternative medicines (CAM) for depressive disorders
Do antidepressants work and which ones work better? (Interview with Michael Thase, MD)
Adjunctive estrogen for perimenopausal depression?
Antidepressants in the Medically Ill
Antidepressants to use and to avoid in persons with comorbid medical illness
Antidepressants to use and to avoid in patients with cardiac disease
Antidepressants to use and to avoid in patients with renal (kidney) disease
Antidepressants to use and to avoid in patients with liver disease
Antidepressants and risk of stroke
Is mirtazapine safe to use after a renal transplant?
N-methyl-D-aspartate (NMDA) receptor antagonists
Esketamine nasal spray (Spravato®)
Esketamine nasal spray (brand name Spravato): Basic information
What does “treatment-resistant depression” in the indication for esketamine (Spravato®) mean?
How well does esketamine nasal spray (Spravato®) work for treatment-resistant depression?
Common and other side effects of esketamine nasal spray (Spravato®)
Dissociation and perceptual disturbances with esketamine nasal spray (Spravato®)
Esketamine nasal spray (Spravato®): Clinical trials in “treatment-resistant depression”
Stimulants in a patient receiving ketamine/ esketamine?
What about concomitant medications during ketamine or esketamine treatment?
Ketamine (off-label)
Ketamine for major depression: An overview
How can response to intravenous ketamine be maintained?
Common myths about IV ketamine for depressive disorders
Stimulants in a patient receiving ketamine/ esketamine?
What to do about concomitant medications during ketamine or esketamine treatment
Oral ketamine (off-label)
Should we consider ORAL ketamine for clinical depression/ suicidality?
Dextromethorphan and bupropion (Auvelity™)
Dextromethorphan and bupropion (Auvelity™): Basic Information
Why is dextromethorphan combined with a CYP 2D6 inhibitor?
Dextromethorphan-bupropion (Auvelity™): Efficacy
Understanding antidepressant clinical trial results: Dextromethorphan-bupropion (Auvelity™)
Potential side effects of dextromethorphan and bupropion (Auvelity™)
Does dextromethorphan-bupropion (Auvelity™) have abuse potential?
A primer on dextromethorphan abuse or dependence
Can generic dextromethorphan and bupropion be used instead of the brand name combination?
Dextromethorphan: pharmacodynamics (receptor effects)
Selective Serotonin Reuptake Inhibitors (SSRIs)
Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Is fluvoxamine more effective for OCD than other SSRIs?
What to do about excessive sweating in this patient with OCD
Fluvoxamine (Luvox®): Basic Information
Paroxetine
Sertraline
Miscellaneous
Who is at higher risk of bleeding with antidepressants?
Antidepressants and bleeding: When and what to ask?
Should we give high-dose SSRI for panic disorder?
Serotonin syndrome with a combination of buspirone and a serotonergic antidepressant?
Do stimulant medications work for major depressive disorder?
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
General
Are there clinically-important differences between the various SNRIs?
SNRIs differ in the extent of norepinephrine reuptake inhibition
Desvenlafaxine
Reasons to prefer desvenlafaxine (Pristiq®) over venlafaxine (Effexor XR®)
How exactly should desvenlafaxine be stopped?
Duloxetine
Antidepressant discontinuation (withdrawal): Duloxetine
How can duloxetine can be tapered very slowly?
Pros and cons of venlafaxine versus duloxetine
Duloxetine (Cymbalta®): Basic Information
Levomilnacipran
Levomilnacipran (Fetzima®): Basic Information
Levomilnacipran (Fetzima®): Efficacy
Levomilnacipran (Fetzima®): Pharmacological Effects
Levomilnacipran (Fetzima®): Pharmacokinetics
Levomilnacipran (Fetzima®): Drug Interactions
Levomilnacipran (Fetzima®): Adverse Effects
Levomilnacipran (Fetzima®): An organized list of references
Venlafaxine
When a patient has difficulty getting off venlafaxine
Reasons to prefer desvenlafaxine (Pristiq®) over venlafaxine (Effexor XR®)
Pros and cons of venlafaxine versus duloxetine
Which causes more weight gain—venlafaxine or duloxetine?
Venlafaxine (Effexor XR®): Basic Information
Venlafaxine (Effexor XR®) versus SSRIs
Other second-generation antidepressants
Bupropion
Bupropion (Wellbutrin SR® or Wellbutrin XL®): Basic Information
Bupropion Preparations (Wellbutrin XL® and others)
Bupropion (Wellbutrin XL®) versus SSRIs
Why isn’t bupropion the most frequently prescribed antidepressant?
Can we increase levels of all THREE neurotransmitters in major depression?
Is generic bupropion as effective as brand-name Wellbutrin®?
What factors can increase the risk of seizures with bupropion?
Bupropion and seizures: the facts and the myths
Is a history of seizures in early childhood a contraindication to using bupropion?
Bupropion in persons with renal impairment
Would you ever use bupropion to treat panic disorder?
Seizure risk if atomoxetine and bupropion are used together?
Does bupropion treat antidepressant-induced sexual dysfunction?
Are varenicline (Chantix) and bupropion safe for smoking cessation in persons with mental disorders?
Can patients on bupropion drink alcohol? Part one
Bupropion for cocaine use disorder?
How and why is bupropion sometimes used to “get high”?
Mirtazapine
Mirtazapine (Remeron®): Basic Information
Is mirtazapine LESS sedating at higher doses?
Can mirtazapine be started at 30 mg per day?
Is mirtazapine safe to use after a renal transplant?
Is mirtazapine (Remeron) better than SSRIs for the treatment of major depressive disorder?
Combining antidepressants: Are two better than one?
Three RCTs of SSRI/ SNRI plus mirtazapine from the start
Is it true that mirtazapine (Remeron®) can cause agranulocytosis?
Mirtazapine may cause akathisia at higher doses
Can mirtazapine increase the risk of QT prolongation?
Trazodone
Vilazodone
Vortioxetine
Vortioxetine (Trintellix®): Basic Information
Vortioxetine (Trintellix®): Efficacy
Does vortioxetine work for Generalized Anxiety Disorder (GAD)?
Vortioxetine versus other antidepressants
Vortioxetine (Trintellix®): Pharmacological effects
What side effects can occur with vortioxetine (Trintellix®)?
