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We are back this month with our special segment “5 Minutes With” that focuses on our faculty for the upcoming Psychopharmacology Update. They share strategic pearls from their upcoming presentations, what they think are some of the latest breakthroughs in psychopharmacology that attendees can look forward to learning more about, and what attendees will come away with that will greatly improve their treatment armamentarium. Read on for candid insights on these topics and more. 

Last month we featured an interview with Dr. Henry A. Nasrallah, Chair of the 22nd Annual Psychopharmacology Update. We spoke about the meeting as well as some up and coming research and treatment options for psychiatric conditions. If you missed it, you can catch it here.

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. 

A huge thank you to our faculty for giving their time this month. Please contact me at colleen@cmhadvisors.com with any comments and/or suggestions, and thanks for reading! —Colleen Hutchinson

Don’t miss!— Psychopharmacology Update (22nd Annual)

Friday/Saturday October 27-28, 2023; Hyatt Regency, Cincinnati, Ohio 

  • Full-day, 3-part Masterclass focusing on Psychopharmacology. I: Brave New Psychopharmacology; II: Judicious Psychopharmacology; III: Creative Psychopharmacology; IV: Strategic Psychopharmacology; V: Harm-Avoidance Psychopharmacology.
  • Workshops on Psychedelics, Addiction and Cannabis on Friday, October 27, 2023

Register here

Psychiatry Update Journal Club 

Breaking New Ground: Zuranolone's Potential for Postpartum Depression

Live at 10:00 AM EST Monday, October 16, 2023

Click here to register!

Join us for the next episode of the Psychiatry Update Journal Club as we explore a major breakthrough in the field of postpartum depression (PPD) treatment. Dr. Leslie Citrome will be in conversation with Dr. Kristina Deligiannidis, lead author of a journal article describing a remarkable double-blind phase 3 trial assessing the potential of zuranolone as an oral treatment for severe PPD.  

Click here to register! 

5 Minutes With… Faculty of the 22nd Annual Psychopharmacology Update

What do you anticipate attendees coming away with from your workshop/presentation at the 22nd Annual Psychopharmacology Update?

Dr. Martinez/Cannabis Workshop: When it comes to cannabis, hyperbole is common. This makes it so important to stick with data. That said, the problem with research is that it takes time – and sometimes it’s conflicting. Evidence-based practice of psychiatry provides our patients with quality care, but it’s not simple. My goal is to present the data, including its complexities, so that attendees gain an understanding of what research has found and what questions remain. In this way, attendees can select the information that applies to their patients, especially when it comes to psychiatric comorbidity and the myriad of cannabis products that have become available.

Dr. Edwin Salsitz/Addiction Workshop: I plan to do an overview of the neurobiology of addiction, discuss the ongoing Fentanyl Crisis, the explosion of Xylazine and finish with some clinical cases. So, it is an ambitious Agenda, and I’m hoping the attendees will come away with an accurate picture of the current addiction landscape in the USA.

Dr. Goldberg/Strategic Pharmacology Masterclass

- knowing when to switch versus augment medications in hard-to-treat mood disorders

- knowing which combination pharmacotherapy strategies are more likely to be successful, and which are not, in major depression and bipolar disorder

- gaining new insights about the use of ketamine and ECT in treatment resistant depression

- understanding the rationale, mechanism and effectiveness of newer treatments for depression, such as dextromethorphan/bupropion or theta burst transcranial magnetic stimulation

- interpreting the role of pharmacogenetic testing as a possible tool to inform treatment of major depressive disorder

- knowing how to treat psychotic disorders that may be resistant to clozapine

Dr. Sidney Zisook/Psychedelics Workshop: New and exciting data suggests these agents will be available for clinical use soon. Participants will be aware of some of the pending clinical indications and pros and cons of their introduction to our clinical landscape.

