Psychopharmacology and Psychiatry Updates

Dive into the cardiac risks associated with lamotrigine usage and the importance of EKG monitoring. Learn why reducing the drug dose might not lower those risks and could lead to psychiatric issues instead. Explore safe prescribing practices, especially for patients with heart conditions, and hear about alternative strategies for managing these complexities. This insightful conversation emphasizes balancing the benefits of medication with potential cardiac effects, ensuring patient safety every step of the way.

Join psychiatrist Oliver Freudenreich, an expert in psychopharmacology from Massachusetts General Hospital, as he sheds light on the complexities of antipsychotic withdrawal. He discusses how psychotic relapse may sometimes be mistaken for withdrawal symptoms. The conversation reveals the common effects of discontinuation, such as insomnia and anxiety, along with risk factors and essential strategies for safe tapering. This insightful dialogue emphasizes the need for careful management and patient communication during this critical transition.

Dive into the cardiac effects of lamotrigine, particularly QTc prolongation and QRS widening. Experts discuss the FDA's concerns and the actual evidence behind them. Learn how lamotrigine's cardiac safety profile holds up under scrutiny and what it means for clinical practice. Discover insights on monitoring high-risk patients and the comparative risks with tricyclic antidepressants. This enlightening discussion equips healthcare professionals with the knowledge to counsel patients effectively.

In this episode, we examine a groundbreaking Danish study that challenges the conventional belief that sedative medications increase fall risk in older adults. Could untreated insomnia, rather than the medications used to treat it, be the real culprit behind falls in elderly patients? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CME: Quick Take Vol. 64 Insomnia in the Elderly: Do Sedatives Increase or Decrease Fall Risk?

In this episode, we explore lamotrigine's side effects and special considerations, particularly focusing on identifying dangerous skin reactions, pregnancy considerations, and overdose risks. Did you know that Asian populations may require special genetic screening before starting lamotrigine due to increased skin reaction risks? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 0.5 CME: Lamotrigine: From Current Indications to Cardiac Side Effects Lamotrigine: Side Effects and Special Considerations

In this episode, we explore the efficacy and safety of iloperidone in treating bipolar disorder, examining new phase 3 trial data that reveals both promising results for mania symptoms and important considerations about side effects. Can this antipsychotic's favorable EPS profile outweigh its metabolic risks? Faculty: Paul Zarkowski, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.75 CMEs: Quick Take Vol. 63 Iloperidone: A Potential Treatment Option for Bipolar Mania

Discover the ins and outs of prescribing lamotrigine, especially its surprising interaction with birth control pills that can halve its effectiveness in just a week. Learn about its mechanisms, including sodium channel blockade, and the importance of a careful titration schedule. The conversation also dives into how estrogen affects lamotrigine levels and necessary dosage adjustments during pregnancy. Equip yourself with essential knowledge for safe prescribing practices while managing bipolar disorder!

In this episode, we explore the pharmacological management of agitation in emergency settings, focusing on benzodiazepines and the novel medication dexmedetomidine. Did you know there's now a sublingual option that works through an entirely different mechanism than traditional anti-agitation medications? Faculty: Scott Zeller, M.D. Host: Richard Seeber, M.D. Learn more about our memberships here Earn 1.25 CME: The Psychopharmacology of Agitation: Managing Behavioral Emergencies The Role of Benzodiazepines and Dexmedetomidine in Managing Agitation

In this engaging discussion, Oliver Freudenreich, a psychopharmacology expert, explores the revolutionary antipsychotic KarXT, which targets the cholinergic system instead of dopamine pathways. He shares insights from promising Phase 3 trial results, indicating KarXT's potential to treat schizophrenia with fewer motor-related side effects. This innovative approach not only showcases the drug's clinical efficacy but also discusses its potential FDA approval and implications for transforming how schizophrenia is managed.

In a thought-provoking discussion, Scott Zeller, Vice President for Acute Psychiatry at Vituity and former president of the American Association for Emergency Psychiatry, challenges traditional views on managing agitation. He emphasizes the importance of involving patients in medication decisions, even in crises. The conversation addresses the stigma of 'chemical restraints' and promotes respectful, patient-centered approaches that prioritize calming strategies. Zeller advocates for innovative methods blending medication with verbal de-escalation to enhance outcomes in emergency settings.