Potential side effects handout for vortioxetine (Trintellix®)
PsychopharMYTH: “Vortioxetine does not cause sexual dysfunction”
Vortioxetine (Trintellix®): Drug Interactions
Brand name change for Brintellix® (vortioxetine)
Vortioxetine (Trintellix®): An organized list of references
Tricyclic/tetracyclic antidepressants
Tricyclic/tetracyclic antidepressants—General articles
Tricyclic/Tetracyclic Antidepressants (TCAs): An overview
How to choose a tricyclic antidepressant
Which TCA do I usually recommend first?
Which tricyclic antidepressants (TCAs) are the most effective ones for major depressive disorder (MDD)?
Many patients are on low-dose TCAs. Can other antidepressants be added?
TCAs other than clomipramine for OCD?
Tricyclic/tetracyclic antidepressants—Tertiary amines
How is imipramine palmoate (Tofranil-PM) different from imipramine hydrochloride (Tofranil)?
Clomipramine versus SSRIs for OCD
When and how to check the clomipramine level
How to interpret clomipramine and desmethylclomipramine levels
Doxepin and cytochrome P450 drug interactions
Are doxepin’s anticholinergic effects dose-dependent?
Doxepin (Sinequan®): Basic Information
Tricyclic/tetracyclic antidepressants—Secondary amines
How to order and interpret the serum nortriptyline level
Nortriptyline (Pamelor®): Basic Information
Monoamine Oxidase Inhibitors (MAOIs)
Classic MAO inhibitors
Classic MAO inhibitors—General
Types of MAO and of MAO inhibitors
Are MAO inhibitors (MAOIs) efficacious and safe for bipolar depression?
Combining an MAO inhibitor and another antidepressant
Can antidepressants be used with MAO-B inhibitors?
How to manage major depressive disorder with atypical features
Phenelzine
Phenelzine (Nardil®): Basic Information
How to choose between phenelzine (Nardil®) and tranylcypromine (Parnate®)
Selegiline
Tranylcypromine
Tranylcypromine (Parnate®): Basic Information
How to choose between phenelzine (Nardil®) and tranylcypromine (Parnate®)
Isocarboxazid
MAO inhibitors—Diet
MAO inhibitor diet
MAO Inhibitor diet (patient handout)
Can I have cheese or pizza?
How about some Chinese food?
MAO inhibitors and goat cheese
MAO inhibitors—Side effects
How to choose between phenelzine (Nardil®) and tranylcypromine (Parnate®)
MAO inhibitor-induced insomnia
MAO inhibitors and edema
MAO inhibitors can affect vitamin B6 (pyridoxine)
Rash, irritation, or itching with transdermal patches
MAO inhibitors—Drug interactions
MAO inhibitors and other medications
MAO Inhibitors and other medications (patient handout) (link to the handouts page)
Be very careful when switching from one MAO inhibitor to another
MAO inhibitors (MAOIs) and contraindicated medications: How long do we have to wait?
How to switch from oral or transdermal selegiline (Emsam®) to another MAO inhibitor
Should we prescribe emergency medication for hypertensive urgency with MAO inhibitors?
Pramipexole
Pramipexole for major depressive disorder or bipolar depression
Tips on using pramipexole for mood disorders
Pramipexole: Basic information
Potential adverse effects of pramipexole
Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined?
Dopamine agonist withdrawal syndrome (DAWS)
Antidepressants—Side effects
Three SSRIs that may cause QT prolongation
Antidepressant-induced tardive dyskinesia
Which antidepressants in patients with a history of, or at higher risk for, bleeding
Antidepressants can injure the liver, some more than others
How common is new-onset hyponatremia during antidepressant treatment?
Tinnitus associated with antidepressant medications
Also see: MAO Inhibitors—Side effects
Antidepressants—Drug interactions
Antipsychotics
General
Antibiotics, antipsychotics, and QTc prolongation
Which antipsychotics to prefer in patients with catatonia
Antipsychotics and QTc prolongation
How often should we order ECG (EKG) during treatment with a psychotropic medication?
Avoid these three antipsychotics in women with breast cancer
The patient who “demands” TWO antipsychotics
Practice guideline: Antipsychotics for agitation/psychosis in dementia
Second-generation (atypical) antipsychotics
General
Second-generation (“atypical”) antipsychotics (List)
Second-generation antipsychotics: Dose equivalents
Dose adjustment for second-generation antipsychotics based on drug interactions
Do adolescents have more metabolic side effects with second-generation antipsychotics?
Does weight gain with second-generation (atypical) antipsychotics plateau after the first few months?
Do adolescents have more metabolic side effects with second-generation antipsychotics?
What should I be doing to monitor patients who are on an antipsychotic?
The patient who “demands” TWO antipsychotics
Long-acting injectable antipsychotics: Overview
Dose equivalents of long-acting injectable second-generation antipsychotics
Aripiprazole (Abilify®)
FDA issues new warning about aripiprazole (impulse control problems)
How exactly to add aripiprazole for hyperprolactinemia with risperidone
What dose of aripiprazole as an adjunct for OCD?
Resolution of hyperglycemia after switching to aripiprazole
Can aripiprazole *worsen* psychosis?
Aripiprazole (Abilify®): Basic Information
Aripiprazole with sensor (Abilify Mycite®): Basic Information
Aripiprazole lauroxil (Aristada®) versus Aripiprazole (Abilify Maintena®)
How to convert from oral to long-acting injectable (LAI) aripiprazole
Be careful in converting from Abilify Maintena® to Aristada®
Why does Abilify Maintena® have an FDA indication for bipolar disorder but Aristada® does not?
Aripiprazole extended-release injectable suspension (Abilify Asimtufii®): Basic Information
Aripiprazole (Abilify Maintena®): Basic Information
Aripiprazole lauroxil (Aristada®): Basic Information
Aripiprazole lauroxil (Aristada Initio™): Basic information
Asenapine (Saphris®)
Brexpiprazole (Rexulti®)
Cariprazine (Vraylar®)
Cariprazine (Vraylar®): Basic Information
Cariprazine (Vraylar): Potential side effects
Activity of cariprazine (Vraylar®) on dopamine D3 and D2 receptors
Cariprazine (Vraylar®): Organized list of references
Clozapine (Clozaril®)
Clozapine—General information
Clozapine (Clozaril®): Basic Information
Why we must refer more patients for clozapine treatment
What can we do about the underutilization of clozapine and delays in starting it?
Where can I find someone who prescribes clozapine?
Clozapine for schizophrenia in children?
