The Carlat Psychiatry Podcast Top 10 Findings: Lithium, Lumateperone, and Lavender
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Oct 21, 2024 Recent research reshapes our understanding of lithium, suggesting it may not cause weight gain and could even aid in weight loss. Discover the promising role of lumateperone in treating major depression, especially for patients unresponsive to standard treatments. The effectiveness of lavender extract, Silexan, is also explored for anxiety relief. Additionally, a comparison of S-ketamine and quetiapine XR sheds light on options for treatment-resistant depression. These insights could change clinical practices in managing mood disorders.
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Lumateperone vs Lorazodone Effects
- Lumateperone and lorazodone have similar effect sizes for bipolar depression but differ in side effects.
- Lumateperone causes more fatigue and dizziness; lorazodone causes more akathisia and nausea and is generic.
Antidepressant Augmentation Tips
- Add lumateperone 42 mg at night for antidepressant augmentation, starting lower to improve tolerability.
- Use aripiprazole 5 mg as first-line augment, then consider higher doses if needed, watching for side effects.
Aripiprazole Dosing Guidance
- Start aripiprazole at low doses (2-5 mg) to avoid akathisia, increase to at least 5 mg for most patients.
- Avoid staying at higher doses unless clear improvement is seen due to side effects risk.