Adult ADHD (November/December)

Date of Issue: 11/01/2019 | Volume: 17 | Number: 11&12

Issue Links:Learning Objectives | Editorial Information

Can ADHD start in adulthood? We take a critical look at this issue, the use of stimulants as cognitive enhancers, and a new natural therapy for ADHD. Plus a guide to light therapy, an antipsychotic patch, the first H3 agonist, and a ranking of 24 medications for generalized anxiety disorder.

In This Issue

Highlights

Highlights From This Issue

Topics: ADHD | Adult ADHD | Micronutrients | Narcolepsy | Schizophrenia

Quick hits on what you’ll find in this issue.

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Clinical Update

Adult-Onset ADHD

Topics: Comorbidity | Diagnosis

“I think I have ADHD” is a common complaint of psychiatric patients. Just about every disorder in the DSM can cause symptoms of ADHD, as can a host of medical problems. In this article we’ll show you how to sort through the possibilities.

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Expert Q&A

Micronutrients in Mental Health

Topics: Alternative treatments | Autism | Autism Spectrum Disorder | Complementary treatments | Dysregulation | Natural Medications | natural treatments | Nutrition

Vitamins like B12 and folate have mental benefits, but what happens when you combine dozens of vitamins and nutrients in a single pill? We were skeptical, but the studies were positive, so we invited Julia Rucklidge to explain how these “micronutrients” work in ADHD, depression, autism, and general mental health.

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Article

Adult ADHD: What Else Could It Be?

Topics: Adult ADHD

In this issue, we tackle one of the vexing problems in outpatient psychiatry: adults who present with ADHD.

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Article

Stimulants as Cognitive Enhancers

Topics: ADHD | Amphetamines | Attention Deficit Hyperactivity Disorder | Cognition | Cosmetic pharmacology | methylphenidate

From the Oval Office to the college dorm, stimulants are often used as performance-enhancing drugs. The ethics of this practice are questionable, but so is the science. New research suggests their pro-cognitive effects are mild at best and come with an unexpected cost on working memory.

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Clinical Update

A Practical Guide to Light Therapy

Topics: Alternative treatments | Bipolar Disorder | Complementary treatments | Depression | Depressive Disorder | Light and Dark Therapy | Light therapy | Lightbox | natural treatments | Seasonal Affective Disorder

Few natural therapies perform well when stacked head-to-head with medication. Light therapy is an exception. When used correctly, it can treat winter and non-winter depression and augment antidepressants. Learn which lightboxes work, how to use them, and a new light therapy protocol for bipolar depression.

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News of Note

Meet the First H3 Antagonist

Topics: Histamine | Narcolepsy | Neurology | News of Note | Pitolisant | Wakix

Pitolisant (Wakix) is now FDA-approved for narcolepsy and is the first histamine H3 agonist released. Though used for a neurologic condition, its novel mechanism has potential psychiatric effects that are worth monitoring.

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News of Note

An Antipsychotic Patch

Topics: Antipsychotic | Asenapine | News of Note | Patch | Saphris | Secuado | Transdermal

Secuado, the first transdermal patch for schizophrenia, is newly approved version of asenapine (aka Saphris). It promises to reduce side effects and enhance adherence. However, it adds a new side effect of its own, and transdermal delivery isn’t clearly better than sublingual, which is how the older Saphris is absorbed.

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Research Update

Pharmacology for GAD: Complex Choices

Topics: Cymbalta | Duloxetine | Effexor | Generalized Anxiety Disorder | Lyrica | Pharmacology | Pregabalin | Research | Research Update | SSRIs | Venlafaxine

A meta-analysis of 25 medications in over 25,000 patients with generalized anxiety disorder. The usual FDA-approved options are there, along with some surprises. Not all are equal, but the most effective of the bunch carries so many side effects that we can only recommend it as a last resort.

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Research Update

Olanzapine for Anorexia Nervosa

Topics: Anorexia Nervosa | Antipsychotics | Eating Disorders | olanzapine | Research | Research Update

A randomized, double- blind, placebo-controlled trial studying the effects of olanzapine on change in body weight and obsessionality in adult outpatients with anorexia nervosa. Although strength of the study includes its large sample size, it is undetermined if patient weight gain is due to a therapeutic effect on anorexia or to olanzapine’s known metabolic effects.

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In Brief

In Brief: Antipsychotic Update

Topics: Dementia | Risperidone

Outdoor activity, massage, and touch therapy ranked most effective for agitation in dementia. Risperidone doesn’t appear to cause fractures.

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CME Post-Test

CME Post-Test - Adult ADHD, TCPR, November/December 2019

Topics: CME Post-Test

The post-test for this issue is available for one year after the publication date to subscribers. By successfully completing the test you will be awarded a certificate for 2 CME credits.

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