Changes in rules about clozapine
Clozapine—Serum level
How to check and interpret clozapine levels
Are the clozapine-norclozapine ratio and norclozapine level useful?
Can oral contraceptives affect clozapine levels?
Caffeine can significantly change serum clozapine levels
Clozapine—Side effects
Potential side effects of clozapine (Clozaril®) handout
Key information about seizures with clozapine
Clozapine-induced hypersalivation (sialorrhea)
Clozapine-induced hypersalivation (sialorrhea): Treatment
Management of clozapine-induced constipation
Benign ethnic neutropenia (BEN)
Iloperidone (Fanapt®)
Lumateperone (Caplyta®)
Lumateperone (Caplyta®): Basic information
Is lumateperone (Caplyta®) really different from other atypical antipsychotics?
How well does lumateperone (Caplyta) work for schizophrenia?
A summary of the potential side effects of lumateperone (Caplyta®)
Potential side effects of lumateperone (Caplyta®) handout
Is lumateperone less likely to cause extrapyramidal symptoms (including parkinsonism or akathisia)?
Can lumateperone (Caplyta®) cause metabolic side effects?
Lurasidone (Latuda®)
Lurasidone (Latuda®): Basic Information
Lurasidone (Latuda®): Pharmacological Effects
Lurasidone (Latuda®): Efficacy
Lurasidone (Latuda®): Drug Interactions
Lurasidone (Latuda®): Adverse Effects
What are the possible risks of using lurasidone (Latuda®) during pregnancy
Which psychiatric medications MUST be taken with food?
Does lurasidone (Latuda®) really have a low risk of increasing serum prolactin?
Olanzapine (Zyprexa®)
Olanzapine (Zyprexa®): Basic Information
Does olanzapine (Zyprexa®) really have a low risk of increasing serum prolactin?
Olanzapine-Samidorphan (Lybalvi®)
Olanzapine and samidorphan (Lybalvi®): Basic information
Samidorphan versus naltrexone: What’s the difference?
How much better is olanzapine-samidorphan (Lybalvi®) than olanzapine alone? Part 1
Olanzapine long-acting injectable (Zyprexa Relprevv®)
Olanzapine (Zyprexa Relprevv®): Basic Information
Extended-Release Olanzapine (Zyprexa Relprevv®): REMS
Paliperidone (Invega®)
Paliperidone (Invega®): Basic Information
Potential side effects of paliperidone (Invega®): Patient handout
Paliperidone palmitate (Invega Sustenna®): Basic Information
Paliperidone palmitate 3-month (Invega Trinza®): Basic Information
Paliperidone palmitate 6-month (Invega Hayfera™): Basic Information
Pimavanserin (Nuplazid®)
Pimavanserin (Nuplazid): Basic Information
What is pimavanserin (Nuplazid®)?
Pimavanserin (Nuplazid®): Potential adverse effects
Quetiapine (Seroquel®)
Quetiapine (Seroquel®, Seroquel XR®): Basic Information
Quetiapine extended-release and food
The dose of quetiapine is NOT the same for each disorder
Is quetiapine (Seroquel®) a reasonable option for treating insomnia?
Why it matters that quetiapine’s metabolite is a *norepinephrine* reuptake inhibitor
Risperidone (Risperdal®)
Equivalence of risperidone oral and long-acting injection (RLAI; Risperdal Consta®)
News: July 6, 2016. Make sure you are discussing increased risk of gynecomastia with risperidone
How exactly to add aripiprazole for hyperprolactinemia with risperidone
Risperidone (Risperdal®): Basic Information
Long-acting injectable (LAI) second-generation (atypical) antipsychotics
Ziprasidone (Geodon®)
Long-acting injectable (LAI) second-generation (atypical) antipsychotics
LAI second-generation antipsychotics: General articles
Long-acting injectable antipsychotics: Overview
Dose equivalents of long-acting injectable second-generation antipsychotics
How *NOT* to offer long-acting injectable (LAI) antipsychotics to patients
Which injections can only be given in the gluteal muscle—and why?
How to choose between injecting into the deltoid or gluteal muscles
CPT billing code for administration of injections
LAI preparations of aripiprazole
Aripiprazole lauroxil (Aristada®) versus Aripiprazole (Abilify Maintena®)
How to convert from oral to long-acting injectable (LAI) aripiprazole
Be careful in converting from Abilify Maintena® to Aristada®
Why does Abilify Maintena® have an FDA indication for bipolar disorder but Aristada® does not?
Aripiprazole extended-release injectable suspension (Abilify Asimtufii®): Basic Information
Aripiprazole (Abilify Maintena®): Basic Information
Aripiprazole lauroxil (Aristada®): Basic Information
Aripiprazole lauroxil (Aristada Initio™): Basic information
LAI olanzapine
LAI preparations of paliperidone
Paliperidone palmitate (Invega Sustenna®)
Paliperidone palmitate 3-month (Invega Trinza®)
Paliperidone palmitate 6-month (Invega Hayfera™): Basic Information
LAI preparations of risperidone
First-generation (typical) antipsychotics
Antipsychotics—Side effects
Amantadine for antipsychotic-induced parkinsonism
Amantadine (Symmetrel): Basic Information
Is TD less likely with second-generation (“atypical”) antipsychotics?
Does any atypical antipsychotic have a lower risk of tardive dyskinesia?
Management of tardive dyskinesia: First-line options
Management of tardive dyskinesia: Second-line options
How long does antipsychotic-induced hyperglycemia take to resolve?
Resolution of hyperglycemia after switching to aripiprazole
Be careful if a person is on both a stimulant and an antipsychotic
What could happen when changing from an antipsychotic to a stimulant?
Key information about seizures with clozapine
Can we use topiramate to treat medication-induced weight gain?
Potential risks of second-generation (atypical) antipsychotics in pregnancy
Akathisia: Treatment with a beta-blocker
Antipsychotics—Drug interactions
Alpha-2 adrenergic receptor agonists
Off-label treatments for schizophrenia and related psychotic disorders
Benzodiazepines
Benzodiazepines—General articles
Three important pieces of information about benzodiazepines
Practical tips on using hypnotics: benzodiazepines
Viewpoint: Has the pendulum swung too far against the use of benzodiazepines?
Cytochrome P450 drug interactions with benzodiazepines
Benzodiazepines in the elderly and in liver disease
Should we consider a benzodiazepine for persons with major depressive disorder?
