Psychopharmacology and Psychiatry Updates

In this episode, we explore how to choose between methadone, buprenorphine, and naltrexone for opioid use disorder treatment. With over 100,000 overdose deaths annually, how do we match the right medication to save each patient's life? Faculty: Smita Das, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Pharmacologic Management of Opioid Use Disorder Tailored Patient Assessment: A Key to Effective OUD Treatment  

In this episode, we explore buprenorphine management for opioid use disorder, covering induction protocols, dosing strategies, and long-term maintenance. Why do patients need to be in withdrawal before starting this life-saving medication, and how can we make this challenging process more manageable? Faculty: Smita Das, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Pharmacologic Management of Opioid Use Disorder Buprenorphine for Managing OUD

Dr. Paul Zarkowski, a leading expert in psychopharmacology, dives into the intriguing relationship between valproate dosage and weight gain. He discusses groundbreaking research suggesting that lower doses might preserve therapeutic effects while reducing this common side effect. The conversation emphasizes the importance of early weight monitoring in treatment and how individual patient factors like gender and BMI play a crucial role. This fresh perspective could revolutionize prescribing practices for those using valproate.

In this episode, we explore methadone maintenance therapy for opioid use disorder, covering dosing strategies, recent regulatory changes, and safety considerations. Why do so many patients fail on methadone despite its proven effectiveness, and how can proper dosing make the difference between recovery and relapse? Faculty: Smita Das, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: Pharmacologic Management of Opioid Use Disorder Methadone for Managing OUD

Oliver Freudenreich, a psychiatrist from Boston, dives into the complex relationship between clozapine and obsessive-compulsive symptoms in schizophrenia. He discusses recent research highlighting whether clozapine triggers OCD or if there are deeper psychological mechanisms involved. The conversation covers the prevalence of OCD-like symptoms in clozapine users, the distinction between psychosis and compulsive behaviors, and tailored treatment strategies for improving patient outcomes. With engaging case studies, the episode unpacks the challenges of managing these intertwined symptoms.

This discussion delves into the rising concern of alcohol use disorder in the U.S. Both naltrexone and topiramate are examined for their roles in treatment, revealing intriguing findings that suggest they might be equally effective. Genetic factors are considered for personalized recovery strategies. With topiramate emerging as a promising option, listeners explore whether it could serve as an effective alternative to the FDA-approved medication. The implications for patient care and individualized treatment decisions are emphasized throughout.

In this engaging discussion, Alexis Ritvo, a board-certified addiction psychiatrist and fellowship program director, dives into the complexities of benzodiazepine discontinuation. She highlights the cognitive and emotional challenges faced during withdrawal, including alarming rates of suicidal ideation. The conversation reveals why many patients seek support from online forums over traditional healthcare and explores alternative therapies and peer support as vital components in recovery. Listeners gain insightful strategies for providing empathetic care and informed consent in discontinuation processes.

Oliver Freudenreich, a seasoned psychiatrist from Boston specializing in clozapine, shares vital insights on the lesser-known, yet dangerous side effects of this antipsychotic. He highlights the risks of bowel obstruction and pneumonia that often slip under the radar compared to agranulocytosis. Drawing from a landmark Finnish study, Oliver emphasizes the crucial need for vigilant patient monitoring. He also discusses the role of pharmacogenetics in managing these risks, advocating for proactive strategies to enhance patient safety.

Alexis Ritvo, a board-certified addiction psychiatrist and fellowship director at the University of Colorado, dives into the complexities of tapering benzodiazepines. She shares evidence-based strategies such as 'cut-and-hold' and 'microtaper' techniques tailored for patient comfort. The discussion emphasizes personalized approaches that enhance safety during withdrawal, alongside the challenges of dosage precision and patient adherence. By highlighting case studies, Ritvo showcases the importance of supportive therapies in navigating benzodiazepine deprescribing.

In this episode, we explore lithium's surprising positive effect on bone mineral density in patients with bipolar disorder. Could the medication many psychiatrists use as a mood stabilizer also be protecting patients from osteoporosis? Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 68 Can Lithium Protect Against Osteoporosis?