Treatment-Resistant MDD: Modafinil Augmentation
Partial response, no response, or residual symptoms following antidepressant therapy is common in clinical psychiatry. Hence, it is of clinical importance to have knowledge of…
Safest Antidepressant with Warfarin?
Answer: (b) Sertraline. Warfarin has two isomers: S-isomer (three times more potent than R-isomer): metabolized by 2C9. R-isomer: metabolized by 1A2 (major) and 2C19 & 3A4 (minor) —> monitor…
How to use Pramipexole for Bipolar Depression?
Pramipexole is currently only FDA approved for Parkinson’s disease & Moderate-to-severe primary Restless Legs Syndrome but Pramipexole has promising data as an augmentation option for…
Emotional Blunting with Antidepressants Versus Anhedonia from MDD?
Antidepressants are well known to cause this side effects of emotional blunting. It is clinically relevant to diagnose this early in the treatment as this…
Invega Hafyera™ (6-monthly paliperidone palmitate): FDA Approved for Schizophrenia
Sep 01, 2021. Today FDA approved the first and only 6 monthly long-acting injectable for schizophrenia treatment: Invega Hafyera. We have summarized Invega Hafyera clinical…
Topiramate & Cognitive Dulling
Topiramate is well known to cause cognitive dulling and patients should use caution when operating machinery including automobiles. How can we prevent the risk of…
Treatment Resistant Depression with Atypical Features Management
Depression with atypical features is defined as significant mood reactivity combined with two of the following clinical features: Hyperphagia Hypersomnia Leaden paralysis Pathological rejection sensitivity…
Testosterone & Depression in Men?
Age-associated hypogonadism (testosterone deficit) can occurs in 30% of men after the age of 55 (1). Low testosterone is associated with decreased muscle mass, bone…
How to Screen for Delirium Superimposed on Dementia?
When delirium and dementia coexist: this is referred to as delirium superimposed on dementia (DSD). Delirium and dementia are associated with: lengthier hospital stays functional…
Mood Stabilizers Use During Pregnancy & Postpartum
The perinatal period can increase the risk of mood symptoms recurrence for patients with bipolar disorder, including the risk of depressive episode recurrences and postpartum…
How to Differentiate Obsessions from Delusions?
The presence of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorders (OCD) in schizophrenia is frequent. It is of clinical relevance to separate obsessive symptoms from delusional…
Antidepressant & Tamoxifen use in Breast Cancer?
Depression and anxiety are common comorbidities in breast cancer patients. As a results patients with breast cancer may require treatment with antidepressants. For this reason,…
Attention PEFA Members: Join PEFA Network
Dear PEFA Members. We are excited to release a new update in our academy: PEFA Network. This is a closed group for PEFA members only and…
Antipsychotics & risk of Hypersexual or Paraphilic Behaviors
We know that dopamine agonism can result in hypersexual or paraphilic behaviors but interestingly, case reports for second-generation antipsychotics association with increase in hypersexual behavior…
Traumatic Brain Injury: Management Series [PEFA]
The risk for psychiatric disorders and symptoms can increase after the traumatic brain injury, and long-term disability from TBI has primarily been attributed to neurobehavioral…
Clomipramine for Pediatric OCD?
We know that CBT and SSRI are considered first-line treatments for pediatric OCD management, but few patients are treatment-refractory and they do not respond to…
Cyproheptadine for PTSD Nightmares
The diagnosis of PTSD requires the endorsement of one of two symptoms from the symptom clusters of (1) reexperiencing, (2) avoidance, and (3) sense of…
Memantine for Treatment-Resistant OCD
OCD is a chronic neuropsychiatric disorder that can cause significant psychosocial impairment (Goodman et al., 2021), and delay in treatment is associated with poor outcomes…
Message Each Other: New PEFA Feature
Today we are excited to announce the release of our website’s new feature for PEFA members. Now PEFA members can message each other privately to…
Clomipramine Therapeutic Level
Therapeutic Drug Monitoring (TDM) of psychotropic medication is a clinically relevant topic as TDM can be a beneficial test in following clinical scenarios checking medication…
Antipsychotics Induced Edema
Antipsychotic-induced edema is not an uncommon side-effect. In most cases, this can be a transient and self-limited side effect but it is important to know…
How to Evaluate Six Neurocognitive Domains in Dementia? [PUBLISHED]
Psychiatry Education Forum Academy published its next discussion series today: It is important to have knowledge of these six neuro-cognitive domains for the evaluation &…
How to Evaluate Six Neurocognitive Domains in Dementia?
Today we are excited to announce Psychiatry Education Forum Academy’s next discussion with release date for this Saturday (July 24): It is important to have…
Autism Spectrum Disorder: Aggression & Irritability Management
We know that medications are not the first-line treatment for autism spectrum disorder (ASD) management but they are helpful when first-line behavioral interventions are not…
Psycho-Ophthalmology: Psychotropics Ocular Adverse Events
Psychotropic medications are known to cause ocular side effects. We have a detailed section on this topic in Psychiatry Education Forum Academy. Let’s begin with…
Overcoming our Therapeutic Neglect of Lithium
A patient in his mid 30s was brought to the hospital by police for increased aggression towards his family members. On evaluation he reported a…
Alzheimer’s Disease: Comparing FDA Approved Medications
Alzheimer’s disease is the most common type/cause of dementia. As we know that FDA recently approved Aducanumab (Aduhelm) for the treatment of Alzheimer’s Disease (read…
[PEFA Journal Club]: Claim 4.75 CME Credits
We just finished our 13 journal club discussions at PEFA (Psychiatry Education Forum Academy). PEFA members can claim a maximum of 4.75 AMA PRA Category…
[Journal Club 13 + Coffee Club]: International Trauma Questionnaire (ITQ) for PTSD & CPTSD
Today we posted the following 13th journal club in PEFA Journal Club’s discussion series and discussion with an expert in our Coffee Club’s discussion section:…
[Journal Club #12 + Coffee Club]: Is Ketamine Safe with History of Psychosis?
Today we posted the following 12th journal club in PEFA Journal Club’s discussion series and discussion with an expert in our Coffee Club’s discussion section:…
[Journal Club 11 + Coffee Club]: Benzodiazepines & Risk of Subsequent Dementia?
Today we posted the following 11th journal club in PEFA Journal Club’s discussion series and discussion with an expert in our Coffee Club’s discussion section:…
[Journal Club #10]: Antipsychotics & Weight Gain
Today we posted our 10th journal club in PEFA Journal Club’s discussion series, discussing the risk of weight gain with antipsychotics: Journal Club #10: Almost…
[Journal Club #9 + Coffee Club]: Adjunctive Metformin for Antipsychotic-Induced Dyslipidemia.
Today we posted the following 9th journal club in PEFA Journal Club’s discussion series and discussion with an expert in our Coffee Club’s discussion section:…
[Journal Club #8]: Is Vortioxetine Effective for Emotional Blunting in MDD?
Today we posted the eighth journal club in PEFA Journal Club’s discussion series, discussing if Vortioxetine is effective for emotional blunting in MDD after inadequate…
[Journal Club #6 + #7]: Two New Schizophrenia Medications with Novel Mechanism of Action
Today we posted the sixth and seventh journal club in PEFA Journal Club’s discussion series, discussing the following two newer antipsychotics for schizophrenia treatment: (A)…
[Journal Club #5 + Coffee Club]: Comparing 32 Oral Antipsychotics for Acute Schizophrenia Management.
Today we posted the following fifth journal club in PEFA Journal Club’s discussion series and discussion with a expert in our Coffee Club’s discussion section:…
Journal Club #4: How Does Schizophrenia Symptoms Progress with Age?
Today we posted the following fourth journal club in PEFA Journal Club’s discussion series: Journal Club #4: Staging of Schizophrenia With the Use of PANSS:…
Journal Club #3: Bipolar Depression Guidelines: CANMAT & ISBD Versus Psychopharmacology Algorithm Project
Today we posted the following third journal club in PEFA Journal Club’s discussion series: Journal Club #3: The Psychopharmacology Algorithm Project at the Harvard South…
Journal Club #2: Omega-3 Fatty Acids for MDD Treatment (ISNPR Practice Guidelines)
Today we posted the following second journal club in PEFA Journal Club’s discussion series: Journal Club #2: International Society for Nutritional Psychiatry Research Practice Guidelines…
Journal Club #1: Update on Nonpsychotic Unipolar Depression Management
We begin PEFA Journal Club’s updated schedule with our first journal club discussion today: Journal Club #1: The Psychopharmacology Algorithm Project at the Harvard South…
PEFA Journal Club: Updated Schedule Released
Psychiatry Education Forum’s Journal Club is an additional feature for PEF Academy’s members. All academy members will be automatically enrolled in this journal club. Here…
Antipsychotics of Choice during Lactation
Antipsychotics of Choice During Lactation: This PEFA academy chapter will summarize the use of antipsychotics during lactation in the following sections: FIRST-LINE treatment options during…
Aducanumab: New Medication FDA Approved for Alzheimer’s Disease
June 07, 2021 Today FDA has approved Aducanumab (Aduhelm) for the treatment of Alzheimer’s Disease. This is the first novel treatment to target the underlying…
Binge Eating Disorder: Diagnose & Treatment Options
PEFA (Psychiatry Education Forum Academy) is excited to announce the release of our new section titled “Feeding & Eating Disorders”. We have the following two…
LYBALVI™: New Medication FDA Approved for Schizophrenia & Bipolar Disorder
June 01, 2021 Today FDA approved LYBALVI for the treatment of: Schizophrenia in adults Bipolar I disorder in adults Acute treatment of manic or mixed…
PEFA Newsletter: May 2021
PSYCHIATRY EDUCATION FORUM ACADEMY’S NEWSLETTER MAY 2021 Here is the summary of topics posted in the month of May at Psychiatry Education Forum Academy. These…
Omega-3 Fatty Acids for MDD?
Recently Omega-3 polyunsaturated fatty acids, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) have drawn the clinical attention for the treatment of major depressive disorder. The…
How do Schizophrenia Symptoms Progress over 40 years?
Today (May 24) is World Schizophrenia Day. The purpose of this day is to increase awareness and reduce the stigma associated with the diagnosis of…
How to Switch Between Valproate Formulations?
Valproate is an FDA approved treatment for bipolar disorder. According to CANMAT and ISBD (2018 guidelines) valproate is indicated for the following phases of bipolar…
Psychological Approaches for Auditory Hallucinations Management
We are excited to announce our next video discussion for Psychiatry Education Forum Academy members: Antipsychotic medications are commonly used to treat the auditory hallucinations…
Benztropine or Glycopyrrolate: Which one is preferred for Antidepressants Induced Sweating?
