In Part 2 of our Listener Requests series, we will cover a variety of topics that will hopefully be of interest to you, our listeners! The topics included in this series were suggested topics from listeners who e-mailed, tweeted, or gave us feedback on our Facebook page or website. In this episode, we will discuss how to give an oral case presentation, antipsychotic metabolic monitoring guidelines and management, and deprescribing medications.

Photo Credit: Cuba Gallery, “black and white,” flickr

Episode Music Credits: Javier Suárez, Tumbling Dishes, Better With Music

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In the final episode of our second psychopharmacology series, we will discuss how to manage antipsychotic side effects. Side effects are quite common for patients taking antipsychotics unfortunately. Knowing how to manage common antipsychotic side effects is incredibly valuable for your patients as it can improve tolerability and treatment compliance. We’ll provide a broad overview for how to conceptualize the treatment of side effects based on which receptors are targeted by the drug. We’ll discuss general principles for managing side effects and then review how to manage specific side effects including extrapyramidal symptoms, hyperprolactinemia, metabolic syndrome, orthostatic hypotension, and more!

Photo Credit: Hernan Pinera, “Move,” Flickr

Episode Music Credits: Javier Suárez, Tumbling Dishes, Better With Music

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In today’s episode of our psychopharmacology series, we will discuss insomnia and treatments for insomnia. Most of the time, sleep medications are not the solution for addressing insomnia! We’ll briefly describe cognitive behavioral therapy for insomnia (CBT-I), which is THE first line treatment for insomnia.  We will then review 6 different classes of medications used to treat insomnia including benzodiazepines, non-benzodiazepine sedative hypnotics (i.e. Z-drugs), melatonin agonists, TCAs, orexin receptor antagonists, and miscellaneous non-FDA approved medications for insomnia. We’ll discuss the evidence base for these medications in treating chronic insomnia (hint: it’s not good) and what factors might make you choose behavioral treatment versus medications. We’ll then review common side effects of sleep medications and test your clinical reasoning with some cases!

Photo Credit: Joao Santos, “Smooth Antelope Canyon b&w,” Flickr

Episode Music Credits: Javier Suárez, Tumbling Dishes, Better With Music

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In today’s episode, we will discuss benzodiazepines, a commonly used type of sedative-hypnotic medication. We will start by reviewing their mechanism of action, common indications for use, contraindications for use, and side effects. We’ll also discuss how to differentiate benzodiazepines based on their unique pharamacologic properties. Finally, we’ll explore some of the controversy around benzodiazepines, particularly in the treatment of chronic anxiety or insomnia, and provide some general guidelines to consider before prescribing these medications to patients.

Photo Credit: Juan Carlos Molina Gimenez, “Ice and Geometry,” Flickr

Episode Music Credits: Javier Suárez, Tumbling Dishes, Better With Music

The Rolling Stones, “Mother’s Little Helper,” Forty Licks

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We are revisiting psychopharmacology in our second psychopharm series. We will kick things off by talking about the “older antidepressants”- tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). While these medications are used less frequently than SSRIs due to their side effect profiles, both TCAs and MAOIs have their select uses in psychiatry (i.e. treatment resistant depression or comorbid pain). We’ll discuss the history behind TCAs and MAOIs, their respective mechanisms of action, common class side effects, and specific medications within each class. We’ll also review unique considerations with MAOIs (including dietary restrictions, hypertensive crisis, and serotonin syndrome) and TCAs (including cardiac toxicity in overdose).

Photo Credit: CiaoHo, “DSC_4598,” Flickr

Episode Music Credits: Javier Suárez, Tumbling Dishes, Better With Music

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In the final episode of our psychopharmacology basics series, we are going to discuss commonly used mood stabilizers including lithium, valproic acid, lamotrigine, carbamazepine, and oxcarbazepine. What conditions are they used for? How do they work? What are their side effect profiles? How do we dose and monitor them? And what’s up with all these levels? We’ll explore all of this and then test your knowledge with some review questions.

Photo credit: mtstradling, “storage tank II,” Flickr

Episode Music Credit: Javier Suárez, Tumbling Dishes, Better With Music

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Get ready to learn about the essentials of antipsychotics! In the first part of our introduction to antipsychotics, we are going to talk broadly about uses for antipsychotics, how they work, and common side effects. We’ll then discuss unique characteristics of specific medications within the typical class of antipsychotics.

Photo Credit: Olivier Chateau, “Hasselblad Xpan,” Flickr

Episode Music Credit: Javier Suárez, Tumbling Dishes, Better With Music

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Get for ready for some fun psychopharm basics! In this episode, we will discuss commonly used antidepressants including SSRIs, SNRIs, and atypical antidepressants. We’ll review general indications, side effects, and clinical circumstances which might cause you to favor one antidepressant over another. Finally, we’ll help you to solidify your knowledge with some clinical cases. 

Photo Credit: Thomas Hawk, “Sometimes Memories Fade,” Flickr

Episode Music Credit: Javier Suárez, Tumbling Dishes, Better With Music

Podcast: Play in new window | Download