Clinical Psychiatry

PTSD

Psychopharmacology PTSD Algorithm Part 2: Treatment Resistance

13-summary-and-final-conclusions

Outline:

  • Assessment and Management of Non-Sleep Symptoms: Using SSRIs
  • Management of Psychotic Symptoms in PTSD
  • Management of Non-Response to Initial SSRI Trial
  • Management of Non-Response to Two SSRI Trials
  • Augmentation Strategies: Adding a Second Drug

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PTSD Pharmacotherapy Algorithm Part 1: Assessment and Management of Sleep Symptoms

psychopharmacology-ptsd-algorithm-part-1-assessment-and-mOutline:

  • Introduction
  • Differential diagnosis of PTSD: the importance of comorbidities
  • Sleep assessment in PTSD: Is sleep disturbed? (node 2)
  • Prazosin for nightmares and disturbed sleep (node 2a)
  • Trazodone for disturbed sleep initiation (node 2b)
  • Other options for improving sleep latency in PTSD
  • Undesirable initial choices for sleep management in PTSD

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Geriatric Psychiatry

Effective Management of Behavioral and Psychological Symptoms of Dementia (BPSD)

05-evidence-of-efficacy-a

Outline:

  • Evidence of efficacy for non-pharmacological and pharmacological interventions in BPSD
    • Non-pharmacological management, antipsychotics, antidepressants
    • Mood stabilizers, AChEIs, memantine and benzodiazepines
  • A simplified algorithm for the management of BPSD
  • Summary of the latest APA recommendations on the use of antipsychotics to treat agitation or psychosis in patients with dementia

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How to Assess Behavioral and Psychological Symptoms of Dementia (BPSD)

01- Introduction

Outline:

  • Prevalence of BPSD
  • Neurobiology
  • Assessment
  • Suggested algorithm

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Substance Use Disorders

Opioid Use Disorder Part 2: Using Buprenorphine and Naloxone

Outline:

  • Introduction – Buprenorphine
  • Buprenorphine for outpatient treatment
    • Mechanism of action: rationale for therapeutic use
    • Formulations
  • Buprenorphine in non-specialty settings
  • Naloxone for overdose prevention

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Opioid Use Disorder Part 1: Epidemiology Update and Diagnosis

Outline:

  • Epidemiology update: How did we get here?
  • What is an opioid use disorder?
    • Nomenclature: opiates vs opioids
    • From opium to heroin
  • Diagnosis: How to recognize an opioid use disorder

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The Neurobiology of Addiction: An Overview

Diapositiva7

Outline:

  • Introduction to the neurobiology of addiction
  • The reward system: its role in associative learning and craving
  • Changes in motivation and the concept of the “antireward” system
  • The role of the prefrontal cortex in addiction

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Psychopharmacology in Pregnancy

Summary: Mood Stabilizers and SGAs Use During Pregnancy

Summary

This document is a summary of two tutorials:

It compares adverse effects for each drug and summarizes key practical points.

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Prescribing Anticonvulsants and Second-Generation Antipsychotics During Pregnancy

SGAs

Outline:

  • Introduction: considerations in bipolar disorder treatment
  • Lithium use in pregnancy
    • Risks of teratogenicity
    • Risks of neonatal toxicity and developmental abnormalities
    • Monitoring and dose adjustment

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Mood Stabilizers in Pregnancy: Introduction and Lithium Use

Mood Stabilizers in Pregnancy Introduction and Lithium Use

Outline:

  • Introduction: considerations in bipolar disorder treatment
  • Lithium use in pregnancy
    • Risks of teratogenicity
    • Risks of neonatal toxicity and developmental abnormalities
    • Monitoring and dose adjustment

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Using Antidepressants in Pregnancy: Balancing Risks vs Benefits

Using Antidepressants in Pregnancy Bala

Outline:

  • Introduction: Risks and Benefits of Antidepressants in Pregnancy
  • Practical Recommendations
  • Summary of Fetal Risks
  • Update on the Risk of Fetal Malformations
  • Update on the Risk of PPHN

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Drug-Drug Interactions

Essential Drug-Drug Interactions in Psychiatric Practice: Antidepressants and Benzodiazepines

Essential Drug-Drug Interactions in Psychiatric Practice Antidepressants and Benzodiazepines

