Antipsychotics for Treatment of Adolescent Onset Schizophrenia: a Review
This article reviews the pharmacological treatment of adolescents with schizophrenia, when possible, with a focus on the past five years of research.Recent FindingsThere are relatively few randomized controlled trials (RCTs) and head-to-head trials informing selection of a medication in pediatric schizophrenia. However, recent literature focusing on the efficacy and tolerability of atypical antipsychotics has led to the Food and Drug Administration (FDA) approval of multiple agents, specifically risperidone, olanzapine, quetiapine, aripiprazole, paliperidone, and lurasidone, for the treatment of pediatric schizophreni...
Source: Current Treatment Options in Psychiatry - February 14, 2020 Category: Psychiatry Source Type: research

The Treatment of Suicide and Self-Injurious Behaviors in Children and Adolescents
This article reviews the efficacy of current treatments for youth suicidality and SIBs.Recent FindingsMost of the existing literature on treatment for suicidality and NSSI in children and adolescents is focused on psychotherapy, specifically cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), psychoeducation, family therapy, and school-based interventions. In contrast, psychopharmacology studies have focused on addressing disorders related to suicidality and NSSI such as major depressive disorder, rather than on the behaviors themselves.SummaryCurrently, there is no single treatment that is considered...
Source: Current Treatment Options in Psychiatry - February 14, 2020 Category: Psychiatry Source Type: research

Project ECHO and Opioid Education: a Systematic Review
AbstractPurpose of ReviewThe widespread incidence of morbidity and mortality associated with opioid use disorder (OUD) has resulted in a national crisis. One component of this public health epidemic includes a lack of an adequately trained healthcare workforce to provide opioid case management, prescribing, and dispensing. The Extension for Community Healthcare Outcomes (Project ECHO) is a tele-mentoring, guided practice model, which provides knowledge exchange from specialists and subspecialists to enable primary care providers and clinicians to deliver best practice care for complex health conditions like OUD. Project EC...
Source: Current Treatment Options in Psychiatry - January 27, 2020 Category: Psychiatry Source Type: research

New ACGME-Accredited Addiction Medicine Fellowship Programs and Their Impact on the Field
AbstractPurposeWith the recognition of addiction medicine as a medical subspecialty by the American Board of Medical Specialties (ABMS) in 2016, fellowship training programs for physicians have sprung up across the country at a rapid pace. As of this writing, 70 such fellowship programs exist (including in Canada and Puerto Rico), with most accredited by the Accreditation Council for Graduate Medical Education (ACGME) or in the process of accreditation. This review explores the significant changes that have occurred already due to these training programs and the potential future implications for the field of addiction medi...
Source: Current Treatment Options in Psychiatry - January 14, 2020 Category: Psychiatry Source Type: research

Current Pharmacological Treatments for Childhood Onset OCD
AbstractPurpose of reviewObsessive-compulsive disorder (OCD) is a chronic condition associated with substantial morbidity, comorbidity, and functional impairment in affected youths. Fortunately, efficacy has been established for multiple pharmacotherapies; however, treatment response remains neither universal nor complete; hence, treatment development efforts continue.Recent findingsThis review aims to examine evidence for recent trials examining augmentation strategies for partial responders to serotonin reuptake inhibitors (SRIs), the efficacy of adding D-cycloserine (DCS) to cognitive behavioral therapy (CBT), intervent...
Source: Current Treatment Options in Psychiatry - January 9, 2020 Category: Psychiatry Source Type: research

Correction to: A Systemic Review of Treatment Options for Grieving Older Adults
The original version did not include Appendix A where noted in the text. Appendix A is seen below. (Source: Current Treatment Options in Psychiatry)
Source: Current Treatment Options in Psychiatry - December 20, 2019 Category: Psychiatry Source Type: research

