As we approach the end of 2022, I want to wish you all a safe and Happy New Year. Hope this new year makes all your dreams come true, and your wishes be fulfilled. Happy new year to all my dear students.
On this last week of 2022, let’s review our top 10 viewed posts of this year:
Psychiatry Education Forum Academy’s Updates
(1) Auvelity: New Oral Fast Acting FDA Approved Antidepressant
On Aug 19, 2022 Axsome Therapeutics announced the FDA Approval of Auvelity, as the first and Only Oral NMDA Receptor Antagonist for the treatment of Major Depressive Disorder in adults.
This topic will discuss this newly approved antidepressant in the following sections:
- Mechanism of Action
- How to Dose?
- Use in Special Population
- Common Adverse Reactions
- Warning & Precautions
- Drug Interactions
- Clinical Facts
- Onset of Action?
(2) 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 dosings in 24 hour period: due to short half life of 2-3 hours with duration of action of 6-10 hours.
- Effect wearing off during later part of night due to short duration of action.
- Increased risk of hypotension.
If patient is not tolerating prazosin, you can consider doxazosin as an alternative medication to target intrusive nightmares symptoms of PTSD.
Child & Adolescent Psychiatry
(3) Autism Spectrum Disorder: Agitation, Irritability & Sensory Sensitivity Management
Research has indicated that aggression rates may be higher in individuals with Autism Spectrum Disorder (ASD) compared to those with other developmental disabilities.
We have summarized the list of medications for both aggression & irritability management in ASD and rated them from high to low benefit rating based on The National Survey on Treatment Effectiveness for Autism.
(4) Comparing Long-Acting Methylphenidate: Concerta vs Jornay PM vs Adhansia XR
This chapter will compare these medications in the following sections:
- FDA-approved age group.
- Timing of administration.
- How are the onset and duration of action different for each medication, in terms of time to reach the peak concentration?
- Is Adhsnasia XR any different than Concerta?
- Which medications can be opened and sprinkled on food?
- Dosing titration schedule for Jornay PM and Adhansia XR.
- Dose conversion among methylphenidate preparation.
(5) How to Evaluate Six Neurocognitive Domains in Dementia?
It is important to have knowledge of these six neuro-cognitive domains for the evaluation & diagnosis of dementia subtypes, and this discussion series is divided into the following six sections
- Complex Attention
- Executive Function
- Memory & Learning
- Social Cognition
Insomnia & Related Disorders
(6) Can Suvorexant help with Chronic Insomnia?
Although CBT-I is the first line treatment for chronic insomnia, it is clinically relevant to have the knowledge of recommended medications for various types of insomnia.
Psychiatry Education Forum Academy has summarized the most recent practice guidelines released by the American Academy of Sleep Medicine for the pharmacological management options for chronic insomnia in adults:
Women’s Mental Health
(7) Lamotrigine Dosing in Pregnancy & Postpartum
A 28-year-old female with a diagnosis of bipolar disorder is stable on lamotrigine 150 mg daily dose. She recently found out that she is pregnant. After a detailed risk and benefit discussion, she has agreed with a plan of continuation of lamotrigine during pregnancy. Which of the following lamotrigine dosing strategy will be needed in her pregnancy?
Feeding & Eating Disorders
(8) Binge Eating Disorder
Lifetime prevalence estimates of DSM-IV anorexia nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and .3% .5%, and 2.0% among men (1). Binge eating disorder is most prevalent eating disorder and hence is important have the knowledge on how to diagnose & treat this condition.
Psychotherapy is considered the first line treatment for binge eating disorder, and pharmacotherapy should be considered as an add-on to psychotherapy.
Psychiatry education forum academy will discuss the diagnosis & treatment of binge eating disorder in the following two chapters.
(9) Can NAC help with Cannabis Use Disorder?
There is clearly a need for an effective treatment for cannabis use disorder.
Psychological treatments are first-line and a combination of cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), and contingency management (CM) has the best evidence base.
These psychosocial treatments have less than optimal responses and will need an augmentation with pharmacological treatment, but none is FDA approved at this time.
To date, the most promising medication for the treatment of cannabis use disorders is N-acetylcysteine (NAC).
(10) OCD Psychopharmacology Algorithm: 3 Days Lecture Series
OCD is a chronic neuropsychiatric disorder that can cause significant psychosocial impairment. Delayed treatment of OCD is associated with poor outcomes but early & effective treatment can improve the quality of life. For this reason, the following 3 days lecture series by Dr. David Osser is of high clinical relevance to every medical professional taking care of patients with OCD.
INTERESTED IN LEARNING MORE?
JOIN PSYCHIATRY EDUCATION FORUM ACADEMY MEMBERSHIP
This is a closed membership for medical professionals only.
- 30+ Courses/Sections: Each chapter within these sections is of direct clinical relevance for your daily practice.
- Journal Club: we will post the most recently published psychiatry articles relevant to your daily clinical practice.
- Coffee Club: contain short discussions with clinical experts in the field of psychiatry.
- Clinical Case Discussions: Discussions of clinical cases from our daily clinical practice.
- Discussion Forum & Community: Connect with other medical professionals and discuss your difficult-to-treat clinical cases.
- Essentials of Inpatient Psychiatry Book: All chapters from this book are included in the academy sections.
- Goal: is to have all important clinically relevant topics in one place for ease of access.