Outline:

  • CYP2D6 and antidepressants
  • Fluvoxamine
  • New antidepressants: vilazodone, levomilnacipran and vortioxetine
  • Benzodiazepines

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Essential Drug-Drug Interactions in Psychiatric Practice: Antipsychotics and Mood Stabilizers

Drug Metabolism

Outline:

  • Drug metabolism:
    • The importance of phase I and II reactions.
    • Enzyme induction and inhibition
  • Pharmacokinetic drug-drug interactions: antipsychotics and mood stabilizers

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Bipolar Disorder

Practical Guide to Long-Term Pharmacotherapy in Bipolar Disorder: An Updated Synthesis of Current Clinical Guidelines

Guide 2Outline:

  • Before You Read the Evidence: A Warning About “Enriched” Study Designs
  • A Summary of Drugs Used to Prevent Mood Episodes
    • Lithium
    • Lamotrigine
    • Valproate
    • Olanzapine
    • Quetiapine
    • Risperidone LAI
    • Aripiprazole
    • Carbamazepine

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Using Second-Generation Antipsychotics in Bipolar Disorder: A Practical Guide

SGAs guide

Outline:

  • Use in bipolar depression
  • Use in mania and mixed episodes
    • Intramuscular agents used for agitation
    • SGAs approved for use in children and adolescents
  • Use in maintenance treatment

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Bipolar Depression Pharmacotherapy Part 2: Prescribing Antidepressants

Antidepressant use in bipolar disorder

Outline:

  • Recommendations on the use of antidepressants:
    • Acute treatment
    • Maintenance treatment
    • Monotherapy
    • Risk of manic switch
    • Drug classes associated with manic switch

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Bipolar Depression Pharmacotherapy: Part 1

bipolar depression pharmacotherapy

Outline:

  • FDA-approved drugs
    • Second-generation antipsychotics
      • Olanzapine/Fluoxetine Combination
      • Quetiapine
      • Lurasidone
  • Non-approved treatments
    • Lithium
    • Lamotrigine
    • Valproate

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Long-Term Treatment of Bipolar Disorder: Different Phases and the Problem of Non-Adherence

treatment non-adherence in bipolar disorder Outline:

  • Interactive animation: the different treatment phases of bipolar disorder
  • Treatment Non-Adherence: Its Importance and How to Avoid It
    • Extent of the problem
    • Definition
    • Complications
    • Types
    • Factors influencing non-adherence
    • Strategies to increase adherence

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Screening for Bipolar Disorder

bipolar disorder screening

Outline:

  • Why is an accurate diagnosis important?
  • Why do we miss the diagnosis of bipolar disorder?
  • Interviewing challenges
  • Three aspects to consider in a bipolar disorder screening
  • Screening instruments:
    • Mood Disorder Questionnaire
    • Bipolar Spectrum Diagnostic Scale
  • PDF: The MoodCheck

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Bipolar Disorder in DSM-5: Highlights of Changes from DSM-IV-TR to DSM-5

Bipolar disorder concept

Outline:

  • Increased activity was added to Criterion A for bipolar disorder
  • Mixed episode is now a specifier
  • Anxious distress is a new specifier
  • NOS was replaced by: other specified bipolar and related disorder and unspecified bipolar and related disorder
  • Antidepressant-induced mania can be now diagnosed as BD

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The Bipolar Disorder Concept: From Kraepelin to DSM-5

From Kraepelin (3)

This tutorial is a simplified review of the evolution of the bipolar disorder concept.

  • The “manic-depressive insanity” concept (Emil Kraepelin)
  • The unipolar vs bipolar distinction (Karl Leonhard)
  • From manic-depressive illness to bipolar subtypes (DSM-II to DSM-5)

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Critical Appraisal

 

Dr. Erick Turner: How to Read Papers in Psychiatry

Erick-Turner-profile

Dr. Turner is Assistant Professor in the Department of Psychiatry at Oregon Health and Science University (OHSU) in Portland. He has previously held positions at the US Food & Drug Administration and the National Institute of Mental Health.

He is here to help us understand clinical research and to improve our critical appraisal skills. One of his research interests is publication bias, or reporting bias. We’ll learn why this concept is important to interpret the medical literature and understand the limitations of the papers we read.