Current Pharmacological Treatments for Childhood-Onset Eating Disorders
AbstractPurpose of reviewEating disorders are common in childhood and adolescence and have the highest mortality rate of the mental illnesses, largely due to the medical complications of malnutrition. Psychiatric co-morbidities can lead to death by suicide. Despite a dearth of evidence on the topic, psychiatrists are often asked to comment on the potential utility of adding psychotropic medications to the treatment plan.Recent findingsIt is challenging to recruit patients with eating disorders to medication studies. There are no psychotropic medications approved for the treatment of eating disorders in children and adolesc...
Source: Current Treatment Options in Psychiatry - December 10, 2019 Category: Psychiatry Source Type: research

Transference-Focused Psychotherapy (TFP)
AbstractPurpose of ReviewIn this article, we describe the goals of transference-focused psychotherapy (TFP), its indications, underlying theory, and its broad structure and techniques. We summarize the current empirical support for TFP in regard to symptom and personality change. Lastly, we discuss recent developments and applications in TFP.Recent FindingsTFP is a theory-based, manualized, empirically supported, outpatient psychotherapy designed specifically to treat patients with severe personality disorders, such as borderline and narcissistic personality disorders. Overall TFP focuses on consolidating identity, increas...
Source: Current Treatment Options in Psychiatry - December 10, 2019 Category: Psychiatry Source Type: research

Group Psychotherapy for Late-Life Depression
AbstractPurpose of reviewDepression is a common and disabling diagnosis in the elderly. Psychotherapy, both individual and group, has emerged as an important adjunctive treatment for late-life depression along with medications and neurostimulation therapies. This review seeks to summarize recent literature on group psychotherapy for late-life depression, define the type of therapies commonly used, and discuss both the theory and practice of group psychotherapy.Recent findingsStudies show that various group-based psychotherapies are effective for late-life depression, and there is increasing support for an integrated approa...
Source: Current Treatment Options in Psychiatry - December 5, 2019 Category: Psychiatry Source Type: research

Digital Mental Health for Alcohol and Substance Use Disorders
AbstractPurposeOnly about 20% of people suffering from substance use disorders access available treatments due to various obstacles; digital interventions could potentially overcome some of these. Meta-analyses suggest the strongest evidence for interventions targeting alcohol use reduction, followed by cannabis and illicit substances. However, most randomized controlled trials (RCTs) used unguided standalone interventions compared to non-active controls, with limited follow-up periods and disregarded comorbidity. This review examines the literature published over the last three years (2016 –2019), with a focus on re...
Source: Current Treatment Options in Psychiatry - November 26, 2019 Category: Psychiatry Source Type: research

Treatment of Parkinson ’s Disease Psychosis
AbstractPurposePsychotic symptoms in Parkinson ’s disease are relatively common and include hallucinations, illusions, and delusions. Psychosis is a major cause of disability and is one of the most distressing symptoms for both patients and caregivers. The management of psychosis is often complex and challenging and involves determining the de gree and severity of psychotic symptoms and whether intervention is required. In this review, the authors describe the phenomenology and risk factors of Parkinson’s disease psychosis (PDP) and current evidence-based treatment options.Recent findingsIn randomized, double-b...
Source: Current Treatment Options in Psychiatry - November 16, 2019 Category: Psychiatry Source Type: research

New Somatic Treatments for Child and Adolescent Depression
AbstractPurpose of ReviewDepression is a common clinical problem in youth, with prevalence increasing significantly during the adolescent period. Although several evidence-based treatments are currently available for treating depression in adults, only a subset of these have been investigated in a pediatric sample. Unfortunately, even well-established, first-line interventions do not lead to sufficient treatment response for many children and adolescents suffering from depression. However, recent research has been conducted in the area of somatic treatments for youth with depression. This review focuses on current (past 3 ...
Source: Current Treatment Options in Psychiatry - November 12, 2019 Category: Psychiatry Source Type: research

