The Lowdown from... Psychopharmacology Update
Welcome back to the Psychiatry newsletter! As we move through fall and into the holiday season, we hope you are in the homestretch of a productive, rewarding, and personal and professional year of success. One of the best ways to ensure your chances of professional success, and success in patient outcomes, is to keep current on clinical advances and treatments by attending medical conferences. This year’s Psychopharmacology Update conference was a critical success, with attendees leaving armed with practical knowledge on the latest advancements in the field.
In this issue, Dr. Donald Black, Dr. David W. Goodman, and Dr. Robert J. Gregory, faculty from Psychopharmacology Update, join us to share insights from their respective areas of expertise and from the meeting. Read on to get current on BPD treatment options, gambling addiction advice, latest treatment options for adult ADHD, and misconceptions regarding all of these conditions.
Keep up to date as well on current research with this month’s Psych Resource section, featuring articles from MDEdge Psychiatry, New England Journal of Medicine, and JAMA Psychiatry—check them out below!
Thank you to these thought leaders for this month’s interview! Please contact me at colleen@cmhadvisors.com with any comments. –Colleen Hutchinson
Need CME?
Psychiatry Update | March 26-28, 2026 | Chicago, IL
Psychiatry Update will be back in Chicago this March! This three-day meeting with renowned faculty and interactive discussions will provide practical takeaways in managing patients with psychiatric disorders and address hot topics including depression, bipolar disorder, schizophrenia, ADHD, and much more. Our interactive Q&A sessions, Welcome Reception, and Exhibit and Poster Hall, make it easy to gain knowledge from one another, exchange ideas, meet new colleagues, and catch up with everyone in your professional circle.
All of this is in service of what matters most – taking home the kind of breakthroughs that can make a difference in your patients’ lives.
Use code PSYCHUPDATE for 30% off. Click here to register.
The Lowdown from... Psychopharmacology Update
Dr. Joseph Goldberg, Clinical Professor of Psychiatry, Icahn School of Medicine at Mount Sinai New York, New York.
Dr. David W. Goodman, Assistant Professor, Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine Baltimore, Maryland; Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, State University of New York, Valhalla, New York.
Dr. Donald W. Black, MD, Professor of Psychiatry, Carver College of Medicine, University of Iowa in Iowa City, Iowa.
Dr. Robert Gregory, Distinguished Service Professor of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, New York.
Can you share takeaways from your Psychopharmacology Update talk, Masterclass II: Optimal Algorithm for Treating Mood Disorders: From Depression to Mixed State of Mania?
Dr. Goldberg: Every patient is unique. One size fits one. It’s critical to tailor every treatment to the characteristics of an individual patient rather than to a diagnosis per se.
Can you give us a couple pearls you shared in your recent Medscape Psychopharmacology Update Gambling Workshop?
Dr. Black:
- You never know how widespread problematic gambling behavior is without asking. Very few psychiatrists ask their patients, so start.
- The best approach is behavioral; find out what your state offers, if anything. If a state gambling treatment program exists, refer the patient to it, and refer them to Gamblers Anonymous. People can self-exclude from casinos in many states. If interested in medication, a trial of naltrexone is in order.
What do you foresee as some of the most hopeful or critical treatment advances that are either on the horizon—or some are already here and helping your patients?
Dr. Black: Clozapine may be old news, but it is the most effective underutilized medication in psychiatry. It is now freed up from the REMS program, so perhaps its use will become more widespread.
Can you share any takeaways or pearls from your Psychopharmacology Update talk, Masterclass IX: Borderline Personality Disorder (BPD)?
Dr. Gregory:
- BPD is a very serious disorder associated with high mortality and morbidity.
- BPD is widely prevalent among psychiatric outpatients and inpatients, especially among patients with suicidality.
- The diagnosis is missed 70-90% of the time by mental health providers.
- Use of a brief screening questionnaire can help with recognition, such as the Upstate Borderline Questionnaire at www.ddptraining.org.
- BPD should be considered a primary focus of treatment since comorbid disorders, such as anxiety and depression, get better when BPD is effectively treated, but not vice versa.
What is or are some of the latest or most effective therapeutic(s) for patients with adult ADHD?
Dr. Goodman: The explosion of adult ADHD research in the last 20+ years has sent research in multiple directions. These directions include increasing diagnostic accuracy, expanding assessment across the lifespan regardless of age, new pharmacologic medications, specific effective psychotherapies, and digital therapeutics. Telehealth has significantly increased access for ADHD evaluation at affordable cost. The most effective therapeutic is the patient walking through the door for an evaluation. Increased public awareness has helped people understand this is something they have; it is not who they are as a person.
What’s the biggest misconception about BPD?
Dr. Gregory: The two most common misconceptions are:
- You do not have to worry about suicide in patients with BPD because they are attention-seeking and manipulative. The reality is that 6-10% of individuals with BPD eventually die by suicide.
- BPD is untreatable. The reality is that evidence-based psychotherapy can be highly effective and life-transforming for individuals with BPD.
What is the most misunderstood aspect of, or misconception regarding, adult ADHD?
Dr. Goodman: That it didn't exist, resulting in adult psychiatry's abdication of care.
What is the biggest misconception patients have about treating mood disorders and how do you address it?
Dr. Goldberg: Treating diagnoses instead of patients. Failure to appreciate the key clinical features of every patient’s unique presentation.
How would you characterize the current treatment options for BPD?
Dr. Gregory:
- Medications, especially antipsychotics, can sometimes take the edge off symptoms of mood lability and impulsivity, but treatment effects are small.
- Benzodiazepines are contraindicated for this disorder.
- Unstructured supportive psychotherapies and CBT are relatively ineffective.
- Five evidence-based psychotherapies, including Dialectical Behavior Therapy, Dynamic Deconstructive Psychotherapy, Transference-Focused Psychotherapy, Mentalization-Based Treatment, and Good Psychiatric Management can be highly effective, sometimes leading to a complete resolution of BPD symptoms and improved functioning.
How do you translate the cutting-edge science and advice you gain at meetings into patient education that is understandable and empowering?
Dr. Goldberg: Glean basic concepts from meetings. Then follow the literature. Live on PubMed. Look things up. Become familiar with the clinical trials literature to follow evidence-based principles.
Psychiatry Resource Section
JAMA Psychiatry Viewpoint— Overmystifying the Psychedelic Experience
Medscape Medical News : ‘Energy Insecurity’ Tied to Anxiety, Depression Risk
Medscape Medical News Article: Brain’s Waste Clearance System Implicated in Dementia
Medscape Medical News Medbrief: Cardiometabolic Effects of Antidepressants Vary Significantly
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