Glycopyrrolate is preferred over Benztropine for the following reasons: for Glycopyrrolate is less known to cross the blood-brain barrier, hence less central adverse events (less…
Medications vs Psychotherapy for MDD: Comparing 5 Major Guidelines
How do you decide between psychotherapy versus medications for the treatment of major depressive disorder? Depression severity is one of the criteria used to make…
Psychotropics & Risk of Tinnitus
Tinnitus is defined as the conscious awareness of a sound in the absence of an external auditory stimulus. Psychotropic medications are commonly used as the…
Naltrexone XR: When & How to Initiate?
Naltrexone XR is an opioid antagonist, which is FDA approved for opioid use disorder. The main benefits of naltrexone-XR are: extended duration of its action…
Pseudobulbar Affect: Identify & Manage
Psychiatry Education Forum Academy’s Coffee Club contains short discussions with clinical experts in the field of psychiatry. Coffee Club’s goal is to get answers for clinically…
Lumateperone: Mechanism of Action?
Lumateperone is the most recently approved FDA-approved medication for the treatment of schizophrenia. Watch the following short video discussion from our journal club regarding the…
How to Diagnose PMDD?
Premenstrual disorders can range from mild premenstrual syndrome (PMS) to premenstrual dysphoric disorder (PMDD). It is known that close to 70-90 % of reproductive age…
Lithium Induced Polyuria: Laboratory Evaluation
Watch the following short 5 minutes video from Psychiatry Education Forum’s Bipolar Disorder Update 2020 Conference. This video will briefly discuss the important laboratory workup…
Psychiatry Education Forum Featured on Psychiatric News.
Thanks to Psychiatric News for covering Psychiatry Education Forum’s Bipolar Disorder Update 2020 Conference. Here is Dr. Harvinder Singh’s interview on Bipolar Disorder Mixed Features:…
Treatment-Resistant GAD: 8 Augmentation & 12 Switching Options
Psychiatry Education Forum Academy will publish a detailed lecture on the management options for treatment-resistant GAD (Generalized Anxiety Disorder) tomorrow: April 18 (Sunday). This detailed…
Genetic Testing in Psychiatry: MTHFR & L-MethylFolate
MTHFR gene encodes for MethyleneTetraHydroFolate Reductase (MTHFR) enzyme. It is important to have the knowledge of the following two MTHFR polymorphisms for you to interpret…
GAD: Initial Medication of Choice?
Generalized Anxiety Disorder (GAD) is a common psychiatric disorder with chronic waxing and waning course for some. Psychiatry Education Forum Academy will summarize the pharmacological…
Transdermal Asenapine
ANSWER: (d) All of the above. Apply to a different application site each time a new transdermal system is applied. Do not cut the patch.…
PEF Clinical Fact: Antipsychotic of Choice in COVID & Pneumonia
INTERESTED IN LEARNING MORE? JOIN PSYCHIATRY EDUCATION FORUM ACADEMY MEMBERSHIP This educational activity is dedicated to the essential and must-know clinical facts regarding the interaction…
Restless Legs with Antidepressants?
Restless leg syndrome is defined as having following four essential clinical consensus criteria: (a) Compelling urge to move the legs with or caused by uncomfortable…
Can L-Theanine Help with Anxiety Management?
Share this post Share on facebook Share on google Share on twitter Share on linkedin Share on pinterest Share on print Share on email L-theanine…
Is Olanzapine Effective for Bipolar Mixed Features Management?
Share this post Share on facebook Share on google Share on twitter Share on linkedin Share on pinterest Share on print Share on email Bipolar…
Anti-NMDA Receptor Encephalitis
ANTI-NMDA RECEPTOR ENCEPHALITIS <p style=”text-align: left;”>This is an autoimmune disorder in which antibodies attack NMDA (<em>N</em>-methyl D aspartate) type glutamate receptors at central neuronal synapses.…
Propranolol for TBI
PROPRANOLOL FOR TRAUMATIC BRAIN INJURY Traumatic brain injury can significantly impact an individual’s life, in terms of cognitive, behavioral, and physical impairments. Among these, aggression…
Top 5 Psychiatry Articles Discussed on PEF
Happy New Year to all PEF Followers I want to thank you all for following Psychiatry Education Forum and giving me the encouragement to continue…
Role of ANK3 in Bipolar Disorder
Share this post Share on facebook Share on google Share on twitter Share on linkedin Share on pinterest Share on print Share on email Ankyrin-3…
Ulipristal Acetate for PMDD Treatment
Share This Post Share on facebook Share on linkedin Share on twitter Share on email Close to 70-90 % of reproductive age women are known…
Asenapine: Transdermal vs Sublingual?
ASENAPINE: TRANSDERMAL VS SUBLINGUAL This post will summarize the key differences between the transdermal and sublingual formulation of asenapine in the following 10 minutes of…
Bipolar Disorder with comorbid ADHD
Bipolar Disorder vs ADHD Which Symptoms are More Prominent in Bipolar Disorder-I, Compared with those with only ADHD? Elevated Mood Grandiosity Flight of Ideas Decreased…
Lithium & Renal Damage: Prevention?
How to Minimize Renal Damage Risk with Chronic Lithium Use? <img width=”768″ height=”854″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2020/11/02889320-0192-4269-938a-0f27a483c3f2-copy-768×854.jpg” alt=”” loading=”lazy” srcset=”https://i1.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/11/02889320-0192-4269-938a-0f27a483c3f2-copy.jpg?resize=768%2C854&ssl=1 768w, https://i1.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/11/02889320-0192-4269-938a-0f27a483c3f2-copy.jpg?resize=270%2C300&ssl=1 270w, https://i1.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/11/02889320-0192-4269-938a-0f27a483c3f2-copy.jpg?w=813&ssl=1 813w” sizes=”(max-width: 768px) 100vw,…
Role of NAC for Treatment-Resistant OCD
ROLE OF NAC FOR TREATMENT-RESISTANT OCD This is a short 5-minute video from <a href=”https://psychiatryeducationforum.teachable.com/p/conference1″ target=”_blank” rel=”noopener noreferrer”>Psychiatry Education Forum’s 1st CME Conference</a>. Here I…
Montelukast & Neuropsychiatric Adverse Events
MONTELUKAST & NEUROPSYCHIATRIC ADVERSE EVENTS Neuropsychiatric Adverse Events from Non-Psychiatric Medications BY DR. HARVINDER SINGH Montelukast is indicated for the treatment of: Prophylaxis and chronic…
Omega-3 Fatty Acids for MDD Treatment: Practice Guidelines
Detailed Answer is available in our first Journal Club discussion: Journal Club #1: ISNPR Practice Guidelines for Omega-3 Fatty Acids in the Treatment of Major…
Comparing Serotonin Modulators: Trazodone vs Nefazodone
This post will compare trazodone and nefazodone in the following table: INTERESTED IN LEARNING MORE? JOIN OUR ACADEMY & GET ACCESS TO FOLLOWING COMPLETE LECTURE…
Grief, Persistent Complex Bereavement Disorder Versus Prolonged Grief Disorder
This topic will be summarized in the following three sections: (1) Grief versus Major Depressive Episode: https://youtu.be/WIQmiWnqhFg (2) Persistent Complex Bereavement Disorder Versus Prolonged Grief…
Remdesivir & Psychotropics Interactions
On Oct 22, 2020: FDA approved the antiviral medication Remdesivir for the treatment of COVID-19 requiring hospitalization. This was the first treatment for COVID-19 to…
Varenicline (Chantix): 5 Clinical Facts
READ BELOW FOR DETAILS (1) Dosing Instructions for Chantix: First set a date to quit smoking. Initiate Chantix one week before this quit date. …
Lithium Formulations & Dosages
This video podcast will be discussed in the following sections: 1. Available lithium formulations and dosages.2. Lithium Citrate vs Lithium Carbonate.3. Which lithium formulation &…
ALKS 3831 (Olanzapine/Samidorphan): Investigational Atypical Antipsychotic Drug
On Oct 9, 2020: Alkermes announced that FDA Advisory Committee voted in support of ALKS 3831 for the treatment of schizophrenia and bipolar I disorder.…
Ginkgo Biloba for Antidepressants Induced Sexual Dysfunction
Can Ginkgo Biloba help with antidepressants induced sexual dysfunction? <p style=”text-align: center;”><strong>MECHANISM OF ACTION:</strong></p><ul><li>Prostaglandin synthesis and vasodilation ==></li><li>resulting in increase peripheral blood flow and to…
Treatment-Resistant PTSD Nightmares Management
Today we released our updated lecture series on the management of treatment-resistant PTSD nightmares management. With this lecture series, we have crossed 260 chapters in…
Beware of “Benadryl Challenge” on TikTok: FDA Warning
You must be aware of life-threatening challenges posted on social media in past, including the Tide Pod Challenge (in 2018) and the Bird Box Challenge…
Why Patients with Dementia develop Behavioral Symptoms?
Behavioral Symptoms Management in Dementia Lecture Series This lecture series will be discussed in the following sections: 1. Types of agitated behaviors in dementia: (Duration:…
FDA Update: Boxed Warning for Benzodiazepines
On Sep 23, 2020: FDA released this new announcement in their Drug Safety Communication, that the following update will be included in the Boxed Warning…
How do Antidepressants Cause Bruxism?
Bruxism is an involuntary activity of the jaw musculature characterized by jaw clenching, bracing, gnashing, and grinding of the teeth. Antidepressants induced bruxism is an…
Role of Depakote for Delirium Treatment.
Delirium can present with hyperactive, hypoactive or mixed clinical presentations. Depakote can be an effective treatment option for the management of delirium. Answer: Hypoactive Delirium…
How to Use Lithium During Pregnancy & Postpartum?
Lithium is considered a gold-standard mood stabilizer for the management of bipolar disorder. How about managing bipolar disorder with lithium during pregnancy OR for a…
How Long to Continue Antidepressants for MDD Treatment?
