Stimulants Carlat Reports | Carlat Publishing

Expert Q&A

Personality Changes Later in Life: Diagnostic and Treatment Considerations

From The Carlat Geriatric Psychiatry Report, Diagnostic Challenges in Older Adults

CGPR: What is the course of personality disorders as people age? Dr. Tampi: Personality usually doesn’t change much. People with borderline personality disorder (BPD), for example, don’t usually experience significant changes once they reach middle age. Experiences over a person’s lifespan may teach them skills that blunt their sharp edges, but

Research Update

The Evidence Base for Polypharmacy in ADHD

From The Carlat Child Psychiatry Report, ADHD in Children and Adolescents

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

Expert Q&A

Unpacking Aggression Associated with ADHD

From The Carlat Child Psychiatry Report, Overarousal in Children and Adolescents

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

Research Update

Which Medications Have the Lowest Risk of Side Effects?

From The Carlat Child Psychiatry Report, Mood Disorders in Children and Adolescents

REVIEW OF: Solmi M et al, World Psychiatry 2020;19(2):214–232 Adverse effects are important considerations when choosing psychotropic medications, especially in children and adolescents. This study pooled available research to compare the safety profiles of various psychotropics used in the pediatric population. The authors screened thousands of st

Clinical Update

Pharmacotherapy for Stimulant Use Disorders

From The Carlat Addiction Treatment Report, Stimulant Use Disorder

Topics: medications | Pharmacotherapy | Stimulants

Stimulant use is surprisingly common. In 2017, 5.5 million people in the US took cocaine, and 757,000 of these people used crack. Another 5.1 million people misused prescription stimulants, representing nearly 2% of the total population (SAMHSA, 2019; www.samhsa.gov/data/). Many pharmacological trials for stimulant use disorder have been conducted, but

Expert Q&A

Diagnosing and Treating Stimulant Use Disorders

From The Carlat Addiction Treatment Report, Stimulant Use Disorder

CATR: Welcome, Dr. dela Cruz. Tell us what you do. Dr. dela Cruz: I’m an assistant professor at UT Southwestern Medical School where I’m the adult psychiatry residency associate program director, and I teach medical students, residents, and fellows. Clinically, I’m an outpatient addiction psychiatrist where I treat a variety of patients with subs

In Brief

The Other Pandemic

From The Carlat Addiction Treatment Report, Integrating Pharmacotherapy and Psychotherapy

Topics: Opioids | Stimulants

Predictions that overdose mortality would worsen during the COVID-19 pandemic have unfortunately proven accurate. Recent data outlined in an alert by the CDC show that rates of overdose deaths from opioids and stimulants accelerated at an alarming rate between March and May 2020, the period coinciding with widespread lockdowns (www.tinyurl.com/4ductzzx)

Clinical Update

How to Treat ADHD in Bipolar Disorder

From The Carlat Psychiatry Report, Bipolar Disorder

Topics: | | | | | | | | | | | | | | | | | | ADHD Alpha Agonists Amphetamines ArModafinil Atomoxetine Attention Deficit Hyperactivity Disorder Bipolar Disorder Bipolar II Comorbidity Guanfacine methylphenidate Modafinil Nuvigil Pharmacology Provigil Psychopharmacology Psychopharmacology Tips stimulant Stimulants

Patients with bipolar disorder often present with cognitive complaints. Our October 2021 issue laid out a diagnostic plan for these symptoms, and in this article, I’ll cover some treatment approaches for patients with a DSM-based ADHD-bipolar comorbidity (ie, the ADHD symptoms began in childhood and persist after the mood episodes have stabilized).

Clinical Update

Atomoxetine: Myths and Truths

From The Carlat Psychiatry Report, Overdiagnosis

Topics: ADHD | Atomoxetine | stimulant | Stimulants

Atomoxetine (Strattera) is approved for ADHD in children and adults but has also been explored in many other disorders. That has led to some myths and truths that we’ll explore here. First, a little about atomoxetine’s mechanism of action. Atomoxetine is a selective norepinephrine reuptake inhibitor, a mechanism shared by maprotiline, a long-forg

Clinical Update

Stimulants and Creativity

From The Carlat Psychiatry Report, Stopping Psych Meds Part 1

Your patient is a 25-year-old music teacher with ADHD. Though her organizational skills have improved with methylphenidate, she complains that it impairs her performance as a jazz musician: “I feel self-conscious, like a robot.” Popular lore holds that creative people have ADHD traits and that ADHD bestows advantages in creative thinking. Stock c