Alprazolam
Alprazolam (Xanax® or Xanax-XR®): Basic Information
Potential side effects of alprazolam (Xanax®)
How to convert from alprazolam immediate-release to extended-release
Potential advantages and disadvantages of alprazolam extended-release (Xanax XR®)
Chlordiazepoxide
Clonazepam
Clonazepam (Klonopin®): Basic Information
Potential side effects of clonazepam (Klonopin®)
Tips on using clonazepam ODT (wafers)
Diazepam
Lorazepam
Oxazepam
Temazepam
Benzodiazepines for alcohol withdrawal
Which benzodiazepines for alcohol withdrawal syndrome (AWS)?
Benzodiazepine regimens for preventing or treating alcohol withdrawal
Benzodiazepine use disorder
Beta-blockers
Clinical tips on using a beta-blocker for performance anxiety (“stage fright”)
Beta-blockers for panic disorder?
Akathisia: Treatment with a beta-blocker
Beta-blockers for lithium-induced benign tremor
What are the different types of beta-blockers?
Can beta-blockers cause depression or is this a myth?
CNS side effects of beta-blockers
Beta-blockers can either worsen or improve erectile dysfunction
Which beta-blockers in persons with diabetes?
Are beta-blockers contraindicated in asthma?
Bibliotherapy
Bibliotherapy: Recommend books to your patients and their families
BEST Books on Depressive disorders: for patients and families
BEST books on how to change habits
BEST books about how to lose weight
An Unquiet Mind
BEST books on Alzheimer’s disease and other dementias
BEST books on Adult Asperger’s Syndrome
Best books on adult ADHD: For patients and families
Book review: Mindfulness prescription for Adult ADHD
Book review: ADHD-Friendly Ways to Organize Your Life
Best book for choosing a rehab
Bright light therapy
A systematic evaluation of bright light therapy devices
Bright light therapy: Which devices to recommend
Specific bright light therapy devices/ lamps to recommend or not recommend
Bright light therapy devices/lamps
Should we recommend wearable bright light therapy devices?
Do wearable bright light therapy devices work?
Which SPECIFIC wearable bright light therapy devices?
Bright light therapy: Instructions to patients
How to do bright light therapy (patient handout)
How exactly to use bright light therapy for bipolar depression
Bright light therapy for bipolar depression (Interview with Dorothy Sit, MD)
Cholinesterase Inhibitors—see Cognitive Enhancers
Cognitive Enhancers
Cholinesterase Inhibitors
Alzheimer’s disease: Medications
How to choose a cholinesterase inhibitor
Switch cholinesterase inhibitors?
Medications for dementia: Alternative preparations
Donepezil (Aricept®, Aricept ODT®): Basic Information
Galantamine (Razadyne, Razadyne ER): Basic Information
Rivastigmine (Exelon®, Exelon® Patch): Basic Information
Memantine
Complementary and Alternative (CAM) interventions
General
Complementary and alternative medicines (CAM) for depressive disorders
Complementary/ herbal products can sometimes cause mania
Complementary and alternative medicines: Online resources
Interactions between herbal and psychotropic medications
Kosher medications, vitamins, and supplements: Specific products
Which CAM products can cause or contribute to insomnia?
Ashwagandha
What is ashwagandha used for?
Should we recommend ashwagandha for anxiety disorders or anxiety symptoms?
What side effects (common or serious) can occur with ashwagandha (Withania somnifera)?
How to check for drug interactions with an herbal product like ashwagandha
Cannabidiol (CBD)
What is cannabidiol (CBD)?
Cannabidiol (CBD): Clinical experience
Cannabidiol for schizophrenia or other psychotic disorders? An overview
What did randomized, double-blind clinical trials of cannabidiol in schizophrenia find?
Lithium orotate
L-theanine
Magnesium
Basic facts about magnesium for mental health clinicians
Commonly used medications that can cause magnesium deficiency
Magnesium supplement for suspected alcohol/ medication-induced deficiency?
Which type of magnesium supplement to recommend
When should we worry that our patient is taking too much magnesium?
N-acetylcysteine (NAC)
What is N-acetylcysteine (NAC)?
Tips on how exactly to prescribe NAC
N-acetylcysteine (NAC): Contraindications and potential adverse effects
What the FDA is saying about N-acetylcysteine (NAC) and how that is affecting us
N-acetylcysteine for obsessive-compulsive disorder (OCD)?
N-acetylcysteine (NAC) for trichotillomania?
N-acetylcysteine (NAC) for Excoriation (skin picking) disorder?
Omega-3 fatty acids (see “Omega-3 fatty acids” below)
S-adenosylmethionine (SAMe)
Yoga
Digital therapeutics
Dopamine Agonists
Dopamine agonists—General articles
Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined?
Dopamine agonist withdrawal syndrome (DAWS)
Pramipexole
Pramipexole: Basic information
Pramipexole for major depressive disorder or bipolar depression
Tips on using pramipexole for mood disorders
Potential adverse effects of pramipexole
Can a dopamine agonist (pramipexole, ropinirole) and a stimulant be combined?
Important! Dopamine agonist withdrawal syndrome (DAWS)
Ropinirole
Electroconvulsive Therapy (ECT)
ECT: General articles
What type of ECT should patients receive and how often?
Pros and cons of ultrabrief pulse ECT
How to evaluate a past course of electroconvulsive therapy (ECT)
Practice guidelines for electroconvulsive therapy (ECT)
ECT: Catatonia
How to use ECT for catatonia
Should some persons with catatonia be given continuation (and even maintenance) ECT?
ECT: Major depressive disorder
When should we consider ECT for major depressive disorder?
How well does ECT work for major depressive disorder?
How well does ECT work for treatment-resistant depression?
Some issues in the practice of ECT for major depressive disorder
ECT: Side effects
Electroconvulsive therapy (ECT) and cognitive impairment
ECT: Other articles
Kitty Dukakis, a Beneficiary of Electroshock Therapy, Emerges as Its Evangelist
Exercise
Does exercise work as a treatment for depressive disorders?
For depressive symptoms, aerobic exercise or resistance training?
How MUCH exercise for treating depressive symptoms?
My favorite YouTube channel for tips related to physical therapy
Highly selected exercise videos for everyone or specifically for seniors
Fasting
There are three different types of intermittent fasting
How well does intermittent fasting work? And, for what?
What side effects can occur with intermittent fasting?