Once you have initiated antidepressants for MDD (Major Depressive Disorder) treatment and patient has achieved remission, how long will you continue this current antidepressant for?…
PTSD Treatment if Prazosin fails: Doxazosin
Prazosin is used for treatment of intrusive nightmares and flashbacks symptoms of PTSD. Prazosin has limitation in some patients due to: Need for multiple…
Evidence-Based Prevention Guidelines of Alzheimer’s Disease
This most recent study published by Jin-Tai Yu et al in J Neurol Neurosurg Psychiatry (on Jul 20, 2020) completed a systematic review & meta-analysis…
Trazodone: Dose, Mechanism & Clinical Response
This post will summarize Trazodone’s mechanism of action and answer the following two questions: What dose of Trazodone is effective for major depression disorder (MDD)…
25% Price Drop: 1st CME Conference
Psychiatry Education Forum’s first CME online conference is dedicated to the essential and must-know clinical facts in psychiatry. This conference will offer a maximum of 10 AMA…
Comparing Antidepressants: Long-Acting Formulations
This post will focus on the following three available long-acting formulations of antidepressants: (1) FLUOXETINE CR: Comparing daily fluoxetine with weekly fluoxetine in terms of:…
ADHD & Depression: Psychotropic Drug-Drug Interactions
This question is more directed toward drug-drug interactions and the role of Cytochrome P450: Atomoxetine is metabolized by CYP2D6, so we should avoid medications inhibiting…
Peer Reviewer for Psychiatry Education Forum
We are currently working on exciting educational activities for Psychiatry Education Forum subscribers. We at Psychiatry Education Forum rely on reliable peer review process to…
Medications Induced Neutropenia: Avoid them with Clozapine.
Neutropenia is the single most important risk factor for infection and Clozapine is well known for the increased for neutropenia. This neutropenia risk will increase…
First FDA Approved Transdermal Antipsychotic: Asenapine (SECUADO®)
On Oct 15, 2019 FDA has approved the first-and-only transdermal patch for the treatment of adults with schizophrenia: SECUADO® (asenapine) Transdermal Patch <p>This post will…
Choosing Antidepressants Based on Comorbid Medical Conditions
Let’s begin this discussion with the following hypothetical case: <img width=”640″ height=”360″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2-1024×576.png” alt=”” srcset=”https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?resize=1024%2C576&ssl=1 1024w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?resize=300%2C169&ssl=1 300w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?resize=768%2C432&ssl=1 768w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?resize=1536%2C864&ssl=1 1536w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?w=1920&ssl=1 1920w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2020/08/Pink-Blooming-Bridal-Bouquets-Sales-Presentation-2.png?w=1280&ssl=1…
Cognitive Impairment with Traumatic Brain Injury
Traumatic brain injury can significantly impact an individual’s life, in terms of cognitive, behavioral and physical impairments. Among these, cognitive impairments are often the most…
Mood Stabilizers: Drug Interactions
This short 10 min video will discuss the important drug interactions for commonly used mood stabilizers for bipolar disorder management: Our course chapter will compare…
PEF Coffee Club: Bipolar Depression
Psychiatry Education Forum’s (PEF) Coffee Club is a new feature for Physician’s Guide for Clinical Psychiatry course subscribers. PEF Coffee Club contains short discussions with…
Snorting your way out? Using Stimulants for Depression
Stimulants have been intuitively considered as treatment options for depression for a very long time. It is often said that Freud treated his own depression…
Treatment-Resistant OCD: Can NAC Help?
A 36 year-old-female with history of Obsessive-Compulsive Disorder (OCD) is currently on fluvoxamine 300 mg/day with clomipramine 250 mg/day with persistence of intrusive obsessive thoughts…
Peer2Peer ChatRoom: Our New Course Feature
PEF Peer2Peer ChatRoom (PEF P2P) is a new feature for Physician’s Guide for Clinical Psychiatry subscribers. This ChatRoom brings together fellow psychiatric practitioners in our…
Grinding your Teeth in Depression
We all know about the risk of extrapyramidal symptoms with the use of antipsychotics. A similar risk can also be seen with antidepressants, but this…
Intranasal Olanzapine: New Drug-Device Product for Acute Agitation?
Agitation is seen in various psychiatric disorders including bipolar disorder and schizophrenia. The use of intramuscular and intravenous medications is common in hospital settings for…
Antidepressants & Restless Leg Syndrome (RLS)
Do you know of a condition “which causes such suffering that it should be known by every physician”?(1) That is what Ekbom, the neurologist who…
Neuroanatomy of Addiction
Understanding the neuroanatomy of the reward pathway and related circuitry is important in psychiatry, as abnormalities in these pathways are known to have a role…
‘Breaking Bad’ on a Routine Urine Drug Screen: The case of an innocent drug-positive
Post Contribution by Dr. Lena Palaniyappan Often we request urine drug screening when we suspect possible drug use, but cannot trust what the patient says.…
Clozapine and New-Onset Obsessions
Clozapine as a treatment option has many strengths. But it also has some weaknesses. This week I had a patient who has been stable on…
Clozapine Drug-Drug Interactions
Choose your answer first before scrolling down…. <strong>Answer: CYP1A2 interaction</strong></p><ul><li>Clozapine is extensively metabolized in the liver via the cytochrome P450 system. </li><li><strong>Cytochrome P450 isoenzyme 1A2…
The Fire of Psychosis
Journalists write a lot more than psychiatrists, right? But how can you write meaningfully when your “brain is on fire”? A 24 year old New…
Atypical Psychosis: Discussion Series Announcement
Psychiatry Education Forum is excited to announce the release of our upcoming discussion series with Dr. Lena Palaniyappan: <h2>ATYPICAL PSYCHOSIS:</h2> <img width=”640″ height=”360″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2020/05/Dr.-Lena-Palaniyappan2–1024×576.jpg” alt=””…
Psychotropic Dose Conversions: Email Lecture Series
We will begin the following email lecture series for Physician’s Guide for Clinical Psychiatry course subscribers: PSYCHOTROPICS DOSE CONVERSION (MAY 18- MAY 29, 2020) (May…
Duloxetine FDA Approved for Pediatric Fibromyalgia (age 13-17 yr)
FDA has expanded the duloxetine indication for the treatment of fibromyalgia in pediatric population (age 13-17 yr). Duloxetine is now approved for following disorders: Major…
Non-Psychiatric Medications with: Neuropsychiatric Adverse Events (Email Lecture Series)
Physician’s Guide for Clinical Psychiatry’s Next Triweekly Email Lecture Series Announcement: In this email lecture series, we will discuss the neuropsychiatric adverse events from following…
Neuroleptic Malignant Syndrome: Diagnostic Criteria
This post is dedicated to the discussion of diagnostic criteria for neuroleptic malignant syndrome. Here is the summary of an international consensus study of Neuroleptic…
Catatonia: Kahlbaum & Kraepelin
REFERENCES: Book: CATATONIA. From Psychopathology to Neurobiology. (HIGHLY RECOMMENDED) (amazon) Kahlbaum KL: Klinische Abhandlungen über psychische Krankheiten. 1. Heft: Die Katatonie oder das Spannungsirresein. Berlin,…
Burning Mouth Syndrome and Psychotropic Medications
Today we are excited to announce that we crossed 250 chapters in Physician’s Guide for Clinical Psychiatry Course. Here is Chapter #252 (which is available…
Clozapine, REMS and COVID-19
FDA issued the statement on March 22, 2020 regarding the patient access to REMS (Risk Evaluation and Mitigation Strategy) medications like clozapine during COVID-19 public…
Psychotropics Induced Sexual Dysfunction
Physician’s Guide for Clinical Psychiatry’s next lecture series will discuss the psychotropics sexual side effects in the following six chapters/emails: (1) WHAT QUESTIONS TO ASK? (MARCH…
Tobacco Use Disorder: Lecture Series
The Tobacco Use Disorder email lecture series will be discussed in the following sections: (1) Varenicline: (March 16) Mechanism Dosing instruction Comparison to bupropion Effect…
Do SSRIs have Active Metabolite?
References: Fuller RW, Snoddy HD, Krushinski JH, Robertson DW. Comparison of norfluoxetine enantiomers as serotonin uptake inhibitors in vivo. Neuropharmacology. 1992 Oct;31(10):997-1000. (PubMed PMID: 1279447)…
Bipolar Depression Updated Guidelines: Psychopharmacology Algorithm Project
The Psychopharmacology Algorithm Project at the Harvard South Shore Program published algorithms for bipolar depression in 1999 and 2010. They just released their updated guidelines…
Depression & Hypothyroidism: 8 Clinical Facts
References: Minerva Endocrinol. 2013 Dec;38(4):365-77. (pubmed) J Affect Disord. 2014 Dec;169:112-7. (pubmed) Arch Intern Med. 2010 Dec 13;170(22):1996-2003. (pubmed) Psychoneuroendocrinology. 2015 Aug;58:114-9. (pubmed) Facebook Twitter…
Antipsychotic induced Weight Gain Management: METFORMIN
This clinical topic will be summarized in the following 9 sections: Does metformin have role in the prevention and treatment of antipsychotic induced weight gain? …
Psychotherapy of Choice for PTSD?
FOR PHYSICIAN’S GUIDE FOR CLINICAL PSYCHIATRY SUBSCRIBERS: (Read Chapter 11.1): VA/DOD Clinical Practice Guidelines for PTSD and Acute Stress Disorder. This chapter will summarize these…
Hydroxyzine and QTc Prolongation
For Physician’s Guide for Clinical Psychiatry Subscribers: Read this chapter for details: (2.34) OTHERS: Hydroxyzine and QTc Prolongation. Read Course Chapter Dr. Harvinder Singh Admin,…
Antidepressants and Risk of Hyponatremia
For Physician’s Guide for Clinical Psychiatry Course Subscribers: (This chapter is only available to course subscribers) This topic will be discussed in the following sections:…
FDA Warning: Increased Cancer Risk with Lorcaserin
On 01-14-2020, FDA released this alert of possible association of cancer with Lorcaserin: FDA mentioned that at this time, the cause of the cancer is…
Dasotraline: New Norepinephrine-Dopamine Reuptake Inhibitor
Dasotraline is an investigational medication discovered by Sunovion Pharmaceuticals Inc. and is currently under development for the treatment of: ADHD (in children) and Binge eating…
Lithium Induced Neuropathy
Lithium induced neuropathy is a rare side effect of lithium. We will discuss this adverse event in the following sections: Underlying mechanism. Clinical Presentation: onset,…
Psychotropic Drug Interactions: Clozapine and GERD Medications.
Detailed answer is available in our first email of Psychotropics Drug-Drug Interactions lecture series:- <a data-elementor-open-lightbox=”” href=”https://app.getresponse.com/view/a62b/EwvVVzw/whArc/email-message/bhdkY” target=”_blank” rel=”noopener noreferrer”> <img width=”599″ height=”638″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2020/01/Screen-Shot-2020-01-08-at-1.20.08-PM.png” alt=””…
DAYVIGO™ (Lemborexant): FDA Approved for Insomnia.
