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Expert Q&A

EmPATH Units: An Innovative Approach to Mental Health Crises

From The Carlat Hospital Psychiatry Report, Minimizing Use of Restraints

Topics: assessments | Emergency Department | psychiatric emergencies | treatment

CHPR: Dr. Nordstrom, please tell us about yourself. Dr. Nordstrom: First and foremost, I am an emergency psychiatrist. I have been working in this field for years and have a passion for it. I am also drawn to healthcare policy and administration, especially when it comes to models of care. As a past president of the American Association for Emergency

Research Update

The Role of rTMS in Poststroke Depression

From The Carlat Hospital Psychiatry Report, Testifying

REVIEW OF: Hordacre B et al, J Neurol 2021;268(4):1474–1484 STUDY TYPE: Randomized controlled trial Poststroke depression is common, disabling, and often treatment refractory. We know repetitive transcranial magnetic stimulation (rTMS) is effective for treatment-resistant depression. Might it offer a safe and effective treatment for poststroke d

Clinical Update

Tools to Help Kids and Teens to Sleep Better

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

Sasha is a 13-year-old whose grades are slipping. She reports trouble concentrating in school, and her parents are worried she might have ADHD. On taking a history, you learn that Sasha stays up late and gets up early, obtaining about six hours of sleep per night. Adolescents have been reporting less sleep over the past 20 years in what’s

Research Update

Dash Diet for Childhood ADHD

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

REVIEW OF: Khoshbakht Y et al, Eur J Nutr 2021;60(7):3647–3658 Dietary approaches for controlling ADHD in children have been studied over many decades, but none have been found to be clearly effective. In a recent study, researchers examined the Dietary Approaches to Stop Hypertension (DASH) diet, which includes several interventions that could be

Clinical Update

Approaches to Autism Intervention

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

Your patient is a young child who has recently been diagnosed with autism. Her parents are asking about the available treatments, and in particular, they want to know whether they should pursue the 40-hour-per-week program recommended by the local autism society. As clinicians, we are often faced with questions from families about the “best” pr

Expert Q&A

Medications for Depression

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

CCPR: You recently published an article reviewing the placebo-controlled trials done over the past 10 years on depression in kids (Ignaszewski MJ and Waslick B, J Child Adolesc Psychopharmacol 2018;Epub ahead of print). Can you tell us about your findings? Dr. Ignaszewski: Historically, there’s been a lot of controversy about the effectiveness of a

News of Note

FDA Approves Adhansia XR

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

We are always in need of a new formulation of stimulant medication that might capture a few more of our patients who just do not quite tolerate or respond well enough to the many existing formulations. So whenever a new one is released, we try to set aside our natural skepticism and take a look at the stated facts before judging its merit. Adhansia X

News of Note

First Non-Drug Treatment Approved by FDA for Treating Children With ADHD

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

NeuroSigma made a splash by announcing that the FDA has granted medical device approval for its external Monarch Trigeminal Nerve Stimulation (eTNS) System for treating kids with ADHD ages 7–12 who are not currently taking medications. What does medical device approval mean? The FDA reviewed the Monarch eTNS System through the de novo pre-market

Research Update 3

Patient Reviews of Substance Use Services

From The Carlat Addiction Treatment Report, Alternative Treatment in Addiction

Topics: Connection | Internet | Patient relationship | treatment | Treatment planning

Review of: Agarwal AK et al, J Gen Intern Med 35(6):1647–1653 When a patient or family member is looking for a specialized drug treatment facility (SDTF), they will often turn to online review sites to get information about facilities in their area. These reviews can drive patients’ choice of facility, but they often don’t focus on the same the

Clinical Update

Despair, Loneliness, and Substance Use Disorders

From The Carlat Addiction Treatment Report, Social Aspects of Addiction

Despair and loneliness are underappreciated contributors to substance use disorders (SUD). Their impact can be seen particularly in rural areas hit hard by industrial restructuring and poverty. This article will explore the interplay between despair, loneliness, and SUD and will review some strategies to use in your patients. Hardship From 1999 to 2

Clinical Update

Faith and Addiction

From The Carlat Addiction Treatment Report, Social Aspects of Addiction

Discussing a patient’s spiritual life might not be something you do routinely. Conversations can be time-consuming, uncomfortable, or seemingly irrelevant to treating a substance use disorder (SUD). But studies have shown that faith can be an asset in addiction treatment. Patients may want to discuss their spiritual lives with you or have questions ab