 Part 1

  • Facts you may not know about FDA’s approval process
    • Current limitations
  • Off-label prescribing
    • How to approach off-label prescribing of old drugs vs. new drugs
  • Types of reporting bias
    • Study publication bias
    • Outcome reporting bias
    • Delayed publication bias
    • Type of paper bias
    • Place of publication bias
    • Multiple publication bias

     

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Part 2

  • Facts you may not know about FDA’s approval process
    • Current limitations
  • Off-label prescribing
    • How to approach off-label prescribing of old drugs vs. new drugs
  • Types of reporting bias

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Insomnia

 

Insomnia Pharmacotherapy: Off-Label Antidepressants and Antipsychotic

Diapositiva6

Off-label agents used for primary insomnia: evidence of efficacy and clinical aspects of antidepressants and second-generation antipsychotics.

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Insomnia Pharmacotherapy: Low-Dose Doxepin and Ramelteon

Diapositiva5Insomnia Pharmacotherapy: Low-Dose Doxepin and Ramelteon

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 Insomnia Pharmacotherapy: Non-Benzodiazepine Hypnotics (Z drugs)

Diapositiva11Non-benzodiazepine hypnotics: zolpidem, zaleplon and eszopiclone. Discussion of ther mechanism of action, indications,available formulations, pharmacokinetics, side effects and dosing.

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Insomnia Pharmacotherapy Part 1: Introduction and Benzodiazepines

Benzodiazepines (14)An introduction to the pharmacotherapy of insomnia. A general approach is presented, followed by the pharmacology of hypnotic benzodiazepines.

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 Assessing Insomnia Effectively

Diapositiva13This video discusses a practical approach to the assessment of insomnia

 

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Neuropsychopharmacology of Sleep: Integrating Neurobiology and Drug Treatment

Diapositiva34This is an integration between the different neurotransmitters that regulate sleep physiology and pharmacological interventions commonly used in clinical practice.

 

 

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ADHD

 

Adult ADHD: Diagnosis and Clinical Features

Diapositiva13This video presents basic concepts regarding ADHD in adults . It is based mostly on DSM-5 criteria.

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Introduction to Drugs for the Treatment of ADHD

Diapositiva11This video discusses the role of the prefrontal cortex in ADHD and the mechanisms of action of amphetamines, methylphenidate, atomoxetine and alpha 2 agonists.

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Stimulants for ADHD: Summary of Formulations

ADHD formulationsThis presentation discusses clinical features of short, intermediate and long acting formulations of methylphenidate and amphetamines.

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 ADHD Pharmacotherapy: Side Effects

 

Diapositiva6This presentation discusses side effects associated with the use of ADHD medications.

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 ADHD Pharmacotherapy: Starting Treatment and Side Effects

Diapositiva5
Two videos discussing how to start drug treatment in ADHD and side effects monitoring.
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Generalized Anxiety Disorder

 

GAD Part 1: Diagnosis and Clinical Features

GADThis video presents basic concepts to diagnose generalized anxiety disorder in clinical practice. Based mostly on DSM V criteria.

Outline:

  • Introduction
  • Epidemiology
  • Diagnosis: DSM V
  • Rating scales
  • Differential diagnosis

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GAD Part 2: Pharmacotherapy

GAD PharmacotherapyThis presentation is based on the latest international guidelines for the treatment of GAD.

Outline:

  • First-line agents
  • Second-line agents
  • Adjunctive therapy
  • Treatment recommendations

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Obsessive-compulsive disorder

 

OCD Part 1: Diagnosis and Clinical Features

Obsessive Compulsive Disorder.pptxThis video presents the basic concepts to diagnose obsessive-compulsive disorder in clinical practice. It is based mostly on DSM V criteria.
Video outline:

    • DSM V criteria for OCD
    • Symptom clusters
    • Diagnostic issues
    • Epidemiology of OCD

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OCD Part 2: Pharmacotherapy of OCD

Pharmacotherapy of OCDThis video presents the basic concepts to treat obsessive-compulsive disorder in clinical practice.
Outline:

  • General concepts on treatment response
  • The use of SSRIs and clomipramine for the treatment of OCD
  • Considerations on the initial treatment plan
  • Introduction to treatment resistance and augmentation

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