On Dec 23, 2019 Eisai Inc. announced the FDA approval of DAYVIGO™ (Lemborexant) for insomnia management. This post will summarize the important clinically relevant facts…
Our Top 5 Posts & Lecture Series of 2019: Happy New Year
We hope you had an amazing 2019! We sure did, thanks to all of your support over the past year. I want to say a…
Lumateperone (Caplyta): New Antipsychotic Approved for Schizophrenia
FDA has approved this new antipsychotic CAPLYTA (lumateperone) for the treatment of schizophrenia. This post will summarize the important clinically relevant facts regarding this medication,…
FDA Warning: Gabapentin and Serious Breathing Difficulties
FDA issued the following warning on 12/19/2019, and requires this information to be included in the package insert of this medication class: Combination of Gabapentinoids…
Prescribing Psychotropics with Medical Co-Morbidities
Detailed answer is available in our next email in the lecture series: <h3><a href=”https://app.getresponse.com/view/a62b/EFlZJSI/whArc/broadcast/18Akc” target=”_blank” rel=”noopener noreferrer”>Antidepressants use with Cardiac Risk</a></h3> <img width=”980″ height=”735″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2019/12/Antidepressants-Cardiac.001.jpeg”…
Tardive Dyskinesia Management
Patient with history of schizoaffective disorder admitted for worsening of command auditory hallucinations and paranoid delusions. He needed higher doses of haloperidol for stabilization of…
MDD: Switch vs Augmentation?
Switching Antidepressants Versus Adding Augmentation Agent in MDD. <h3>How do you decide?</h3> <h4>This question is answered by following two studies:</h4> <h3>(1) Canadian Network for Mood…
Cause and effect: The case for cause marketing
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent tempus sapien odio, sed porttitor mauris pretium eu. Suspendisse ornare tincidunt diam, ornare auctor nibh varius…
5 common myths about graphic design
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent tempus sapien odio, sed porttitor mauris pretium eu. Suspendisse ornare tincidunt diam, ornare auctor nibh varius…
4 tips for effectively communicating with clients
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent tempus sapien odio, sed porttitor mauris pretium eu. Suspendisse ornare tincidunt diam, ornare auctor nibh varius…
User Experience (UX) Design Trends for 2020
Lorem ipsum dolor sit amet, consectetur adipiscing elit. Praesent tempus sapien odio, sed porttitor mauris pretium eu. Suspendisse ornare tincidunt diam, ornare auctor nibh varius…
Mood Stabilizer Comparison: CANMAT & ISBD (2018)
WATCH THIS VIDEO FOR MORE DETAILS: This video will compare Lithium, Depakote, Carbamazepine, Oxcarbazepine and Lamotrigine in following sections: FDA Indications. CANMAT and ISBD 2018…
Lamotrigine Clearance: Drug Interactions
Choose your answer before scrolling down. Lamotrigine is metabolized predominantly by glucuronic acid conjugation, so medications that induce or inhibit glucuronidation may affect…
Restarting Clozapine After Missed Dose
Answer: <img width=”1024″ height=”729″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2019/10/Screen-Shot-2019-10-29-at-3.32.28-PM-1024×729.png” alt=”” srcset=”https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2019/10/Screen-Shot-2019-10-29-at-3.32.28-PM.png?resize=1024%2C729&ssl=1 1024w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2019/10/Screen-Shot-2019-10-29-at-3.32.28-PM.png?resize=300%2C213&ssl=1 300w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2019/10/Screen-Shot-2019-10-29-at-3.32.28-PM.png?resize=768%2C546&ssl=1 768w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2019/10/Screen-Shot-2019-10-29-at-3.32.28-PM.png?w=1196&ssl=1 1196w” sizes=”(max-width: 1024px) 100vw, 1024px” /> <h3>Detailed answer is available at following…
Long-Acting Antipsychotics Dose Conversion.
Dr. Harvinder Singh, MD Admin, Psychiatry Education Forum Facebook Twitter Instagram Youtube Linkedin Physician’s Guide for Clinical Psychiatry Course Subscribers will have more detailed access…
Autism Spectrum Disorder: Pharmacological Management
Autism spectrum disorder is a neuro-developmental disorder characterized by deficits in social communication and social reciprocity, as well as repetitive behavior and restricted interests. First…
Antidepressants Induced Sexual Dysfunction
(Q) 28 year old male with history of major depressive disorder, reports having sexual side effects on trial of fluoxetine, sertraline, mirtazapine and venlafaxine.…
Antidepressants: Mechanism of Action (Part-2)
(Q.1): Which of the following antidepressant medication acts via: 5HT-2 Antagonism 5HT-3 Antagonism Alpha 2 Antagonism Venlafaxine Mirtazapine Vortioxetine Vilazodone (Q.2):…
Antidepressants: Mechanism of Action (Part-1)
(Q.1): Which of the following antidepressant medication acts via: 5HT-2 Antagonism 5HT-3 Antagonism Alpha 2 Antagonism Venlafaxine Mirtazapine Vortioxetine Vilazodone (Q.2): Which…
Duration of Antipsychotic use after Mania Remission.
Before proceeding further: Submit your answer first ANSWER: (c) 6 MONTHS (a) Continuing antipsychotics beyond 6 months (24 weeks) may not further protect against mania recurrence…
Naltrexone XR (Vivitrol)
This podcast will be summarized in the following sections: (1) Assessment: before initiation of Naltrexone XR (2) Clinical Opiate Withdrawal Scale (COWS) (3) Naltrexone (oral)…
Triweekly Email Summary Published (Sep 2019)
Click here for more details: https://course-email-summary.subscribemenow.com/ Free preview of our email sent today: Bipolar Disorder Guidelines: Mania (CANMAT & ISBD): http://bit.ly/Email-Summary-Bipolar-1
Lamotrigine Dosing in Pregnancy
The answer is available at our following two channels: (1) YouTube This podcast will answer the following six questions: (2) Physician’s Guide for Clinical Psychiatry…
Clozapine Drug Interactions
YouTube Channel (Video Podcast): For Course Subscribers: Clozapine Interaction table PDF available for download (free preview available for a limited time only): https://psychiatryeducationforum.teachable.com/courses/451404/lectures/8430830 Subscribe to…
Join our Email Newsletter
Dear Psychiatry Education Forum Members. We send 1-2 educational emails/week to our email subscribers. We have upgraded to a new email service provider and this…
Lead Poisoning in Children
This post will be summarized by answering the following questions: (Q.1): What are the Neurological and Non-Neurological Symptoms of Lead Poisoning? (Q.2): What are the…
Excoriation (Skin-Picking) Disorder Management
Management of Excoriation (Skin-Picking) disorder will be discussed in the following two chapters (video podcasts). This brings our total course chapters count to 225. In…
Naltrexone for Impulse Control & Self-Injurious Behaviors.
I will summarize this topic by answering the following nine questions: (Q.1) What Dose of Naltrexone is found effective?(Q.2) Naltrexone was found effective for which…
Physician’s Guide for Clinical Psychiatry: 6 Months Anniversary Announcements.
Physician’s Guide for Clinical Psychiatry course was released 6 months ago on Jan 19 with 180 chapters. We just published our 222nd chapter yesterday (= 42 chapters…
Suicide Risk Evaluation
Suicide risk assessment is the most important aspect of psychiatric evaluation. This video podcast will discuss the clinical factors that may increase or decrease the…
Top 3 Most Viewed Posts Last Week
Before this summary, I want to thank you all for subscribing to our YouTube channel (Psychiatry Education Forum): we crossed 100 subscribers this week 🙂…
Mental Status Exam: Back to Basics
Hello Friends. This post is dedicated to our new PGY1 psychiatry residents. This video podcast will summarize the basic details of a mental status examination. Highly recommended…
Psychiatry and Medical Co-Morbidities: Thrombocytopenia
Answer is available in our next video podcast here: Detailed answer available for course subscribers here: https://mailchi.mp/ac53f9c8e8fb/antidepressants-and-risk-of-thrombocytopenia
Psychiatry Education Forum Updates (June 2019)
Hello Friends. June is almost over and so is half of 2019 🙂 How are you all liking our posts so far? Please do not…
Antidepressant with Medical Co-Morbidities
Post your answers below We have summarized this topic in this short 20 min video podcast here: https://youtu.be/UXYBXOjUNuI
Q: Bipolar disorder, Depression
Post your answer by using “Leave a Comment” option below. More detailed answer is available here: https://mailchi.mp/62acf1868385/comparing-fda-approved-medications-bipolar-1-depressed
Drug Interactions: HIV Medications and Psychotropics.
Answer posted here: https://mailchi.mp/2c27d4fc37d1/drug-interaction-hiv-medication-psychotropics
Cariprazine (Vraylar) Approved for Depressive Episodes in Bipolar I Disorder
Cariprazine (Vraylar) was initially approved for acute treatment of manic or mixed episodes associated with bipolar I disorder in adults. This week FDA also approved…
Antipsychotics and Warfarin Interactions
Answer Posted: https://psychiatryeducationforum.teachable.com/courses/451404/lectures/10380068 Subscribe for similar clinically relevant topics and podcasts.
Clozapine-Induced Gastrointestinal Hypomotility
This podcast will summarize Clozapine-Induced Gastrointestinal Hypomotility (CIGH) in the following six sections:1. How clozapine can cause CIGH?2. Clinical signs of ileus states.3. Risk factors for CIGH…
Comparing Antidepressants: (1) SSRIs vs SSRIs.
Chapter: http://bit.ly/Comparing_Antidepressants_1 YouTube: https://youtu.be/lB3l77VA4bc Chapter: http://bit.ly/Comparing_Antidepressants_2 YouTube: https://youtu.be/u8WLCAcv4tE Subscribe for similar clinically relevant topics and podcasts.
Behavioral Symptoms Management in Dementia: Lecture Series.
Welcome to Behavioral Symptoms Management in Dementia Lecture Series. This post will summarize the list of chapters (based on their release dates). Here is our…
Antidepressants use with Renal Impairment.
Answer with detailed explanation is available in our following course chapter (available for free access): Subscribe for similar clinically relevant topics and podcasts.
Physician’s Guide for Clinical Psychiatry Course Video
This short video will answer the following commonly asked questions regarding our Physician’s Guide for Clinical Psychiatry course:Q.1. Why I created this course?Q.2. Who is…
Long Acting Antipsychotics Dose Conversions.