A Systematic Review of Treatment Options for Grieving Older Adults
AbstractPurpose of reviewThe purpose of this systematic review was to characterize the studies published on grief interventions for bereaved older adults in the last 5 years. Grief intervention studies were included that exclusively focused on older adults as well as those that included older adults in their samples, in order to summarize the most up-to-date treatment options available for bereaved older adults.Recent findingsTwenty-four articles that investigated grief interventions in older adults were identified. Generally, findings suggest that viable treatment approaches for bereaved older adults are those incorporati...
Source: Current Treatment Options in Psychiatry - November 1, 2019 Category: Psychiatry Source Type: research

Using Acceptance and Commitment Therapy in the Treatment of Borderline Personality Disorder: Rationale, Preliminary Evidence, and Future Directions
AbstractAimsRecent iterations of behavior therapy emphasize transdiagnostic processes highlighting commonalities of human experience, mindfulness, language, and acceptance. In contrast to traditional treatment models —which emphasize symptom reduction—these therapies instead prioritize improving quality of life and life engagement. Acceptance and commitment therapy (ACT) is one such approach with over 300 randomized controlled trials, 40 meta-analyses, and countless uncontrolled studies published on its use. ACT not only shares features of many existing evidence-based treatments for borderline personality disor...
Source: Current Treatment Options in Psychiatry - October 12, 2019 Category: Psychiatry Source Type: research

Self-Ratings of Personality Pathology: Insights Regarding Their Validity and Treatment Utility
AbstractPurpose of reviewThe validity of self-ratings of personality pathology often is questioned because personality disorders (PD) historically have been viewed as being characterized by poor insight. However, recent research indicates that PD self-ratings are valid in many ways and have significant clinical utility. Building upon this growing literature, our goal here is to provide practical discussion of how incorporating dimensional PD ratings into assessment protocols can benefit diagnosis and treatment.Recent findingsWe first review evidence suggesting that PD self-ratings are particularly useful for assessing cons...
Source: Current Treatment Options in Psychiatry - September 13, 2019 Category: Psychiatry Source Type: research

Harnessing the Potential of Social Media to Develop the Next Generation of Digital Health Treatments in Youth Mental Health
AbstractPurpose of reviewThis narrative review presents a summary of current research regarding the impact of social networking sites (SNS) on the health and well-being of young people. The review consolidates research on the following topics: risks and benefits associated with SNS use by young people with anxiety and depression, and psychosis respectively; an outline of eOrygen ’s Moderated Online Social Therapy (MOST) platform; and a discussion of the ways in which research in the digital health field inform the design and delivery of the MOST intervention.Recent findingsRecent findings in the digital health field ...
Source: Current Treatment Options in Psychiatry - September 11, 2019 Category: Psychiatry Source Type: research

Digital Innovations for Global Mental Health: Opportunities for Data Science, Task Sharing, and Early Intervention
AbstractPurposeGlobally, individuals living with mental disorders are more likely to have access to a mobile phone than mental health care. In this commentary, we highlight opportunities for expanding access to and use of digital technologies to advance research and intervention in mental health, with emphasis on the potential impact in lower resource settings.Recent findingsDrawing from empirical evidence, largely from higher income settings, we considered three emerging areas where digital technology will potentially play a prominent role: supporting methods in data science to further our understanding of mental health a...
Source: Current Treatment Options in Psychiatry - September 7, 2019 Category: Psychiatry Source Type: research

The DSM-5 Alternative Model for Personality Disorders and Clinical Treatment: a Review
AbstractPurpose of reviewThe goal of the current paper is to review theDSM-5 Alternative Model for Personality Disorders (AMPD), with particular focus on treatment of personality pathology. We briefly outline limitations of the traditional personality disorder diagnostic system, then, review differences between it and the AMPD, and how the alternative model can be applied for intervention planning.Recent findingsCriterion A of the AMPD refers to the level of self and interpersonal impairment and is required for establishing the presence of a personality disorder diagnosis. Criterion B characterizes the nature of that diagn...
Source: Current Treatment Options in Psychiatry - September 6, 2019 Category: Psychiatry Source Type: research