Dr. Citrome/ Brave New Psychopharmacology: I will be covering muscarinic receptor agonism as a treatment for schizophrenia, as well as the modulation of glutamatergic NMDA receptors, Sigma-1 receptors, and GABA-A receptors for the treatment of depression. I will also take a deeper dive into orexin receptor antagonism as a means of alleviating insomnia.

Dr. Nasrallah/ Strategic Pharmacology Masterclass: This will include various strategic psychopharmacology “pearls” to increase efficacy and reduce adverse effects in various psychiatric populations.

What are some of the latest breakthroughs in psychopharmacology and research that you think are of great import to Psych Pharm Update attendees who want to return to practice with practical and useful treatment information?

Dr. Martinez: An exciting recent breakthrough is a new medication being developed for cannabis use disorder called AEFO117. It’s being developed by a French biotech company.  It’s exciting because cannabis use disorder is difficult to treat: many clinical trials have shown no or limited efficacy. That’s the good news. The bad news is that there’s a good chance that we have a wave of cannabis addiction on the horizon, and we’ve got to be better prepared for this. We need to do as much as possible to promote prevention and early detection of cannabis use disorder among our patients.

Dr. Zisook: The cat is out of the box! New and exciting drugs and treatment paradigms have recently become available to treat many of our most chronic and severe mental conditions, and more are on the way. This may be the most exciting time in modern psychiatry since the Prozac revolution in the 1980s.

Dr. Goldberg: In terms of latest breakthroughs, I expect the conference will provide up to date information on the emerging role of psilocybin and other psychedelics in the treatment of mood disorders; new information about novel mechanisms of action in the treatment of mood and psychotic disorders, including novel NMDA receptor antagonists and TAAR1 agonists.

Dr. Salsitz: Most importantly, attendees should know that no one, including users and sellers of illicit drugs, knows what is in the powders, pills, and liquids that are being sold and used. Fatal overdoses are increasing every year despite multiple interventions and public health initiatives. New illicit drug classes, for example the Nitazenes, are on the horizon, and may worsen the overdose epidemic. Fentanyl has decreased the effectiveness of the medications for opioid use disorders (MOUD) and made initiation of buprenorphine more difficult. Currently Xylazine is a major problem, particularly the wounds and ulcerations associated with its use. So, putting it all together will enable attendees to practice evidence-based medicine, including the latest harm reduction interventions.

Dr. Citrome: Novel mechanisms of action for new antipsychotics, antidepressants, and hypnotics that provide an opportunity to achieve results perhaps faster, more robustly, and with improved tolerability.

Dr. Nasrallah: There is a surge of new innovative medications based on novel mechanisms of action to be discussed. These include the following: 

  • two antipsychotics that do not block dopamine receptors (KAR-XT and emraclidine)
  • glutamatergic rapid-acting antidepressants (dextromethorphan) 
  • an oral medication for post-partum depression zuranolone (via GABAa receptors)
  • a sublingual alpha 2 adrenergic agonist medication for agitation (Dexmedetomidine)
  • psilocybin for treatment resistant depression, anxiety and PTSD (trials in progress)
  • esmethadone for major depression
  • asenapine transdermal antipsychotic
  • serotonin 5HT2-A for negative symptoms of schizophrenia (studies in progress with pimavanserin and roluperidone)
  • and a glycine transport inhibitor for cognitive deficits in schizophrenia.

Psychiatry Resource Section

New England Journal of Medicine Perspective: Intention To Treat: Awakened Hope for Narcolepsy

JAMA Psychiatry Original Investigation: Dialectical Behavior Therapy for Adolescents With Bipolar Disorder - A Randomized Clinical Trial

Medscape Medical News Article: Anxiety, Depression Ease After AF Ablation: Clinical or Placebo Effect?

Medscape Medical News Article: MDMA Effective in Diverse Patients With PTSD

APA Learning Center September Free Members Course: The Shame of Suicide and Attempted Suicide in Physicians: Five Physicians Who Are Speaking Out —CME: 1.5, COP: 1.5

Clinical Psychiatry News: Online CBT aids remission of anxiety, depression in students