This table will summarize the dose conversion between: (1) Oral Risperidone (Risp) (2) Oral Paliperidone (Invg) (3) Risperidone Consta (R. Cont) (4) Invega Sustenna (I.…
Premenstrual Dysphoric Disorder (PMDD)
This is our fifth video podcast and will be summarized in the following sections: Diagnosing PMDD. PMS vs PMDD. Evaluating PMDD with Scales. Treatment Options:…
FDA Psychiatric Medication Shortages (April 2019)
Following Psychiatric medications are CURRENTLY IN SHORTAGE: (1) Buspirone (2) Diazepam Injection (3) Diphenhydramine Injection (4) Flurazepam Hydrochloride Capsules (5) Fluvoxamine ER Capsules (6) Haloperidol…
Video Podcast #1: Comparing Mood Stabilizers
This is our first video podcast lecture. This podcast will compare Lithium, Depakote, Carbamazepine, Oxcarbazepine and Lamotrigine in following sections: FDA Indications. CANMAT and ISBD…
FDA Approved Zulresso (brexanolone) for Post-partum Depression.
FDA approved Zulresso (brexanolone) injection for intravenous (IV) use for the treatment of postpartum depression (PPD) in adult women. Mechanism: Brexanolone is positive allosteric modulator…
Metformin for treatment of antipsychotic induced weight gain.
↓ ↓ Answer: 30 eGFR < 30 mL/min/1.73 m2: Metformin isContraindicated eGFR between 30-45 mL/min/1.73 m2 : Initiation of metformin is not recommended If eGFR falls…
Updated Guidelines by International Society of Psychiatric Genetics
International Society of Psychiatric Genetics (ISPG) updated their guidelines on the use of genetic testing in psychiatric practice. Here is a summary of these recommendations:…
Delirium Rating Scale-Revised-98 (DRS-R-98)
Delirium screening tools such as the Confusion Assessment Method and the Delirium Symptom Interview: are designed to detect some delirium symptoms but not to measure…
Esketamine (Spravato) FDA approved for Treatment Resistant Depression.
Esketamine is a glutamate receptor modulator: acts as noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist. On March 05, 2019: FDA approved Spravato (esketamine) nasal spray, as an…
Autism spectrum disorder: co-morbid symptoms management
Autism spectrum disorder is a neurodevelopmental disorder characterized by deficits in social communication and social reciprocity, as well as repetitive behavior and restricted interests. ↓…
Antipsychotics Induced Edema.
Answer: C ↓ ↓ (190th Chapter Added to Course): Free preview available for next 48 hours only: Chapter #(2.8): Antipsychotics Induced Edema: Evaluation & Management.…
Warfarin and Antidepressants Drug Interactions
↓ ↓ Answer: Fluoxetine. Detailed Explanation Posted in Following Course Updated Chapter: (3.4) ANTIDEPRESSANTS and Warfarin (Chapter Updated) https://psychiatryeducationforum.teachable.com/courses/physicians-guide-for-clinical-psychiatry/lectures/8430865 Dr. Harvinder Singh, M.D. (Admin & Course…
(Q.3): Neuro-anatomical Correlates of Traumatic Brain Injury
Question Series on Traumatic Brain Injury Continues…. Read below for answer and other details: Symptom 1: Patient with impairments of consciousness following traumatic brain injury.…
Parkinson’s disease and Impulse Control Disorders
Impulse control disorders (ICDs) in Parkinson’s disease: (a) Problem or Pathological Gambling (b) Compulsive Buying (c) Compulsive Sexual Behavior (d) Binge or Compulsive Eating Dopamine Agonist Treatment and Association…
Q: Optimal Duration of Augmentation Antipsychotic use in Bipolar Disorder?
Patient with diagnosis of bipolar I disorder had remission of his recent manic episode with combination of mood stabilizer (lithium/ divalproex) and antipsychotic (risperidone/ olanzapine)…
Somatic Symptom and Related Disorders (#2): Management of Medically Unexplained Symptoms in Primary Care.
Kroenke (1) published the following stepped approach for evaluation and management of medically unexplained symptoms in primary care setting: STEP #1: Determine Severity (a) for acutely…
Somatic Symptom and Related Disorders (#1): Differentiating Disorders.
DSM-5 Somatic Symptom & Related Disorders includes: Somatic Symptom Disorder Illness Anxiety Disorder Conversion Disorder (Functional Neurological Symptom Disorder) Psychological Factors Affecting Other Medical Conditions…
Catatonia (#3): Treatment with Benzodiazepines.
FIRST LINE MEDICATION: BENZODIAZEPINES (LORAZEPAM). Route of administration: IV or IM preferred over oral. Initiating dose of lorazepam: 2 mg (Lorazepam Challenge Test) Examine patient…
Catatonia (#2): Catatonic Disorder Due to Another Medical Condition: 293.89 (F06.1)
This post will focus on likely causes for catatonia secondary to underlying medical conditions. DSM-5 defines this as Catatonic Disorder Due to Another Medical Condition:…
Catatonia (#1): History of Catatonia: Kahlbaum & Kraepelin.
Kahlbaum is well known for his monograph “Catatonia or Tension Insanity“, where he described catatonic symptoms as having behavioral and motor components. He described this…
Atypical Antipsychotics Augmentation for Treatment-Resistant Depression.
A Systematic Review and Network Meta-Analysis conducted by Peng Xie et al. investigated the comparative efficacy and tolerability of adjunctive atypical antipsychotics for treatment-resistant depression.…
Dose Conversion: Risperidone Consta & Invega Sustenna
(Q.1): HOW TO CONVERT ORAL RISPERIDONE TO RISPERIDONE CONSTA? ORAL RISPERIDONE RISPERIDONE CONSTA 3 mg/day or less. 25 mg >3 to <5 mg/day or less…
Stimulant and Guanfacine combination for ADHD: (#3) Comorbid Oppositional Symptoms in ADHD.
The following study by Robert L. Findling et al tested the effect of guanfacine extended release (GXR) adjunctive to a psychostimulant on oppositional symptoms in…
Stimulant and Guanfacine combination for ADHD: (#2) Cognitive Effects.
The following study done by Dr. James T. McCracken et al tested the effects of stimulant and guanfacine monotherapies relative to combined treatment on cognitive functions important in ADHD.…
Stimulant and Guanfacine combination for ADHD: (#1) Cardiovascular Effects.
Q: Is this combination safe and well tolerated from cardiovascular side effect profile of individual medications? Stimulants are known for increase in pulse…
Lithium and Risk of Hypercalcemia & Hyperparathyroidism
This post will focus on: Differentiate Lithium associated hypercalcemia/hyperparathyroidism from primary hyperparathyroidism. Symptoms of hypercalcemia. Monitoring guideline. LITHIUM ASSOCIATED HYPER-CALCEMIA/ HYPER-PARATHYROIDISM PRIMARY HYPER-PARATHYROIDISM…
Opioid use disorder: Buprenorphine/Naloxone, Methadone & Naltrexone.
This chapter will compare following three FDA approved medications for opioid use disorder: Methadone (MET). Buprenorphine/Nalaxone (BUP). Naltrexone injectable- Vivitrol (NTX). MET BUP NTX…
Prevent our Weekly Emails in Spam Folder
Dear Psychiatry Education Forum Members and Physician’s Guide for Clinical Psychiatry Subscribers. I have noticed that only 60-70% of our emails are going to…
Restarting Lamotrigine after abrupt Discontinuation.
(Q.1): Patient is stable on Lamotrigine but suddenly stopped it due to rash. Lamotrigine can be restarted (without need for titration) within how many days of…
Low-Dose Naltrexone for Depression
DEFINITION OF LOW-DOSE NALTREXONE (LDN): Naltrexone is used in 50- 100 mg daily dose for opioid use disorder treatment. LDN is 1/10th of…
Top 5 Viewed Posts in October 2018.
Here is our list of top five viewed posts in October. POST #1: Trazodone for Treatment of Major Depressive Disorder. This…
Typical Antipsychotics- Quiz Series.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Answer 1: (e) None of the above. Typical Antipsychotics should be avoided…
Depakote Induced Hair Loss: Mechanism & Management.
MECHANISM OF HAIR LOSS: Depakote —> can result in biotin deficiency and low biotinidase enzyme activity —> results in alopecia (hair loss). Additional role…
High Dose Buspirone for Tardive Dyskinesias.
MECHANISM OF ACTION: Partial agonist at 5-HT1A. Low affinity as antagonist for dopamine D2 auto-receptors. According to rat models: Repeated use of haloperidol —> result…
Does duration of antipsychotic use predict their weight gain potential?
This is second part of our post on this topic. First part is available here: Antipsychotics Induced Weight Gain. This post will focus…
Antipsychotics Induced Weight Gain
Weight gain is one of the untoward side effect of antipsychotic medications and the extent of weight gain varies among all antipsychotics. This post will…
Trazodone for Treatment of Major Depressive Disorder
This post will attempt to answer following questions regarding role of trazodone in treatment of major depressive disorder (MDD): How is Trazodone different from SSRIs…
Sertraline Receptor Profile
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . A is correct:Sertraline is more potent at blocking DA receptor…
Maudsley Staging Method (MSM) for Treatment Resistant Depression (TRD)
This post will answer following three questions: How to use and score Maudsley Staging Method (MSM) for treatment resistant depression (TRD)? What is the optimal…
Pharmacological Interventions for Benzodiazepine Discontinuation
Cochrane conducted this database of systematic reviews to assess the benefits and harms of pharmacological interventions to facilitate discontinuation of chronic benzodiazepine use. …
Total Serum Valproic Acid (VPA) Concentration & Low Albumin Level.
Total VPA levels monitoring in patients with low albumin level may not represent correct VPA level. Hermida et al published this study…
Antidepressants of Choice in Adolescents
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . A Cochrane systematic review was done to answer this…
EnLyte and Deplin: What is the difference?
(1) * Deplin is a medical food containing L-methylfolate, the active dietary form of the vitamin B9 (folate).* EnLyte is an FDA-regulated prescription medication. This ensures prescribing uniformity and integrity, maintains your (the…
Therapeutic Drug Monitoring: ARIPIPRAZOLE
Therapeutic Drug Monitoring: Aripiprazole <img src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/elementor/thumbs/0-ogfdvzu02tegyrenmh4w7eyg4fz8zzfh13uz94u7bc.jpeg” title=”0″ alt=”0″ /> <h4>Therapeutic drug monitoring have limited value in the clinical use of aripiprazole. It may be useful…
Basal Ganglia Structures and Diseases Associated with Damage.
