5 Minutes With… Psych Update Spring 2023 Faculty Pt.2
Introduction
Happy June, Innovations Readers! We are back with the second part of our special segment “5 Minutes With” that questions some of our foremost thought leaders in psychiatry who also served as faculty for Psychiatry Update Spring 2023 in Chicago. They opine on the best tool in their clinical arsenals, mental health therapies that are safe and easy to incorporate but may be underutilized, and specific advances on the horizon that will greatly improve their treatment armamentarium. Read on for candid insights from Dr. Christoph Correll, Dr. Margaret Sibley, Dr. Ann Childress, Dr. Holly Swartz, and Dr. Donald Black.
Our last issue featured Part 1 with these thought leaders. If you missed it, you can find that interview here.
Don’t miss—Is Brexpiprazole Efficacious and Safe for the Treatment of Agitation Associated with Alzheimer’s Disease?: Psychiatry Update Journal Club Monday, June 19 at 12pm.
- During this live event, Dr. Leslie Citrome will talk with Dr. George Grossberg, Director of Geriatric Psychiatry at Saint Louis University School of Medicine regarding the potential of brexpiprazole for the treatment of agitation associated with Alzheimer's disease.
- Brexpiprazole was approved on May 10, 2023 for the treatment of agitation associated with dementia due to Alzheimer’s disease. Brexpiprazole is the first FDA-approved agent for this specific indication.
- Dr. Citrome and Dr. Grossberg review the published paper that reports on these two 12-week, randomized, double-blind, placebo-controlled, parallel-arm studies.We hope you can join us. There will be targeted questions and valuable interaction!
- Click here to register!
This month’s Psych Resource section will keep you updated with articles from Clinical Psychiatry News, Current Psychiatry, MDedge Psychiatry, New England Journal of Medicine, and JAMA Psychiatry—check them out below.
Thank you to our participants for their perspectives this month. Please contact me at colleen@cmhadvisors.com with any comments and/or suggestions. Thanks for reading! —Colleen Hutchinson
5 Minutes with Psych Update Spring 2023 Faculty
- Christoph Correll, MD, is Professor of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; and Investigator, Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York.
- Margaret H. Sibley, Ph.D. is Associate Professor of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Licensed Clinical Psychologist at Seattle Children’s Hospital and a researcher who specializes in the diagnosis and treatment of ADHD in adolescence and adulthood, having published over 100 scientific works on this topic, as well as a book on the psychosocial treatment of adolescent ADHD.
- Ann Childress, MD, is President of the Center for Psychiatry and Behavioral Medicine, Clinical Associate Professor, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas and Adjunct Associate Professor, Touro University Nevada College of Osteopathic Medicine.
- Holly A. Swartz, MD, is Professor of Psychiatry at the University of Pittsburgh; Editor-in-Chief, American Journal of Psychotherapy; and Treasurer of the International Society for Bipolar Disorders, Pittsburgh, PA.
- Donald W. Black is Past-President of the American Academy of Clinical Psychiatrists (AACP) and Professor of Psychiatry at University of Iowa Carver College of Medicine in Iowa City, Iowa.
Best device/tool in my clinical arsenal:
Dr. Freeman: A good thorough initial evaluation and excellent peers for peer supervision.
Dr. Black: My ability to interview and assess patients. This is the most basic and fundamental skill in a psychiatrist’s toolbox.
Dr. Correll: Short answer: Listening and asking questions. Long answer: Clinical experience and judgment paired with research knowledge, patient-centeredness, and measurement-based approaches.
Dr. Swartz: Psychoeducation about sleep hygiene remains my favorite intervention for sleep problems. In general, behavioral interventions for insomnia are at least as—if not more—efficacious than conventional sedative hypnotics.
Dr. Sibley: Motivational interviewing.
Are there advances in mental health therapies that are safe and easy to incorporate, but may be underutilized?
Dr. Swartz: Data from the Trio-BD study (Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study: A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial. Calkin et al. Journal of Clinical Psychiatry, 2022) showed that treating insulin resistance in individuals with treatment resistant bipolar disorder may lead to improved mood. Looking for insulin resistance and adding a medication like metformin (as was done in Trio-BD) should be part of routine practice.
Dr. Cornell: Measurement-based care, long-acting injectable antipsychotics, clozapine, lithium.
Dr. Black: I think many of our most effective medications are totally underutilized, such as clozapine and carbamazepine. The new generation of psychiatrists are fearful of them.
Dr. Sibley: Technology is leading to a lot of valuable apps to help people track their mental health symptoms and behaviors. This creates valuable data on a person that can be reviewed with providers and with the person themself to notice patterns, which helps find solutions to difficulties.
Most promising new treatment on the horizon:
Dr. Childress: Non-invasive brain stimulation for negative symptoms of schizophrenia.
Dr. Freeman: Neurosteroids and psychedelics, hybrid models of outpatient care.
Dr. Black: What’s exciting is the potential to treat negative symptoms. Cariprazine, which is a dopamine D3/D2 receptor partial agonist, and serotonin 5-HT1A receptor partial agonist, is showing promise, and is paving the way for newer antipsychotics. The next generation of antipsychotics may well be a game changer for schizophrenia treatment.
Dr. Swartz: Like everyone else, I am cautiously optimistic that psychedelic-assisted psychotherapy may help many with PTSD.
What I am most looking forward to this year and next:
Dr. Swartz: Perhaps this is aspirational, but I hope to see a return to civil discourse in our public spaces and equitable access to care for all.
Dr. Freeman: I believe we will move forward in optimizing virtual and in-person care, not only to provide the best quality care, but also to make it as accessible and equitable as possible.
Psychiatry Resource Section
JAMA Psychiatry Viewpoint: Emerging Challenges for Psychedelic Therapy
https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2803841
MDEdge Clinical Psychiatry News Article: Alcohol Dependence in Teens Tied to Subsequent Depression
https://www.medscape.com/viewarticle/992873?src=
APA Learning Center April Free Members Course: Ethical Issues in Treating LGBTQ Patients —CME:1.25, Participation:1.25
https://education.psychiatry.org/diweb/catalog/item/eid/C2300409
JAMA Psychiatry Original Investigation: Effect of Brief Interpersonal Therapy on Depression During Pregnancy: A Randomized Clinical Trial
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2803843
MDEdge Clinical Psychiatry News Article: Molecular mechanisms may predict major depressive disorder
New England Journal of Medicine Editorial: Ketamine and ECT in Depression — Risks and Rewards
https://www.nejm.org/doi/full/10.1056/NEJMe2305130
Current Psychiatry Commentary: ECT vs. ketamine for major depressive disorder: New data