The Evidence Base for Polypharmacy in ADHD

Topics: ADHD | aggression | Central Alpha Agonists | Combined Pharmacotherapy | Divalproex | polypharmacy | Risperidone | Stimulants

REVIEW OF: Baker M et al, J Child Adolesc Psychopharmacol 2021;31(3):148–163 TYPE of Study: Literature review Psychotropic polypharmacy is increasingly the norm in clinical practice. We use it to address persistent symptoms or to target comorbid conditions, though we do so at the risk of increased side effects, more drug interactions, and worsened p

Unpacking Aggression Associated with ADHD

Topics: ADHD | aggression | Risperidone | Stimulants | Valproate

CCPR: You recently did a study on stepped treatment for ADHD and aggressive behavior (Blader JC et al, J Am Acad Child Adolesc Psychiatry 2021;60(2):236–251). It is riveting in its relevance to everyday practice. I am thinking of one school-age child who came to me after multiple trials of stimulants and mood stabilizers who was still very impulsively

Medications to Rapidly Treat Psychotic Agitation

Topics: Agitation | Antipsychotics | Aripiprazole | Benzodiazepines | Chlorpromazine | De-escalation | Diphenhydramine | Droperidol | Emergency | Haloperidol | Hydroxyzine | olanzapine | Pharmacotherapy | Promethazine | Psychosis | Quetiapine | Risperidone | Violence | Ziprasidone

If you work in an emergency department (ED) or psychiatric inpatient unit, you’ve encountered agitated and even violent patients. We can help many patients settle down by listening empathically, validating their emotions, and offering oral medications, but even with our best efforts, these interventions do not always work. Medications help reduce agit

Pharmacotherapy for Autism Spectrum Disorder

Topics: Aripiprazole | Autism | Bumetanide | complementary medicine | Lurasidone | Pharmacotherapy | Risperidone | Supplements

CCPR: Welcome, Dr. Krause. Tell us a little bit about the recent paper you coauthored called Pharmacologic Management of Autism Spectrum Disorder: A Review of Seven Studies (Kothadia RJ et al, Current Psychiatry 2021;20(1):33–38). Dr. Krause: Our study was a review of reviews. The aim was to see if we could find any new insights into medication treat

Weight Gain From Aripiprazole Same as Risperidone

Topics: Antipsychotics | Aripiprazole | Autism | Autism Spectrum Disorder | Risperidone | Weight gain

Review of: Schoemakers RJ et al, J Child Adolesc Psychopharm 2019;29(3):192–196 Many providers prefer aripiprazole over risperidone for young patients due to observed lower incidence of weight gain. This is supported in studies with follow-up of less than 3 months. However, does aripiprazole fare better with long-term use? Researchers reviewed r

Antipsychotic Maintenance: How Long is Enough?

Topics: Antidepressant Augmentation | Antidepressants | Antipsychotics | Bipolar Disorder | Deprescribing | Depression | Depressive Disorder | Mania | Metabolic syndrome | Mood Stabilizers | olanzapine | Psychopharmacology | Psychopharmacology Tips | Risperidone | Side Effects | Tardive dyskinesia

Your 58-year-old patient started risperidone to augment lithium 2 years ago. It got her out of a severe mania, and she has stayed well since then. Now she’s worried about long-term risks and wondering if it’s time to come off. Augmentation with an atypical antipsychotic may offer rapid relief from mania and depression, but antipsychotics’ potenti

The Schizophrenia-OCD Overlap

Topics: Antipsychotics | Aripiprazole | Clozapine | Comorbidity | Diagnosis | Lamictal | Lamotrigine | Obsessive Compulsive Disorder | OCD | olanzapine | Pharmacology Tips | polypharmacy | Quetiapine | Risperidone | Schizoaffective disorder | Schizophrenia

TCPR: What is schizo-obsessive disorder?Dr. Poyurovsky: Schizo-obsessive disorder (schizo-OCD) is not a DSM diagnosis. The term is used to refer to patients with schizophrenic disorders that have comorbid features of OCD. We see these obsessive-compulsive symptoms in schizophrenia more often than would be expected by chance. About one in four patients h

Mood Stabilizers: What You Don’t Know Can Hurt Them

Topics: Antipsychotics | Aripiprazole | Asenapine | Bipolar Depression | Bipolar Disorder | Bipolar II | Cariprazine | Lithium | Lurasidone | Mania | Medication adherence | Mood Stabilizers | olanzapine | Oxcarbazepine | Pharmacology | Pharmacology Tips | Psychopharmacology | Psychopharmacology Tips | Quetiapine | Research | Research Update | Risperidone | safety | Saphris | Side Effects

Review of: Bai Y et al, J Clin Psychopharmacol 2020;40(2):167–179 STUDY TYPE: Combined meta-analysis and literature review of placebo-controlled trials Medication adherence is an ongoing struggle in bipolar disorder, and it’s compounded by the fact that our patients often don’t advertise their ­non-adherence. While numbers vary, reviews general

How to Choose an Antipsychotic in Schizophrenia

Topics: Antipsychotics | Aripiprazole | Cariprazine | Clozapine | Negative Symptoms | olanzapine | Psychopharmacology | Psychopharmacology Tips | Psychosis | Risperidone | Schizophrenia

It’s been over a decade since the CATIE trial changed the way we look at antipsychotic drugs. Since then, the number of second-generation antipsychotics has about doubled, and the number of clinical trials has risen even more. Antipsychotics are not all the same, though, and when it comes to schizophrenia, a few stand out in ways that can help you fin

In Brief: Antipsychotic Update

Topics: Dementia | Risperidone

Outdoor activity, massage, and touch therapy ranked most effective for agitation in dementia. In a meta-analysis of 163 randomized controlled trials, nonpharmacologic interventions were more effective than antipsychotics for aggression and agitation in dementia (Watt JA, Ann Intern Med 2019 Oct 15). Risperidone doesn’t appear to cause fractures. Ri