This diagram will answer basic overview of diseases associated with damage to basal ganglia structures: <img width=”1024″ height=”851″ src=”https://psychiatryeducationforum.com/project1/wp-content/uploads/2018/09/Basal-Ganglia-1024×851.jpg” alt=”” srcset=”https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2018/09/Basal-Ganglia.jpg?resize=1024%2C851&ssl=1 1024w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2018/09/Basal-Ganglia.jpg?resize=300%2C249&ssl=1 300w, https://i0.wp.com/www.psychiatryeducationforum.com/wp-content/uploads/2018/09/Basal-Ganglia.jpg?resize=768%2C638&ssl=1…
5-HT2A Receptor Antagonists for Neuroleptic Induced Akathisia
This systematic review and meta-analysis published in 2014, compared the efficacy of 5-HT2A receptor antagonists for neuroleptic induced akathisia. This was the first meta-analysis on this…
Pseudobulbar Affect (PBA) Management
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . CLINICAL FEATURES: Uncontrolled crying or laughing. These episodes…
Lamotrigine to Augment Clozapine: 6 Clinical Points to Consider.
#1: Make sure that blood clozapine levels are in the therapeutic range and the patient is taking the maximum tolerable doses of clozapine over at least 18-24…
Major Depression Disorder: Sleep-Wake Cycle & Antidepressants.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . BRAIN STRUCTURES (AND NEUROTRANSMITTERS) IMPLICATED IN SLEEP WAKE CYCLE: …
DRUG INTERACTION: Lamotrigine + Antiretrovirals
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . REDUCED LAMOTRIGINE LEVELS Atazanavir/Ritonavir: may decrease lamotrigine plasma concentrations due…
Pharmacologic Treatment of Depression in Older Patients with COPD
CLINICAL RECOMMENDATIONS: (1) ANTIDEPRESSANT DOSING: ‘start low and go slow’ with antidepressants. Try not reach a therapeutic dose in patients with adequate tolerance.…
Psychosis Management in Parkinson’s Disease
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Quetiapine is the drug of choice for…
Antidepressants Discontinuation Syndrome Vs Depression Relapse
Q: How can you clinically differentiate antidepressants discontinuation syndrome from relapse and recurrence of underlying depression? (1) SYMPTOMS: Distinctive symptom of discontinuation is dizziness, which…
Designer Drugs: Clinical Features
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Designer drugs are synthetic analogs of controlled substances. This post will…
United Kingdom Parkinsons Disease Society Brain Bank Clinical Diagnostic Criteria’s
Diagnosis of a parkinsonian syndrome Bradykinesia and at least one of the following: Muscular rigidity. Rest tremor (4-6 Hz). Postural instability unrelated to…
PERSERIS™ (Risperidone): Once-Monthly Injectable.
FDA approved the first once monthly long acting injectable form of Risperidone: PERSERIS™ (in July 2018). INDICATION: Schizophrenia in adults. DOSAGE: 90 mg and 120…
Drug Interactions: Antidepressants and Tramadol.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Tramadol is indicated for the management of moderate to moderately…
Fibromyalgia
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Fibromyalgia is combination of widespread chronic musculoskeletal pain, fatigue and sleep…
Diabetes Mellitus: Non-Insulin Treatment Options
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . . . . . . This…
Antidepressants of choice during Lactation.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . PREFERRED ANTIDEPRESSANT IN BREAST FEEDING: Sertraline Paroxetine Nortriptyline …
Postpartum Psychosis: Four Step Algorithm
Postpartum psychosis is a severe disorder that requires acute clinical intervention. Bergink et al published the following four step algorithm for postpartum psychosis management: …
PTSD and Prazosin: High Dose for Resistant PTSD Nightmares.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Higher dose of prazosin may be needed for…
Long Acting Injectable: Haloperidol Decanoate (PART 2)
PART 1 is available here: Haloperidol Decanoate (PART 1) This part will focus on loading and conversion strategies for haloperidol decanoate. HOW…
Long Acting Injectable: Haloperidol Decanoate (PART 1).
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . PHARMACOKINETICS: Peak Levels Reached by: 6 days after the injection. Half Life:…
PTSD Medication Option if Prazosin Fails: Doxazosin.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Prazosin is used for treatment of intrusive nightmares and flashbacks…
Lamotrigine (LTG) in Pregnancy: Dosage and Serum Concentration
(1) Ideally obtain total serum LTG level at therapeutic dose before pregnancy. (2) If patient is seen during pregnancy: obtain levels as early as possible…
FDA Approved EPIDIOLEX® (Cannabidiol) for Epilepsy
June 25, 2018: FDA approved EPIDIOLEX® (Cannabidiol) oral solution for treatment of seizures associated with: Lennox-Gastaut syndrome and Dravet syndrome. in patients 2 yr and…
Non-Epileptic vs Epileptic Seizures
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . (1) ONSET: Gradual Onset: common in non-epileptic seizures but…
Hyperprolactinemia (Part 3/3): Management Recommendations
This is our third post in this series on hyperprolactinemia. Part 1/3: Hyperprolactinemia & Antipsychotics https://wp.me/p7Us3Y-ko Part 2/3: Hyperprolactinemia & Antidepressants https://wp.me/p7Us3Y-kA This post will focus…
Hyperprolactinemia (Part 2/3): Antidepressants
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . SERTRALINE: Strongest dopamine reuptake blocker among SSRIs. Literature review found highest…
Hyperprolactinemia (Part 1/3): Antipsychotics
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Antipsychotics that Increases Prolactin (45 to >100 ng/ml) and Should…
Obsessive Compulsive Disorder: When to Discontinue Treatment?
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . APA 2007 guideline recommends that successful medication treatment for…
Methadone: Drug Interactions
Methadone: Drug Interactions BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . DECREASE METHADONE Carbamazepine CYP3A4…
Rule out: Hypogonadisim or Low Testosterone
Rule out: Hypogonadisim or Low Testosterone HOW TO MAKE THIS DIAGNOSIS: Consistent symptoms and signs + unequivocally low serum testosterone levels. Initial…
Anti-NMDA Receptor Encephalitis.
Anti-NMDA Receptor Encephalitis This is an autoimmune disorder in which antibodies attack NMDA (N-methyl D aspartate) type glutamate receptors at central neuronal synapses. CLINICAL…
Antipsychotics and Risk of Bleeding
Antipsychotics and Risk of Bleeding BM Verdel et al (1) assessed several classes of serotonergic drugs in order to evaluate whether they constitute a…
Psychiatry & Co-Morbid Medical Conditions: Renal (Q.2)
Psychiatry & Co-Morbid Medical Conditions: Renal This question series will focus on clinically relevant questions related to the role of psychotropic medications…
Psychiatry & Co-Morbid Medical Conditions- Renal (Q.1)
Psychiatry & Co-Morbid Medical Conditions: Renal This question series will focus on clinically relevant questions related to the role of psychotropic medications…
Psychiatry & Co-Morbid Medical Conditions: Hepatic (Q.3)
Psychiatry & Co-Morbid Medical Conditions: Hepatic This is our third question in this series: “Psychiatry and Co-Morbid Medical Conditions“. This post will…
Psychiatry & Co-Morbid Medical Conditions: Hepatic (Q.2)
Psychiatry & Co-Morbid Medical Conditions: Hepatic (Q.1) Which of the following psychotropic medication is not as influenced by first-pass metabolism? Sertraline…
Psychiatry & Co-Morbid Medical Conditions: Hepatic (Q.1)
Psychiatry & Co-Morbid Medical Conditions: Hepatic This is our first post in this series: “Psychiatry and Co-Morbid Medical Conditions“. This post will…
Antipsychotics use for psychosis/agitation management in dementia.
Antipsychotics use for Psychosis or Agitation Management in Dementia -Post by Dr. Harvinder Singh. American Psychiatric Association (APA) have published detailed guidelines on this topic.…
Clozapine: Managing Side Effects
Clozapine: Managing Side Effects By Dr. Harvinder Singh. Physicians are aware of serious side effects from clozapine including agranulocytosis, myocarditis, cardiomyopathy, pulmonary embolism and seizure…
Marshall Protocol: antimicrobial treatment for chronic inflammatory diseases.
Marshall Protocol: antimicrobial treatment for chronic inflammatory diseases. Five key elements of this approach includes: taking a minimum of four doses of olmesartan (Benicar)…
Inflammatory Biomarkers and Risk of Schizophrenia
Inflammatory Biomarkers and Risk of Schizophrenia Question: Whether inflammatory biomarkers have an effect on the risk of developing schizophrenia.? Findings: This study published in JAMA Psychiatry…
FDA Approved NSS-2 BRIDGE for Opioid Withdrawal.
FDA Approved NSS-2 BRIDGE for Opioid Withdrawal On November 15, 2017 U.S. Food and Drug Administration granted a new indication to an electric stimulation device for…
Sertraline: Basic Facts
Sertraline BASIC-DESCRIPTION Brand Name Zoloft FDA Indications MDD OCD (> 6yr) Panic disorder Social Anxiety PTSD PMDD…
Hypothyroidism and Depression: Clinical Facts
Hypothyroidism and Depression: Clinical Facts 1. Depressive patients have a higher frequency of hypothyroidism and patients with hypothyroidism have a higher occurrence of depressive syndrome. 2. Thyroid peroxidase…
Mood Stabilizers: Information Table
Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course to have access to all important clinically…
Q.12. Buprenorphine
Q.12: Buprenorphine Sublingual Tablets are indicated for the treatment of opioid dependence. Which of the following statement is correct regarding Buprenorphine? (a) Induction with buprenorphine…
Q.10: Which CYP450 is responsible for this conversion from trazodone to mCPP?
Patients taking trazodone may get false positive results on the urine enzyme immunoassay test for MDMA. The reason for this false positive result is trazodone’s…
Q.11: Medications Affecting Lamotrigine Clearance ?
Q.11: Which of the following medication is NOT known to increase the apparent clearance of lamotrigine? (a) Carbamazepine (b) Estrogen-containing oral contraceptives (c) Rifampin (d) Valproate (e)…
Antidepressants & Comorbid Medical Conditions
Antidepressants & Comorbid Medical Conditions Antidepressant to avoid in patients with seizure disorders: Buproprion Antidepressant to avoid in patients with uncontrolled hypertension: Venlafaxine Antidepressant…
Topiramate with Hydrochlorthiazide
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Answer: (b) Potassium followed by (d) Bicarbonate …
Q.8: Dementia associated with Parkinson’s Disease
Q.8: Which of the following medication is FDA approved for treatment of Dementia associated with Parkinson’s Disease?(a) Donepezil(b) Galantamine(c) Rivastigmine(d) Memantine Answer: (c) Rivastigmine FDA…
Q.7 Benzodiazepines and Abnormal Liver Functions
Q.7. 40 year old male with history of major depression disorder presents for evaluation and management of recent increase in anxiety. Laboratory workup revealed abnormal liver…
Q.6 Alcohol use disorder
Q.6: 45 year old male with history of depression, seizure disorder, hepatitis and coronary artery disease. He is interested in medication options of his recent increase…
Gabapentin and Low Creatinine Clearance
Q: Gabapentin is eliminated from the systemic circulation by renal excretion. Which of the following is recommended total daily gabapentin dose range for patient with…
VA/DOD Clinical Practice Guidelines for PTSD.
