Psychopharmacology and Psychiatry Updates

In this episode, we explore the latest research on antidepressant discontinuation symptoms, revealing that about 14% of patients experience these effects when stopping medication. Which antidepressants are most likely to cause these "brain zaps" and other withdrawal symptoms? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CME: Quick Take Vol. 67 Which Antidepressants Have the Highest Risk of Discontinuation Symptoms?

In this engaging discussion, Alexis Ritvo, a board-certified addiction psychiatrist and fellowship program director, sheds light on the intricate world of benzodiazepines. The conversation emphasizes the unique addiction risks associated with alprazolam compared to other options. Ritvo highlights evidence-based practices for selecting the right medication, stressing the importance of informed decisions for patient safety. They explore benzodiazepines' appropriate uses, including managing anxiety and withdrawal, while navigating the complexities of treatment selection.

In this episode, we explore the evidence behind Transcranial Magnetic Stimulation (TMS) for depression, from early clinical trials to real-world effectiveness. What makes some patients respond better to TMS than others? We discuss response rates, treatment protocols, and the exciting development of faster treatment options. Faculty: Simon Kung, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: TMS in Psychiatry: Innovations and Best Practices Exploring the Evidence of TMS for Depression

In this episode, we explore the crucial aspects of patient selection for Transcranial Magnetic Stimulation (TMS) in treating depression. We discuss insurance criteria, contraindications, and practical considerations. Did you know that while TMS was FDA-approved in 2008, it wasn't widely accessible until Medicare began covering it in 2014? Faculty: Simon Kung, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1 CME: TMS in Psychiatry: Innovations and Best Practices Optimizing Patient Selection for TMS Treatment

Oliver Freudenreich, a psychiatrist from Massachusetts General Hospital and Harvard Medical School, delves into groundbreaking Finnish research that tracked 62,000 clozapine patients over 22 years. He discusses the rare side effect agranulocytosis, its long-term risks, and what this means for clozapine prescribing practices. Freudenreich compares clozapine to other antipsychotics, revealing its benefits and mortality rate advantages. The conversation highlights the urgent need for enhanced monitoring and better patient communication in mental health treatment.

Transcranial Magnetic Stimulation (TMS) is gaining attention as a treatment for Obsessive-Compulsive Disorder (OCD). Discover how FDA-approved devices are tailored specifically for OCD and the unique protocols that require anxiety triggers before each session. Learn about the different brain regions targeted by TMS for OCD compared to depression. The discussion also emphasizes the importance of combining TMS with psychotherapy to maximize treatment effectiveness. Patient outcomes are highlighted, showcasing the potential of TMS as a groundbreaking therapy.

Scott Beach, an expert in Alzheimer's disease treatment, shares insights on donanemab, a pioneering monoclonal antibody designed to combat Alzheimer's. The discussion delves into the TRAILBLAZER-ALZ 2 trial and its promising results in reducing beta-amyloid plaques. Beach emphasizes the innovative treatment duration protocol and the potential safety concerns involved. Could this novel approach change the landscape of Alzheimer's management? Tune in for an exploration of personalized treatment strategies and what the future holds for patients.

Scott Beach, a psychopharmacology expert, shares insights from a groundbreaking Danish registry study on long-term benzodiazepine use. The findings challenge the belief that patients inevitably escalate dosages over time, revealing that many users decrease their doses instead. Beach discusses the implications for vulnerable populations, particularly in palliative care, where deprescribing is critical. He advocates for a patient-centric approach to treatment, emphasizing the need for personalized prescribing practices and ongoing education to reshape current guidelines.

This discussion delves into the side effects and safety profile of Transcranial Magnetic Stimulation (TMS) therapy. Surprisingly, fewer than 2% of patients stop treatment due to discomfort! The conversation covers common side effects, including headaches and muscle twitching, and factors that influence patient tolerance. Ongoing research into TMS's cognitive benefits is highlighted, along with comparisons to traditional electroconvulsive therapy (ECT). Insightful management strategies for side effects are also shared, addressing patient concerns effectively.

Scott Beach, M.D., a leading expert in pharmacology, dives into a significant 23-year study examining the interplay between SSRIs and oral anticoagulants. He discusses the startling 33% increased risk of major bleeding events observed in patients with atrial fibrillation using both treatments. The conversation also highlights critical strategies for safe prescribing and monitoring, particularly during the initial treatment phase. Beach emphasizes the need for personalized approaches to mitigate risks, including potential medication adjustments and diligent oversight.