Who should NOT do intermittent fasting
How exactly to do time-restricted eating
GABA-A positive modulators
Healthier Eating
Healthier eating—General articles
Tips on how to eat a healthier diet
How to guide patients toward healthier eating even if money is tight
Healthier eating—Recommended books
The BEST books about nutrition and diet
BEST books about how to get to and maintain a healthy weight
Healthier Eating–Mediterranean diet (MedDiet)
Tell patients why they should follow a Mediterranean diet (MedDiet)
Mediterranean diet (MedDiet): A simple and practical guide
Healthier Eating–Protein
Do you advise patients to consume more high-protein foods?
How to increase protein intake *without* increasing calories
Healthier Eating–Fats
Recommendations for dietary fats in a healthy diet
What to advise patients about saturated and unsaturated fats
Healthier Eating–Fiber
Why and how to recommend increased intake of soluble fiber
How to choose and use a fiber supplement
Healthier Eating–Sugar
Glycemic index
Healthier Eating—Miscellaneous Articles
Which supplements to recommend with a vegetarian or vegan diet
Which foods and beverages can cause excessive abdominal gas or bloating?
A primer on the Paleolithic (“Paleo”) diet
DASH diet: A simple and practical guide
National Nutrition Month
Hypnotics
Benzodiazepines
Z-drugs
Practical tips on using hypnotics: the Z drugs
How to match the patient with the right Z-drug
Are the Z-drugs (zolpidem and others) safe to take during pregnancy?
Hypnotic if waking up in the middle of the night?
Eszopiclone (Lunesta®): Basic Information
Zolpidem (Ambien® and Ambien CR®): Basic Information
Zaleplon (Sonata®): Basic Information
Melatonin receptor agonists
Melatonin
Does melatonin work for insomnia?
Low-dose preparations of melatonin
Which brand and preparation of melatonin to recommend
Melatonin agonists for preventing and treating delirium?
What are the potential side effects of melatonin?
Can melatonin have negative effects on puberty?
Can melatonin increase blood sugar?
What drug interactions can occur with melatonin?
Ramelteon
Pros and cons of ramelteon (Rozerem®) as a hypnotic
Ramelteon (Rozerem®): Basic Information
Orexin receptor antagonists
What is the orexin system and why is it so important?
An overview of dual orexin receptor antagonists (DORAs)
Potential side effects of dual orexin receptor antagonists (DORAs)
Do dual orexin receptor antagonists (DORAs) have a low risk of abuse or dependence?
Are dual orexin receptor antagonists (DORAs) safe in obstructive sleep apnea?
Daridorexant (Quviviq®): Basic information
Lemborexant (Dayvigo®): Basic information
Suvorexant (Belsomra®): Basic information
Other topics about hypnotics
FDA-approved medications for the treatment of insomnia (hypnotics)
Non-addictive sleep medications
Is quetiapine (Seroquel®) a reasonable option for treating insomnia?
Best hypnotics in elderly patients?
Hypnotics to avoid in the elderly (older adults)
Which hypnotics to use or avoid in persons with sleep apnea
Doxepin (Silenor®): Basic Information
Other topics about hypnotics
Ketogenic diet and psychotropic medications
L-methylfolate, folate, and related compounds
L-methylfolate, folate, and related compounds: Evaluation
Serum folate is not the right test to order
L-methylfolate, folate, and related compounds: Therapeutic use
What you need to know about L-methylfolate (Deplin®)
Four forms of folate
Folate, folic acid, and methylfolate: Multiple choice questions
A simple way to significantly reduce the cost of l-methylfolate (Deplin®)
L-methylfolate (Deplin®): Basic information
Which l-methylfolate preparations should we recommend?
L-methylfolate, folate, and related compounds: Side effects
Folic acid may counteract the benefit of lamotrigine
L-methylfolate can sometimes precipitate irritability, agitation, insomnia, or aggressiveness
Does folate/ L-methylfolate supplementation DECREASE or INCREASE the risk of breast cancer?
Medications for treating feeding and eating disorders
Medications for treating obsessive-compulsive and related disorders
SSRIs for OCD
Higher than usual doses of SSRIs for OCD?
SSRIs for OCD: How high can we go?
Clomipramine versus SSRIs for OCD
Add clomipramine to an SSRI for OCD?
Concerns about combining clomipramine and SSRIs
How exactly to add clomipramine to an SSRI
When and how to check the clomipramine level
How to interpret clomipramine and desmethylclomipramine levels
OCD: Second-line medications
Antipsychotic “augmentation” for OCD
Is fluvoxamine more effective for OCD than other SSRIs?
N-acetylcysteine (NAC) for obsessive-compulsive disorder (OCD)?
Poor man’s vortioxetine
Body Dysmorphic Disorder: Pharmacological treatment
How to use serotonin reuptake inhibitors to treat body dysmorphic disorder
How to treat excoriation (skin picking) disorder: Pharmacological treatment
Medications for treating sexual dysfunction
General
Beta-blockers can worsen or improve erectile dysfunction
Cyproheptadine (Periactin®) for antidepressant-induced sexual dysfunction (ADISD)?
Which antidepressant for the treatment of premature ejaculation?
Treatment of premature ejaculation with antidepressants—daily or as-needed?
Flibanserin
Flibanserin (Addyi®)
Flibanserin (Addyi®) in postmenopausal women
Flibanserin (Addyi®): Basic information
Flibanserin (Addyi®): Systematic list of references
Phosphodiesterase-5 inhibitors (PDE-5 inhibitors)
Medications for treating trauma and stress-related disorders
Does prazosin work for PTSD? If so, for which symptoms?
How exactly should we dose prazosin in PTSD?
Warning! Prazosin can lead to hypotension/ syncope after the first dose
PTSD-associated nightmares: Menu of treatment options
Are psychostimulant medications contraindicated in persons with PTSD?
Melatonin receptor agonists
Melatonin
Melatonin: An introduction
Does melatonin work for insomnia?
What are the potential side effects of melatonin?
Can melatonin have negative effects on puberty?
Can melatonin increase blood sugar?
Low-dose preparations of melatonin
Which brand and preparation of melatonin to recommend
Ramelteon
Miscellaneous
Mood Stabilizers
Mood stabilizers—General articles
How many days to wait before measuring the blood level of any medication
When to measure serum levels of mood stabilizers
Combination therapy (mood stabilizer plus antipsychotic) for acute mania?
A practical guide to the management of bipolar disorders with mixed features
Does gabapentin work for bipolar disorder?