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . According to VA/DOD recently published guidelines (June 2017): For…
False Positive Urine Drug Screen
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . Sertraline —> can cause false positive results for benzodiazepines…
Tasimelteon: Important Drug Interactions
Tasimelteon: Important Drug Interactions Q.2. Tasimelteon is a melatonin receptor agonist indicated for the treatment of Non-24-Hour Sleep-Wake Disorder.Addition of which of the following medication…
(Q.1) Treatment for Depression after Traumatic Brain Injury
Answer: (b) Sertraline Read the following chapter in our online course: (15.1) Treatment of Depression after Traumatic Brain Injury. This chapter will answer above question…
Treatment Resistant Depression: Switch or Augmentation
The VAST-D Randomized Clinical Trial published in JAMA answered this question. This post will focus on details and findings of this trial. …
Tardive Dyskinesia: Comparing Medications
Tardive Dyskinesia: Comparing Medications Tardive dyskinesia (TD) is a movement disorder induced by long term use of dopamine blocking medications. We don’t have many available treatment…
Augmentation Treatment for Depression: Liothyronine (T3)
Augmentation Treatment for Depression: Liothyronine (T3) Which one is preferred for depression augmentation treatment: T3 or T4? T3 is preferred over T4 for depression…
U.S. FDA Approves Mydayis™ (mixed salts of single entity amphetamine product)
U.S. FDA Approves Mydayis™ (mixed salts of single entity amphetamine product) Shire plc (LSE: SHP, NASDAQ: SHPG) announced on June 20, 2017 that the U.S.…
Antidepressants in Bipolar Disorder: Clinical Facts
Q.1: Monotherapy with Antidepressants is not recommended in patient with bipolar disorder. Which antidepressants are preferred in conjunction with mood stabilizer? SSRIs (other than…
Oral Creatine Augmentation to Enhance SSRI Response in Women With MDD
Underlying Mechanism Behind using Creatine: Creatine supplementation is known to increase –> cerebral concentration of phosphocreatine. Increase cerebral creatine –> causes shift in brain…
Borderline Personality Disorder: Most Reliable Clinical Feature?
Q: Presence of Which Single Clinical Feature Identifies Most Patients with Borderline Personality Disorder and Absence of Which Rules out this Disorder? Answer: Affective Instability. Zimmermen…
The Cunningham Panel™ Overview
THE CUNNINGHAM PANEL OVERVIEW The Cunningham Panel™ can help identify the level of autoimmune antibodies associated with Neuropsychiatric Disorders and the capability they have to…
FDA Approved INGREZZA™ (Valbenazine)
This is the first and only FDA-approved product indicated for the treatment of adults with tardive dyskinesia. This post will summarize basic details regarding this medication.…
ADHD and Comorbid Bipolar Disorder
ADHD and Comorbid Bipolar Disorder Q: Which Symptoms are More Prominent in Bipolar Disorder-I, Compared with those with only ADHD? Elevated Mood Grandiosity Flight…
Neuropsychiatric Side Effects of Levetiracetam (KEPPRA)
Neuropsychiatric Side Effects of Levetiracetam (KEPPRA) Levetiracetam (KEPPRA) is associated with following three neuropsychiatric adverse events: Somnolence and Fatigue, Coordination difficulties, and Behavioral abnormalities. This…
Role of Melatonin with Antipsychotic Induced Metabolic Effects
Role of Melatonin With Antipsychotic Induced Metabolic Effects The following three randomized, double-blind, parallel-group, placebo-controlled clinical trials evaluated the metabolic effect of melatonin in patients…
Donepezil, Rivastigmine & Galantamine: Use in Renal and Hepatic Impairment.
Donepezil, Rivastigmine & Galantamine: Use in Renal and Hepatic Impairment Donepezil Single doses of donepezil can be safely administered to patients with moderately…
Treatment of Juvenile Myoclonic Epilepsy (JME)
Avoid Triggers:○ Sleep deprivation ○ Alcohol○ Recreational drugs: Stimulants such as cocaine, amphetamines, GHB, and ketamine may exacerbate or trigger seizures and should be…
Clozapine Associated Agranulocytosis Monitoring
Patient with treatment resistant schizophrenia is admitted for fifth time this year secondary to worsening of psychotic symptoms. He is compliant with medications and have…
Skin Rashes with Mood Stabilizers
Skin Rashes with Mood Stabilizers LITHIUM (1) Acne: Onset: first 6 months of treatment. Mechanism: Lithium included increase in circulating neutrophil chemotaxis, stimulating…
Antidepressants and Risk of Bleeding
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . What is the Underlying Mechanism? SSRIs limit uptake of blood…
Treatment Resistant Obsessive-Compulsive Disorder
Treatment Resistant Obsessive-Compulsive Disorder (OCD) is defined as patients who have undergone an adequate trial of SRI (clomipramine or SSRI) and do not respond or…
What Medications Affect Clozapine Levels?
40 year old patient with history of schizophrenia stabilized on clozapine presented with recent worsening of psychotic symptoms. He recently started smoking and initiated treatment…
Billing in Tobacco Use Disorder
Billing in Tobacco Use Disorder As of January 2011, Medicare covers face to face tobacco cessation counseling from a Medicare recognized practitioner (physician, physician assistant,…
Are Antidepressants Safe in Pregnancy?
Are Antidepressants Safe in Pregnancy? Q.1: Is first-trimester use of SSRIs associated with increased risk of birth defects? This study used the data from the Slone…
When will you Initiate Statin Therapy?
52 year old male with history of major depression disorder stable on fluoxetine 20 mg daily. Medical History: diabetes mellitus Labs: LDL-C: 130 mg/dL. Will…
Dasotraline: New DNRI (Dopamine and Norepinephrine Reuptake Inhibitor)
Dasotraline: New DNRI (Dopamine and Norepinephrine Reuptake Inhibitor) Dasotraline: Dasotraline is an investigational medication discovered by Sunovion Pharmaceuticals Inc. and is currently under development…
Subclinical Hypothyroidism: Will you initiate thyroid replacement therapy?
28 year old non pregnant female presents with symptoms of depression. On evaluation her thyroid-stimulating hormone (TSH) level is elevated with normal free thyroxine…
Personality Disorders- Differential Diagnosis
(1) Cluster A Personality Disorders- Differential Diagnosis 1. Paranoid Personality Disorder Paranoid Personality Disorder Delusional disorder and Schizophrenia Reality testing intact Reality testing lost …
Antipsychotics use with Impaired Renal Function
Antipsychotics use with Impaired Renal Function This post will summarize the use of individual antipsychotics in patient’s with impaired renal function. Medications Use in Impaired…
How to Assess Competence to Consent for Treatment
Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course to have access to all important clinically relevant…
Modifiable Predictors of Conversion to Dementia in Mild Cognitive Impairment
Modifiable Predictors of Conversion to Dementia in Mild Cognitive Impairment (MCI) Diabetes: increases the risk of Alzheimer’s dementia in people with amnestic MCI and that…
Vilazodone (VIIBRYD): Four Clinical Facts
Vilazodone (VIIBRYD): Four Clinical Facts Q.1: Does Food Affect Vilazodone Absorption? YES: Vilazodone should be taken with food. In Fasted State: Vilazodone blood concentrations…
Management of hyperprolactinemia: Cabergoline
Cabergoline is preferred over Bromocriptine for its efficacy and favorable side effect profile (less risk of nausea compared to Bromocriptine). This post will summarize…
Psycho-Pharmacologic Management of Autism Spectrum Disorder
Psycho-Pharmacologic Management of Autism Spectrum Disorder Do you all agree with this algorithm. This algorithm is a condensed version of various articles (Please correct me…
Post Stroke Depression: UnderDiagnosed & UnderTreated
Post Stroke Depression: UnderDiagnosed & UnderTreated This Topic is Posted in Following Four Sections: Pathophysiology of Post Stroke Depression. Risk Factors Associated with Post Stroke Depression.…
Hyperammonemia with Valproate- Management
Q: Patient on Valproate found to have high Ammonia level. What will you do next? (1) Is Patient Asymptomatic or Symptomatic (altered consciousness, confusion, nausea,…
Aggression, Emotional and Reward Circuit
Aggression, Emotional and Reward Circuit Q.1: How are Aggression Circuit, Emotional Circuit and Reward Circuit connected? Q.2: Which Mid-Brain Structure and Hypothalamus part (medial…
SSRI (Selective Serotonin Reuptake Inhibitors): Important Facts to Know
SSRI (Selective Serotonin Reuptake Inhibitors): Important Facts to Know (1) Do SSRIs have Active Metabolites? Fluoxetine (Norfluoxetine with half life of 7–14 days). Note: R-norfluoxetine is…
10 Facts Regarding Personality Disorders
10 Facts Regarding Personality Disorders (1) Personality disorders in cluster B are said to combine abnormalities in both thinking and affect, but not to be…
Bupropion: 10 Clinical Facts
Bupropion: 10 Clinical Facts <h4><strong>Clinical Fact #1:</strong></h4> Bupropion is least likely to precipitate mania of all antidepressants in patient with bipolar disorder. Reference: N Engl…
Reasons for Clozapine Discontinuation and No Rechallange
Reasons for Clozapine Discontinuation and No Rechallange CARDIAC SIDE EFFECTS QTc > 500 msec —> Discontinue Clozapine. Myocarditis (Increased Heart Rate, ST elevation, Troponins >2…
Anti-Inflammatory Treatment: Effect on Depression and Adverse Effects.
JAMA psychiatry published this systematic review and meta-analysis of randomized clinical trials done by Ole Kohler and colleagues in 2014. According to author, this…
Q: How Does Muscuranic Cholinergic Receptor Blockade Reduces EPS Caused by Conventional Antipsychotics?
Q: How Does Muscuranic Cholinergic Receptor Blockade Reduces EPS Caused by Conventional Antipsychotics? Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin)…
Second-Generation Antidepressants: Which one is better? Comparing Benefits & Harms.
