Mania, defined by extreme energy levels and fluctuating emotions, can cause considerable disruptions in a patient’s life. This article translates the DSM-5 diagnostic criteria for mania into layman’s terms, useful for patients unfamiliar with the medical terminology.

The article includes fictional case studies: ‘Jack’ and ‘Jessica’. These hypothetical scenarios highlight how manic episodes can profoundly affect personal relationships and professional engagements.

Here’s an overview of the main points:

• Understanding Mania: The piece simplifies the understanding of manic episodes, characterized by unusually high or irritable moods and increased activity levels. These symptoms last for at least a week and can significantly impact social and occupational settings.

• DSM-5 Diagnostic Criteria: The article breaks down the DSM-5 criteria into digestible chunks, underscoring key symptoms such as inflated self-esteem, reduced need for sleep, excess talkativeness, fast-paced thoughts, easy distractions, increased goal-oriented activities, and tendencies for risky behaviors.

• Real-Life Scenarios: The stories of ‘Jack’ and ‘Jessica’ provide an illustrative view of how mania symptoms manifest. These stories underscore the severity of their conditions due to the significant impacts on their relationships and work performances—signaling a critical need for intervention.

We invite you to guide your patients towards the article. It’s a valuable resource for those looking to understand their symptoms better or anyone seeking to broaden their knowledge about their mental health.

The post Mania in Bipolar Disorder: A New Patient Guide first appeared on Pharmacology Corner.

Below some key points.

• Fluvoxamine is FDA-approved for OCD in children and adults, but evidence does not show it is more effective than other SSRIs for OCD.
• Fluvoxamine is used off-label for depression, panic disorder, and as an adjunct to clozapine.
• Fluvoxamine has a long half-life of 16 hours. It is a potent inhibitor of CYP1A2 and should not be used with MAOIs.
• Common side effects include nausea, somnolence, sexual dysfunction, and antidepressant-induced excessive sweating (dose-related).
• Discontinuation symptoms tend to be worse with fluvoxamine compared to other SSRIs. Gradual tapering is recommended.
• Hyponatremia and bleeding are potential serious side effects. Risk of bleeding may increase with aspirin, NSAIDs or warfarin.
• In hepatic impairment, clearance is reduced by 30%. Start with a low dose and slowly increase.
• Fluvoxamine inhibits CYP1A2, 2C19, 2C9, 2D6, and 3A4. Dose adjustments may be needed for substrates like warfarin, theophylline, omeprazole, and tizanidine.
• Animal studies show fluvoxamine is a sigma-1 receptor agonist, which may play a role in effects on psychotic depression.

Check out the full guide for more details on using fluvoxamine in your practice:

Fluvoxamine Practical Guide: Pharmacology, Indications, Dosing Guidelines, and Adverse Effects

The post New Article: Fluvoxamine Practical Guide first appeared on Pharmacology Corner.

Key points:

• Fluoxetine potently inhibits the serotonin transporter and acts as a 5HT2C antagonist at higher doses.
• It is FDA-approved for depression, OCD, panic disorder and bulimia. Fluoxetine is also used off-label for repetitive behaviors in ASD.
• It has a long half-life of 2-4 days (norfluoxetine metabolite: 7-14 days).
• Adverse effects include nausea, diarrhea, insomnia, sexual dysfunction, and activation.
• Fluoxetine is excreted at higher levels in breast milk than most SSRIs.

Fluoxetine Practical Guide: Pharmacology, Indications, Dosing Guidelines and Adverse Effects

The post New Article: Fluoxetine Pharmacology and Practical Prescribing Guide first appeared on Pharmacology Corner.

This article is a must-read for clinicians who want to deepen their understanding of these two commonly prescribed antidepressants.

Some pearls extracted from the article:

• Both citalopram (Celexa) and escitalopram (Lexapro) have low potential for drug-drug interactions due to their minimal inhibition of CYP450 isoenzymes.

• Citalopram has been linked with QT prolongation. While it was initially approved for use in doses ranging from 20 to 60 mg/day, in 2011 the FDA recommended against its use in doses higher than 40 mg/day.
• A helpful prescribing tip highlighted in the article is that the equivalent dose of escitalopram is half that of citalopram.

Here’s what you can expect to learn:

• Pharmacology
• Dosage forms and available strengths
• FDA-approved indications and dosing
• Off-label uses
• Switching
• Pharmacokinetics
• Side Effects
• Special populations

Citalopram and Escitalopram: A Summary of Key Differences and Similarities

The post A Deep Dive into Citalopram and Escitalopram first appeared on Pharmacology Corner.

We are sure you will find this useful, the episodes are very well edited and to the point.

Click one of the links below to subscribe :

• Apple podcasts
• Google podcasts
• Stitcher
• Spotify
• RSS (other podcasting apps)

The post New Psychiatry and Psychopharmacology Podcast first appeared on Pharmacology Corner.

This includes guidelines from: NICE, BAP, WFSBP and CANMAT.

Find more here: Bipolar Disorder Treatment Guidelines

The post New Psychiatry Guidelines: Bipolar Disorder first appeared on Pharmacology Corner.

Long-Acting Injectable Antipsychotics: A Practical Guide for Prescribers

1 Advantages and disadvantages of long-acting antipsychotics
1.1 Potential advantages
1.2 Potential disadvantages
2 Clinical questions answered
3 Tables summarizing individual agents
3.1 First-generation antipsychotics available as long-acting injectable medications
3.2 Second-generation antipsychotics available as long-acting injectable medications
4 Practical considerations
4.1 Abilify Mantenna
4.2 Aristada
4.3 Zyprexa Relprevv
4.4 Invega Sustenna
4.5 Invega Trinza
4.6 Risperdal Consta

The post New Depot Antipsychotics first appeared on Pharmacology Corner.

Here is the outline for the tutorial:

1 Mechanism of action
1.1 The prefrontal cortex and the role of NE and DA in ADHD
1.2 Methylphenidate inhibits the reuptake of NE and DA
2 Methylphenidate formulations
2.1 Short-acting
2.1.1 Presentations
2.2 Intermediate-acting
2.3 Long-acting
2.3.1 Methylphenidate OROS
2.3.2 Methylphenidate controlled delivery
2.3.3 Methylphenidate SODAS
2.3.4 Dexmethylphenidate sustained release capsules
2.3.5 Methylphenidate patch
2.3.6 Methylphenidate oral suspension

Methylphenidate for ADHD: Mechanism of Action and Formulations

The post Methylphenidate in ADHD: Psychopharmacology first appeared on Pharmacology Corner.

In this new Psychopharmacology Institute podcast, Dr. Guzman interviews expert psychiatrist Dr. David Veale on treatment resistant-OCD. It’s interesting to learn about the role of clomipramine in the treatment algorithm.

Outline

• Practical definition of treatment-resistant OCD
• Stepped-approach to pharmacotherapy
• Efficacy of second-generation antipsychotics as augmentation strategy
  • When to use them
• Other treatment options

Pharmacotherapy of treatment-resistant OCD

The post Pharmacotherapy of OCD: Interview first appeared on Pharmacology Corner.

To learn more about these similarities and differences check the following video published at the Psychopharmacology Institute website:

Citalopram and Escitalopram: A Summary of Key Differences and Similarities

The post Citalopram and Escitalopram compared first appeared on Pharmacology Corner.