Encourage pregnant women on an antiepileptic drug to enroll in these registries
Carbamazepine and Oxcarbazepine
Carbamazepine
Carbamazepine (Equetro®, Tegretol®-XR): Basic Information
Carbamazepine for neuropsychiatric symptoms in persons with dementia?
How should carbamazepine be discontinued?
What to do about contraception in women on carbamazepine or oxcarbazepine
HLA antigens and psychotropic drugs
Oxcarbazepine
Does oxcarbazepine (Trileptal®) work?
Advantages and Disadvantages of Trileptal® (oxcarbazepine) versus Tegretol® (carbamazepine)
How to start, titrate, and dose oxcarbazepine (Trileptal®)
Oxcarbazepine (Trileptal®): Plasma levels
What to do about contraception in women on carbamazepine or oxcarbazepine
Divalproex (or valproate or valproic acid)
How to prescribe divalproex
Also see: Mood stabilizers—General articles
Divalproex (Depakote®, Depakote ER®): Basic Information
Divalproex (Depakote®) or valproic acid (Depakene®) preparations
Divalproex (valproate) loading dose
What lab tests should we do in patients on divalproex (Depakote)?
All about when and how to order a FREE valproic acid level?
What is the optimal serum valproic acid (valproate) level?
Ketogenic diet and valproate
How to add valproate to lamotrigine
Efficacy of divalproex for different conditions
Does divalproex (valproate) work for bipolar depression?
Valproate for neuropsychiatric symptoms in dementia?
Side effects of divalproex
Valproate and hair loss (alopecia)
Valproate-induced pancreatitis
False-positive elevation of plasma ammonia
Valproate (Depakote®) and elevated serum ammonia level (hyperammonemia)
L-carnitine (levocarnitine; Carnitor®): Basic information
What to do if a patient develops thrombocytopenia during treatment with valproate
Drug interactions of divalproex
Lamotrigine
Lamotrigine—General articles
Lamotrigine (Lamictal®): Basic Information
Can lamotrigine monotherapy be used for maintenance treatment in bipolar I disorder?
Lamotrigine: No additional benefit at 400 mg per day?
Why don’t we routinely prescribe lamotrigine extended-release (Lamictal XR®)?
How to add valproate to lamotrigine
Tips on using lamotrigine for mood disorders: Interview with Dr. Nassir Ghaemi
Lamotrigine—How to start
How to start and titrate lamotrigine (Lamictal®)
Dermatological precautions when starting lamotrigine
Lamotrigine—How to restart
Restarting lamotrigine
If lamotrigine is missed for a few days
Restarting lamotrigine: how many days?
Restarting lamotrigine: A case study
Lamotrigine—Skin rash
Dermatological precautions when starting lamotrigine
Is it a benign or dangerous skin rash?
How common are benign and serious rashes with lamotrigine?
Lamotrigine rechallenge after a skin rash?
Lamotrigine—Side effects (other than skin rash)
Can lamotrigine levels predict adverse effects?
What to do about the risk of arrhythmias with lamotrigine
Can lamotrigine cause psychiatric side effects?
Can lamotrigine cause bruising?
Is the use of lamotrigine during pregnancy safe?
Oral sores in a patient on lamotrigine
Lamotrigine—Drug interactions
5 Action Items about OCs and lamotrigine
Does lamotrigine decrease the effectiveness of oral contraceptives?
How to reduce lamotrigine when an inducer is stopped
Folic acid may counteract the benefit of lamotrigine
Lithium
Lithium: Therapeutic use
Also see: Mood stabilizers—General articles
How to know who will respond better to lithium
Lithium: In how many doses per day?
“Simple and Practical” patient education about lithium
Is the extended-release preparation of lithium carbonate better?
Should we prescribe low-dose lithium?
Lithium augmentation in major depressive disorder: How much?
Lithium augmentation in major depressive disorder: How long
Let’s not stop lithium abruptly or rapidly
If serum lithium levels vary unexpectedly, consider these possible causes
How to manage lithium treatment before and after bariatric surgery
When and how to prescribe lithium citrate oral solution
What should we tell patients who ask about lithium orotate?
Lithium: Side effects and their management
Lithium toxicity
Clinical tips for identifying lithium toxicity clinically
Lithium: Hyperparathyroidism
Lithium induced hyperparathyroidism
How to screen for lithium-induced hyperparathyroidism
Lithium-induced hyperparathyroidism: Management
How to calculate corrected serum calcium
Sensipar® (cinacalcet) Prescribing Information
Lithium: Hypothyroidism
An introduction to lithium-induced hypothyroidism
How common is lithium-induced hypothyroidism?
What are the risk factors for lithium-induced hypothyroidism?
How should lithium-induced hypothyroidism be evaluated?
How should lithium-induced hypothyroidism be managed?
Lithium: Renal impairment
Lithium-induced renal impairment: Clinical recommendations
Case: Rising serum creatinine in a patient on lithium
Case: Elevated serum creatinine that remained stable for many years
Is the extended-release preparation of lithium carbonate better?
Which preparation of lithium is less likely to harm the kidneys?
Lithium-induced polyuria and diabetes insipidus
Lithium-induced polyuria and diabetes insipidus: Evaluation
Lithium-induced polyuria and diabetes insipidus: Treatment
24-hour urine for creatinine clearance
How to collect a 24-hour urine sample
Lithium: Skin/ hair-related side effects
All about lithium-induced hair loss
Acne is a potential side effect of lithium
Lithium and psoriasis
Lithium: Tremors
Lithium-induced benign tremor: Introduction
Lithium-induced benign tremor: Evaluation
Lithium-induced benign tremor: Treatment
Beta-blockers for lithium-induced benign tremor
Vitamin B6 for lithium-induced benign tremor?
Lithium: Miscellaneous
Lithium’s effects on the electrocardiogram (ECG, EKG)
Tips on using lithium for bipolar disorder during pregnancy
Lithium: Drug interactions
Topiramate
Muscarinic agonist
Xanomeline+Trospium (Cobenfy™)
The rationale for xanomeline+trospium (Cobenfy™), approved for the treatment of schizophrenia
Efficacy of xanomeline+trospium (Cobenfy™) and comparison with second-generation antipsychotics
Xanomeline+trospium (Cobenfy™): Side effects
Omega-3 fatty acids
Omega-3 Fatty Acids in Mental Health
Omega-3 fatty acids for depressive disorders?
Omega-3 fatty acids for the treatment of hypertriglyceridemia
Which omega-3?
