MedscapeLIVE! Psychiatry 2024
What’s New, What’s Hot, and What’s Working!
The Most Critical New Treatments, Promising New Therapies on the Horizon, and Best Device/Tool in the Clinical Arsenal —Drs. Christoph Correll, Holly Swartz, & Edwin Saltz Tell All…
Introduction
Welcome back to the Psychiatry newsletter! With 2024 off and running, we are all busy with our practices and personal lives. Finding the balance between them can be challenging, especially when so much is going on in psychiatry research and development and we try to keep up. Medscape has some exciting learning events and opportunities to help you via upcoming meetings, target interviews, and more. We will help you get up to speed on the rapidly expanding realm of research in psychiatry. The list of advances in our area are quickly expanding, which leads to the kind of paradigm shifts in treatment options and protocols that can improve your practice, but be hard to keep current on. For help with adoption of existing and new gold standards, look to our faculty in Psychiatry to keep you up to date on all things innovation-related.
This month catch up with some of Medscape’s faculty Dr. Christoph Correll, Dr. Holly Swartz, and Dr. Edwin Saltz, who candidly share their thoughts and opinions on new critical treatment options and therapies they have adopted into current practice and look forward to on the horizon. Read on to see what they say about what they’re finding success with for their patients!
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Keep up to date as well on current research with this month’s Psych Resource section, featuring articles from Clinical Psychiatry News, Current Psychiatry, MDEdge Psychiatry, New England Journal of Medicine, and JAMA Psychiatry—check them out below!
Thank you to Dr. Christoph Correll, Dr. Holly Swartz, and Dr. Edwin Saltz for this month’s interview! Please contact me at colleen@cmhadvisors.com with any comments. –Colleen Hutchinson
What’s New, What’s Hot, and What’s Working!
Most critical new advance in your area of psychiatry treatment:
Dr. Christoph Correll: Three positive RCTs with the M1/M4 muscarinic agonist xanomeline/trospium for adult inpatients with schizophrenia and acute exacerbation, with effect sizes of 0.81 (recalculated), 0.61 and 0.60 at week 5 with a date for FDA decision about potential FDA approval on September 26, 2024.
Dr. Edwin Salsitz: The continued effort to utilize and destigmatize medications for the treatment of substance use disorders.
Dr. Holly Swartz: Psychedelics + psychotherapy for PTSD.
Most promising new treatment on the horizon:
Dr. Salsitz: The emerging evidence of the efficacy of GLP-1 agonists (e.g., semaglutide) in the treatment of substance use disorders.
Dr. Correll: Other muscarinic receptor activators, such as emraclidine, an M4 positive allosteric modulator, with effect sizes of 0.59 and 0.68 at week 6 in adult inpatients with schizophrenia and acute exacerbation in a phase 1B study, and other agents with muscarinic agonism or positive allosteric modulation that are in development. The prospect of improved cognition in schizophrenia with muscarinic receptor activation and potential broadening of the indications of muscarinic receptor agonists/positive allosteric modulators for other psychotic and non-psychotic mental health conditions is also an exciting possibility.
Dr. Swartz: LSD-analogue for anxiety disorders.
What is the best device/tool in your clinical arsenal?
Dr. Salsitz: The expanded use of Harm Reduction modalities, such as safe injection sites.
Dr. Swartz: Empathy.
Dr. Correll: I do not have one (yet). The widespread integration of apps into routine clinical care still requires further information.
Most reliable treatment in your clinical armamentarium?
Dr. Correll: Stimulants for ADHD.
Dr. Salsitz: Without a doubt, medications for treatment of substance use disorders. Unfortunately, there are no FDA-approved medications for stimulant use disorders—cocaine and methamphetamine.
Dr. Swartz: Lithium.
What was something you have recently LEARNED from other faculty/conference proceedings that was practical for you to take back to practice and utilize?
Dr. Swartz: Memantine for skin picking and trichotillomania.
Dr. Correll:
Dr. Salsitz: Expanded use of Depot Buprenorphine (BUP-Depot) formulations. This can be weekly or monthly subcutaneous administration. Eliminates the issues of adherence and diversion.
What would you consider to be the most controversial treatment option in psychiatric medicine and how do you feel about it?
Dr. Correll: The role and position in clinical care of psychedelic agents for depression. I believe that what the field will need are neuroplastogens that are not psychoneuroplastogens, i.e., similar biological beneficial effects, but without psychotomimetic effects and related need for supervised treatment.
Dr. Salsitz: In treating substance use disorders, there is still resistance among some providers to the use of medications.
Dr. Swartz: “Medical” marijuana. There is no psychiatric indication for cannabis products, and yet they are being wildly over-prescribed (well, it’s not actually a prescription since these are not FDA-approved medications) for many psychiatric disorders. In fact, THC makes most of the conditions for which “medical” marijuana is recommended worse, including insomnia, anxiety, and PTSD.
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Psychiatry Resource Section
Medscape Medical News Article: Alzheimer's Prevalence Predicted to Double by 2050
JAMA Psychiatry JAMA Psychiatry—The Year in Review, 2023
Clinical Psychiatry News: Remote CBT as Effective as In-Person Therapy for Mental Illness
New England Journal of Medicine Clinical Practice: Treatment-Resistant Depression in Older Adults
Medscape Medical News Article: MDMA Effective in Diverse Patients With PTSD
Clinical Psychiatry News: What Do Sex Therapists Do? (Hint: It’s Not What You Think)