Second-Generation Antidepressants: Which one is better? Comparing Benefits & Harms. Two important studies have reviewed the comparative efficacy of second generation antidepressants, but their…
Q: Is Quetiapine 600 mg Superior to 300 mg for Bipolar I and II Depression?
The following two double blind randomized trails will answer this question. ARTICLE 1: This randomized, double-blind, placebo-controlled trial published by Calabrese et al…
Q&A Series: (Q.3) Can you Name this Medication?
Q&A SERIES: (Q.3): Can you Name this Medication with following Mechanism of Action on Serotonin Receptors and Serotonin Transporter? Answer: Vortioxetine. Please do post your…
Diagnosing Serotonin Syndrome
This research article published in BMC Neurology tested the validity of following four hypothesis that have become widely accepted:- The Hunter classification performs clinically better than Sternbach…
Serotonin Pathway: Medications Mechanism of Action
Serotonin Pathway: Medications Mechanism of Action A: Tryptophan Hydroxylase Inhibitors: p-Chlorophenylalanine B:5 Hydroxy-Tryptaphan Decarboxylase Inhibitors: Alpha Methyl 5-HT C:Mono Amine Oxidase Inhibitors (MAOI): Tranylcypromine, Pargyline…
Association of Antipsychotics with QTc Prolongation and Torsades de Pointes
Association of Antipsychotics with QTc Prolongation and Torsades de Pointes 45 year old male with with history of schizophrenia is admitted with worsening of…
Lithium and Renal Failure: Role of Corrected Creatinine Clearance
Lithium and Renal Failure:Role of Corrected Creatinine Clearance Lithium can affect renal function in several ways:– The most common complication of chronic lithium therapy…
Hydroxyzine: Important Eight Recommendations by European Medicines Agency
Hydroxyzine: Important Eight Recommendations by European Medicines Agency (1) Hydroxyzine has the potential to block hERG channels and other types of cardiac channels, resulting…
Q&A Series: (Q.2)
Q&A SERIES: (Q.2:) Which of the following antidepressant have Level 1 evidence for treating depression during Hepatitis C treatment? Paroxetine Citalopram Escitalopram…
Brain Structure and Function Abnormalities in Major Depression Disorder
Brain Structure and Function Abnormalities in Major Depression Disorder (1) Reduced Functioning of Preforntal Cortex (primarily dorsolateral prefrontal cortex and striatum). The knowledge gained from…
Hyperprolactinemia during Antipsychotics Treatment Increases the Coagulation Markers.
Hyperprolactinemia during Antipsychotics Treatment Increases the Coagulation Markers. Participants: 182 patients with schizophrenia (male =89, female =93) who received antipsychotic treatments for at least…
Antipsychotics of Choice in Breast Cancer
Antipsychotics of Choice in Breast Cancer Special consideration is required when prescribing antipsychotic drugs for patients with an existing diagnosis of breast cancer. In…
Which Antipsychotic is Least Likely to Exacerbate OCD symptoms in “Schizo-Obsessive” Disorder?
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . There is growing evidence that patients with comorbid obsessive–compulsive disorder (OCD)…
Converting Antipsychotics: Oral to Long-Acting Injectables
CONVERTING ANTIPSYCHOTICS: ORAL TO LONG-ACTING INJECTABLES (1) Fluphenazine (Prolixin®) PO to Fluphenazine Decanoate: METHOD 1: 10mg PO = 12.5mg IM 1.25 X PO daily dose…
Treatment Options of Sexually Inappropriate Behavior in Dementia
Treatment Options of Sexually Inappropriate Behavior in Dementia 1. The most common individual treatment choices were Haloperidol (15%), Thioridazine (11%), and Risperidone (10%). Antipsychotics are commonly used for…
Comparing Atypical Antipsychotics
Comparing Atypical Antipsychotics: Schizophrenia, Bipolar Disorder, Depression, Dementia and Developmental Disorders (A) Schizophrenia Clozapine is superior to Olanzapine in preventing suicide attempts and worsening suicidal…
Hippocampal Formation changes in Schizophrenia
Hippocampal Formation changes in Schizophrenia. Reduced glutamatergic transmission in the dentate gyrus is the basis for “reduced pattern separation” function in schizophrenia and,…
Mechanism of Action of Medications Approved for Weight Loss
Mechanism of Action of Medications Approved for Weight Loss (1) Lorcaserin Stimulates 5HT2C receptor —> stimulates POMC neuron —-> releases alpha MSH —>…
Role of Endogenous Opioids in Depression
Role of Endogenous Opioids in Depression The roles of opioid receptors in pain and addiction is well known, but their function in mood…
What Features Differentiates Bipolar Depression from MDD?
Q: What Features Differentiates Bipolar Depression from MDD? Bipolar depression is characterized by significantly higher rates of: Psychomotor retardation Difficulty thinking Early morning awakening, morning worsening Psychotic…
Antidepressants in Dialysis Patients- Part 1
Antidepressants in Dialysis Patients- Part 1 Part 1 will focus on SSRIs, SNRIs, NDRIs, NaSSAs, NRI & Serotonin Modulators. 1. SSRIs (Selective Serotonin…
Q&A Series: (Q.1)
? Q&A SERIES (Q.1) 43 year old male with history of major depression disorder is referred to you by his primary care…
Bupropion and Risk of Seizures
What is the Incidence of seizure risk with Buproprion? With the IR formulation, the rate is 0.4% (4/1000) at doses of 300 to 450…
Schizophrenia Treatment: During Pregnancy & Postpartum
Schizophrenia Treatment: During Pregnancy & Postpartum (1) ANTIPSYCHOTICS Typical Antipsychotics (a) Teratogenesis: No increase in teratogenesis in women taking thioridizine, fluphenazine, perphenazine, chlorpromazine, promethazine,…
Clinical Summary of First-Line Psychiatric Treatment Recommendations for HIV/AIDS Patients
Clinical Summary of First-Line Psychiatric Treatment Recommendations for HIV/AIDS Patients Treatment of Depression * Initial antidepressant choice —> Citalopram/escitalopram* If no benefit —> switch…
Serotonin States and Social Anxiety
Serotonin States and Social Anxiety Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course to have access…
FDA Approved Low Dose ZUBSOLV® for Opioid Dependence
FDA Approved Low Dose ZUBSOLV® (Buprenorphine and Naloxone) for Opioid Dependence Treatment Contents: 0.7 mg of buprenorphine and 0.18 mg of naloxone. Available Dose Strengths…
Bipolar Disorder Type II vs Borderline Personality Disorder
Bipolar Disorder Type II vs Borderline Personality Disorder Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course…
Antipsychotic Medications and the Risk of Seizures
Antipsychotic Medications and the Risk of Seizures This study did a nested case-control analysis to investigate the association between antipsychotic drug use and the development…
The Effect of Antipsychotic Treatment on Cortical Gray Matter Changes in Schizophrenia: Does the Class Matter?
Copyright © Psychiatry Education Forum Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course to have…
Neuroleptic Malignant Syndrome Vs Serotonin Syndrome
Copyright © Psychiatry Education Forum Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in our online course to have access…
Alcohol Withdrawal: Medications Comparison
Alcohol Withdrawal: Medications Comparison Chlordiazepoxide Diazepam Lorazepam Oxazepam Onset of Action Oral: ~30 min Oral (Rapid) and IV (Immediate) Oral (60 min) and IV (~20 min)…
Association of Hormonal Contraception With Depression
Association of Hormonal Contraception With Depression JAMA Psychiatry published this nationwide prospective cohort study online on September 28, 2016. Study Design: All…
Drug Interaction: Linezolid & Psychiatric Medications
Drug Interaction: Linezolid and Psychiatric Medications The antibacterial drug Linezolid (Zyvox®) is known to cause serious neurological adverse reactions (serotonin syndrome) when administered with certain psychiatric medications.…
Basal Ganglia Pathways & Pathology
Basal Ganglia Pathways & Pathology Copyright © Psychiatry Education Forum Please do post your questions or comments below. Dr. Harvinder Singh, M.D. (Admin) Enroll in…
Evidence Based Guidelines Bipolar Disorder Treatment
Evidence Based Guidelines for Bipolar Disorder Treatment: Revised Third Edition Recommendations From the British Association for Psychopharmacology (A) ACUTE MANIC EPISODES (1) Patient NOT on…
Medications for Alcohol Use Disorder Treatment
Medications for Alcohol Use Disorder Treatment NALTREXONE ACAMPROSATE DISULFIRAM MECHANISM OF ACTION Blocks mu opioid receptors, which reduces reinforcing effects of alcohol with resultant decreased feelings…
How are Venlafaxine and Duloxetine Different?
SNRIs: Venlafaxine vs Duloxetine Copyright © Psychiatry Education Forum Dr. Harvinder Singh, M.D. (Admin & Course Instructor) Subscribe to Physician’s Guide for Clinical Psychiatry Course for…
SSRIs and Risk of Abnormal Bleeding
SSRIs and Risk of Abnormal Bleeding What is the Underlying Mechanism? SSRIs limit uptake of blood serotonin by platelets. Since platelets are unable…
Supportive Psychotherapy- High Yield Facts
Supportive Psychotherapy- High Yield Facts Praise: – If therapist expresses praise for something that patient cannot feel good about, therapist’s words will be ineffective…
Switching Dose from Oral Risperidone to Risperidone Long-Acting Injection
Switching Dose from Oral Risperidone to Risperidone Long-Acting Injection Oral Risperidone Dose = Risperidone Long-Acting Injection 3 mg/day or less = 25 mg > 3 mg/day-…
Identifying Dementia Patient at Risk of Unsafe Driving
For patients with dementia, consider the following characteristics useful for identifying patients at increased risk for unsafe driving (Strength of evidence: A, B &C-…
NeuroAnatomical Location of Depression Symptoms
NeuroAnatomical Location of Depression Symptoms Amygdala and Prefrontal cortex: Guilt, Suicidality and Worthlessness. Nucleus accumbens: Pleasure, Interest, and Energy. Hypothalamus: Sleep and Appetite. Functional…
L-Methylfolate: Who Will benefit
Q: Which Patients with Depression are Candidate for L-Methylfolate Treatment? 1. Low levels of folate and its active metabolites such as L-methylfolate. Documented low levels…
Evidence-Based Guideline: Treatment of Tardive Syndromes
Evidence-Based Guideline: Treatment of Tardive Syndromes Objective: To make evidence-based recommendations regarding management of tardive syndromes (TDS), including tardive dyskinesias (TDD), by addressing 5 questions:…
Lithium: Refresh Your Basics
Lithium: Refresh Your Basics 1. Does food alters the absorption and side effects of Lithium? Risk of diarrhea when Lithium is given…