Omega-3 fatty acids for vegetarian and vegan patients
Omega-3-acid ethyl esters (Lovaza®): Basic information
Psychedelics
Considerable beneficial effects are reported by psilocybin users
What side effects can psilocybin have?
Can psilocybin lead to suicide or other self-harm?
Is psilocybin addictive?
Can psychedelics cause serotonin toxicity (syndrome)?
Can a psychedelic be taken along with lithium?
What we need to know about hallucinogen persisting perception disorder (HPPD)
Psychotherapy
General topics
BEST books on learning psychotherapy
BEST books: Social skills training
How to find a cognitive therapist
Three quick tips about relationship issues
Tips on dealing with “slips” in recovery
Brief non-pharmacological interventions (90833)
Sleep hygiene worksheets-Part 1 and Part 2
(Almost) never tell her that she’s doing better
Don’t screw up in the last 5 seconds!
Relaxation practice: Handout for patients
Stages of psychological change: A poem
CBT for brief sessions: Interview with Donna Sudak, MD
You may be using the box of tissues all wrong!
Using a calendar to support forming a habit
How to improve outcomes in prolonged grief
Psychotherapy—Split treatment
(Psychopharmacology and psychotherapy being received from separate clinicians)
Three REVEALING questions to ask patients about their therapists
How to get the benefits of split treatment
Tips for managing split treatment
How to help patients get more out of their psychotherapy
How to reduce risk in split treatment
Specific types of psychotherapy
An introduction to Dialectical Behaviour Therapy (DBT)
An introduction to Eye Movement Desensitization and Reprocessing (EMDR)
An introduction to Emotionally Focused Therapy (EFT)
An introduction to Accelerated Resolution Therapy (ART)
Meditation and Relaxation
Relaxation practice: A simple and powerful tool for anxiety, tension, and insomnia
Best books on mindfulness meditation
Add mindfulness meditation as a treatment (Interview with Seema Desai, MD)
Top 10 Free Self-Help Apps for Meditation and Mindfulness
Quotes about meditation
Adult ADHD
TED talks recommended for mental health clinicians
Thyroid hormones
Thyroid hormones for psychopharmacologists: What’s what
Pros and cons of liothyronine (T3) and levothyroxine (T4)
Levothyroxine (T4) for augmentation of antidepressants?
Thyroid hormone for adjunctive treatment (augmentation) with an SSRI?
Liothyronine (T3) adjunctive treatment: How much and for how long?
Transcranial Magnetic Stimulation (TMS)
TMS—General articles
What does transcranial magnetic stimulation (TMS) work for?
What percentage of patients with MDD responds to TMS?
Who may respond better to transcranial magnetic stimulation (TMS)?
Deep TMS (dTMS) for obsessive-compulsive disorder (OCD)
Which type of TMS device should we ask patients to look for?
Practice guidelines for transcranial magnetic stimulation (TMS)
TMS—Potential side effects
How much is the risk of a seizure with TMS?
TMS-Potential interaction with medications
What to do with meds if a person is on TMS
Important! Motor threshold in TMS may be affected by medications
Do benzodiazepines reduce the response to TMS treatment?
TMS-Interview with an expert
Primer on TMS: Interview with John O’Reardon, MD
TMS-How to refer your patient for TMS
How to refer your patient for TMS
Finding a clinician who provides TMS (External Link)
Finding a clinician who provides deep TMS (dTMS; External Link)
Vesicular monoamine transporter 2 (VMAT2) Inhibitors
Deutetrabenazine
Valbenazine
General
Vitamins and Minerals
Multivitamin/ multimineral
Do’s and don’ts for taking a multivitamin
Which vitamin supplements should we be cautious about recommending?
Biotin
When to consider recommending biotin supplementation
Biotin can interfere with many laboratory tests—and lead to serious misdiagnosis
Iron
Instructions for WHEN and HOW to take iron supplements
Which foods are rich in iron?
How to maximize absorption of iron supplements
Laboratory testing to identify iron deficiency
What is the best single test for checking the body’s iron stores?
How to order and interpret iron studies
Are we missing iron deficiency without anemia?
Let’s ask about heavy menstrual bleeding
How to improve the tolerability of iron supplementation
Iron deficiency, pica, and restless legs syndrome associated with blood donation
Restless Legs Syndrome (RLS) and iron deficiency
Magnesium
Basic facts about magnesium for mental health clinicians
Magnesium supplement for suspected alcohol/ medication-induced deficiency?
Which type of magnesium supplement to recommend
Vitamin B12
How to evaluate a person’s vitamin B12 status
Vitamin B12 and mental health
Testing for B vitamins in persons with cognitive impairment
A patient with a low vitamin B12 level
Which supplements to recommend with a vegetarian or vegan diet
Elevated vitamin B12 levels are common and could be very serious
Vitamin D
What is vitamin D?
How should vitamin D status be measured?
How should we define vitamin D insufficiency (deficiency)?
How should vitamin D insufficiency or deficiency be treated?
Does vitamin D supplementation increase the risk of kidney stones?
Can vitamin D treat clinical depression?
Vitamin E
Vitamin E: A primer for clinicians
Does vitamin E work for tardive dyskinesia?
Vitamin E: Potential adverse effects and drug interactions
Also see: L-methylfolate, folate, and related compounds
Wakefulness-promoting agents
Armodafinil
Modafinil
Modafinil for ADHD?
Modafinil as an adjunct for major depressive disorder?
Do modafinil/ armodafinil need cardiovascular monitoring
Modafinil (Provigil®): Basic Information
Solriamfetol
Weight-loss medications and treatments
Overview
Medications for weight loss?
An overview of medications for the treatment of obesity
Naltrexone and bupropion
A generic alternative to naltrexone/bupropion (Contrave®)?
Bupropion plus naltrexone (Contrave): Basic information
Metformin
Metformin to prevent or treat metabolic adverse effects due to antipsychotics
Who is more likely to benefit from metformin for the management of metabolic adverse effects?
Metformin for antipsychotic-induced weight gain in children and adolescents?
Potential adverse effects of metformin
Tips on prescribing metformin
Metformin AND topiramate for metabolic adverse effects?
Metformin for weight gain or obesity unrelated to antipsychotic medications?
GLP-1 receptor agonists
A simple primer on what GLP-1 receptor agonists are
GLP-1 receptor agonists in patients on antipsychotic medications?
