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…
Category: Psycho-Pharmacology
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…
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…
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,…
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…
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…
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…
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…
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…
[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…
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 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…
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…
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…
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.…
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…
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…
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…
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…
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…
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…
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…
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…
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)…
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…
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…
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…
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…
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…
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…
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…
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? …
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:…
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=””…
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”…
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…
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…
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.…
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)…
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…
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…
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
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.
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.
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.…
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…
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…
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. ↓…
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: 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)…
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…
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…
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…
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…
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…
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…
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…
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…
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…
Hyperprolactinemia (Part 2/3): Antidepressants
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . SERTRALINE: Strongest dopamine reuptake blocker among SSRIs. Literature review found highest…
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Methadone: Drug Interactions
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Antipsychotics and Risk of Bleeding
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Clozapine: Managing Side Effects
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Sertraline: Basic Facts
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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.8: Dementia associated with Parkinson’s Disease
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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
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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…
Tasimelteon: Important Drug Interactions
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(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
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U.S. FDA Approves Mydayis™ (mixed salts of single entity amphetamine product)
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Oral Creatine Augmentation to Enhance SSRI Response in Women With MDD
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FDA Approved INGREZZA™ (Valbenazine)
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Neuropsychiatric Side Effects of Levetiracetam (KEPPRA)
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Donepezil, Rivastigmine & Galantamine: Use in Renal and Hepatic Impairment.
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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…
Antidepressants and Risk of Bleeding
BEFORE SCROLLING DOWN ==> SUBMIT YOUR ANSWERS FIRST 🙂 . . . . What is the Underlying Mechanism? SSRIs limit uptake of blood…
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…
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…
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…
Vilazodone (VIIBRYD): Four Clinical Facts
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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
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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,…
SSRI (Selective Serotonin Reuptake Inhibitors): Important Facts to Know
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Reasons for Clozapine Discontinuation and No Rechallange
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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?
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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…
Hydroxyzine: Important Eight Recommendations by European Medicines Agency
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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
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Comparing Atypical Antipsychotics
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Mechanism of Action of Medications Approved for Weight Loss
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Antidepressants in Dialysis Patients- Part 1
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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…
Clinical Summary of First-Line Psychiatric Treatment Recommendations for HIV/AIDS Patients
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FDA Approved Low Dose ZUBSOLV® for Opioid Dependence
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Antipsychotic Medications and the Risk of Seizures
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Alcohol Withdrawal: Medications Comparison
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Medications for Alcohol Use Disorder Treatment
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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
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Switching Dose from Oral Risperidone to Risperidone Long-Acting Injection
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L-Methylfolate: Who Will benefit
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Lithium: Refresh Your Basics
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