GLP-1 receptor agonists may reduce alcohol craving/ use
Semaglutide injection (Wegovy™) for weight loss in obesity and overweight
Semaglutide injection (Wegovy™): Basic information
Semaglutide injection (Wegovy™): Side effects
Semaglutide injection (Wegovy™): Serious side effects, warnings, and contraindications
Does tirzepatide (Zepbound™) produce *even more* weight loss than semaglutide (Wegovy®)?
Tirzepatide (Zepbound™): Basic information
Liraglutide (Victoza®, Saxenda®)
Orlistat
Orlistat (Xenical®): Basic Information
Phentermine and topiramate
Phentermine and topiramate extended-release (Qsymia®): Basic Information
Bariatric surgery
What to do about psychotropic medications after bariatric surgery
How to manage lithium treatment before and after bariatric surgery
Is bupropion sustained-release OK to use after bariatric surgery?
Why and how to monitor and evaluate for suicide risk after bariatric surgery
Why, who, and how to monitor for increased alcohol use after bariatric surgery
Treatments: Cost of medications, Pharmacies, and Prescription Drug Plans
How to find out the price of medications, compare prices, and get the lowest possible price
Tips on reducing the cost of medications by using higher-strength pills
Should we encourage patients to use independent pharmacies?
What is the procedure for obtaining an early medication refill?
Medication prices on Costco.com versus on Goodrx.com
Should we recommend Costplusdrugs.com for lowering the cost of medications?
A simple way to significantly reduce the cost of l-methylfolate (Deplin®)
Prior authorization for medications
Pharmacy benefit managers
Canadian pharmacies?
Medications from Canadian pharmacies?
Using a Canadian pharmacy can reduce the cost of some medications
Formulations of medications
Formulations of medications—General articles
Abbreviations for controlled-release formulations are out of control!
Antidepressants: What are the alternatives to the oral route?
Formulations of medications—Capsules
Do sustained-release preparations have fewer adverse effects?
Extended-release preparations of psychotropic medications
Can extended-release capsules be opened?
When a patient has difficulty getting off venlafaxine
How can duloxetine be tapered very slowly?
Two patients where opening medication capsules was helpful
Formulations of medications—Tablets
Are bupropion SR and bupropion ER the same thing?
Why, when, and how to split medication tablets
Recommended pill cutters and pill crushers
Which tablets are actually extended-release formulations and so should not be cut?
What if patients report seeing intact pills in their stools?
Orally disintegrating tablets (ODTs) can be useful
Psychotropic medications are sometimes given sublingually
Formulations of medications—Liquids
Which antidepressants come in liquid forms?
Inactive Ingredients (Excipients) in Medications
Gluten in medications
Can lactose in medication pills cause intolerance?
How to find out whether a medication contains ingredients of animal origin
Other topics: Generic medications
Are generic medications really equivalent to brand-name medications?
Generic and “authorized generic” medications
Which manufacturers of generic versions of psychotropic medications are better or worse?
Which generics of Concerta® (methylphenidate extended-release) to recommend
Is generic bupropion as effective as brand-name Wellbutrin®?
Can generic dextromethorphan and bupropion be used instead of the brand name combination?
A generic alternative to naltrexone/bupropion (Contrave®)?
Laws and Regulations About Medications
Laws about prescriptions for psychostimulants
Can I take my medication with me when I travel to another country?
What to do about medications when traveling to Japan
Off-Label Prescribing
We prescribe “off-label” more often than we think
Important! Off-label prescribing is of many different types
Off-label prescribing: Clinical recommendations
Pharmacodynamics and Pharmacokinetics
Which medications are mostly excreted unchanged and why is this important?
Some medications have a low “therapeutic index”. What exactly is that?
Psychiatric medications with a long half-life
ABCB1 polymorphisms and psychotropic medications
Why is dextromethorphan combined with a CYP 2D6 inhibitor?
What does the Ki (inhibition constant) for a drug mean?
A simple guide to serotonin receptors
Dopamine receptors: A primer for clinicians
Melanocortin 4 receptor (MC4R) and weight gain
Psychopharmacology in Special Populations
Agitation
Dexmedetomidine (Igalmi™): Basic information
Bariatric surgery
What to do about medications after bariatric surgery
How to manage lithium treatment before and after bariatric surgery
Is bupropion sustained-release OK to use after bariatric surgery?
Why and how to monitor and evaluate for suicide risk after bariatric surgery
Why, who, and how to monitor for increased alcohol use after bariatric surgery
Pregnancy and lactation
Five websites for information regarding psychotropic medications and pregnancy
Lactation and psychotropic medications: Resources
Pregnancy registries for women who become pregnant while on a psychotropic medication
Is lamotrigine use during pregnancy safe?
Tips on using lithium during pregnancy
Are the Z-drugs (zolpidem and others) safe to take during pregnancy?
Are you about to prescribe a medication that could lead to an unwanted pregnancy?
Surgery and anesthesia
What to do about psychotropic medications during elective major surgery
Can patients who are NPO not take medications orally?
Demystified: Potentially very serious interactions between MAO inhibitors (MAOI) and opioid analgesics
What to do about stimulant medications for surgery or other procedures under anesthesia
Other
Are psychiatric medications safe AFTER laser iridotomy for narrow-angle glaucoma?
Interaction of Medications with Food
Which psychiatric medications MUST be taken with food?
For medications that must be taken “with food,” how recent does the eating have to be?
Quetiapine extended-release and food
Medications to be taken consistently, either with or without food
Monitoring for Side Effects
Miscellaneous articles
What to do about old prescriptions
Short answers to questions from our Members
Can persons on psychotropic medications donate blood?
What do the es-, the levo-, and the dex- mean in drug names?
Your patient may be taking a psychiatric medication by another brand name
How to find basic information about medications on this website
The BEST app for medication reminders/medication management
Tips for writing prescriptions: for how long, how many refills?
Is e-prescribing worth it?
Prescription Drug Monitoring Programs (PDMPs)
Where to look up information on drug shortages
Flibanserin (Addyi®)
Milnacipran (Savella®): Basic Information
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What articles do you have on treatments for perimenopausal mood and vasomotor symptoms?
Specifically I am looking for article on SSRIs and SNRIs and other non-hormonal options.
Many thanks
I went to our Main Menu for “Disorders/ Conditions” and, in that Menu, to the category of “Women’s mental health”. It showed that we have the following two articles about perimenopausal symptoms and their treatment:
Tips on managing perimenopausal symptoms
Adjunctive estrogen for perimenopausal depression?