Correction to: Using Optogenetics to Dissect the Neural Circuits Underlying OCD and Related Disorders
The article Using Optogenetics to Dissect the Neural Circuits Underlying OCD and Related Disorders, written by Sean C. Piantadosi and Susanne E. Ahmari, was originally published electronically on the publisher ’s internet portal (currently SpringerLink) on 15 July 2015 without open access. (Source: Current Treatment Options in Psychiatry)
Source: Current Treatment Options in Psychiatry - August 19, 2019 Category: Psychiatry Source Type: research

Adapting Evidence-Based Psychotherapies While Maintaining Fidelity
AbstractPurpose of reviewExtensive resources have been devoted to implementing evidence-based psychotherapies (EBPs) to facilitate the best available treatments to clients. Yet, when treatment settings or client characteristics do not align with the contexts in which an EBP was developed and tested, adaptations may be indicated. The purpose of this article is to provide a summary of the adaptation literature and highlight key issues, using Cognitive Processing Therapy as an example throughout the paper.Recent findingsInformed by the literature to date, we use Stirman and colleagues ’ Framework for Reporting Adaptatio...
Source: Current Treatment Options in Psychiatry - July 22, 2019 Category: Psychiatry Source Type: research

Digital Technology to Enhance Clinical Care of Early Psychosis
AbstractPurpose of reviewDespite considerable evidence supporting the clinical benefits of early intervention for psychosis, issues remain with access and maintenance of long-term recovery. As digital technology has advanced rapidly over recent decades, so too has recognition for its capacity to address the challenges in providing care for those with mental ill health. The current report provides an overview of research focusing on the use of digital technologies to enhance clinical care of people with early psychosis.Recent findingsResearch suggests that people with early psychosis use technology in a similar fashion to t...
Source: Current Treatment Options in Psychiatry - July 11, 2019 Category: Psychiatry Source Type: research

Use of Digital Mental Health for Marginalized and Underserved Populations
AbstractPurpose of reviewDigital mental health (DMH) interventions provide opportunities to alleviate mental health disparities among marginalized populations by overcoming traditional barriers to care and putting quality mental health services in the palm of one ’s hand. While progress has been made towards realizing this goal, the potential for impactful change has yet to be realized. This paper reviews current examples of DMH interventions for certain marginalized and underserved groups, namely, ethnic and racial minorities including Latinx and African- Americans, rural populations, individuals experiencing homele...
Source: Current Treatment Options in Psychiatry - July 5, 2019 Category: Psychiatry Source Type: research

Towards the Design of Ethical Standards Related to Digital Mental Health and all Its Applications
AbstractPurpose of the reviewDigital health technologies offer tremendous potential in increasing access to services and augmenting existing services. Utilizing these technologies, however, poses new ethical considerations for clinicians, researchers, and healthcare organizations. These issues have been particularly apparent recently with several public instances of misuse of digitally available personal data. Responsibility for ethics is distributed among creators, end users, and purveyors which has meant that this aspect of digital technology production and use tends to be thought of as someone else ’s problem.Rece...
Source: Current Treatment Options in Psychiatry - July 5, 2019 Category: Psychiatry Source Type: research

The Future of Peer Support in Digital Psychiatry: Promise, Progress, and Opportunities
AbstractPurposeThis selective review highlights promising findings and future opportunities relevant to digital peer support services. This review considered literature published in peer-reviewed scholarly journals within the past 36  months.Recent findingsDigital peer support spans multiple technology modalities: peer-delivered and smartphone-supported interventions, peer-supported asynchronous technology, artificial peer support, informal peer-to-peer support via social media, video games, and virtual worlds. Digital peer support is an emerging area of research that shows promise in improving mental health symptoms,...
Source: Current Treatment Options in Psychiatry - June 20, 2019 Category: Psychiatry Source Type: research

Recent Developments in Digital Mental Health Interventions for College and University Students
AbstractPurposeMental health problems are prevalent among university students. Insufficient resources at student health centers and other barriers to treatment result in low rates of students receiving treatment, potentially impacting academic performance and long-term health. Digital mental health interventions have been proposed as a means of reducing the treatment gap, given their potential for flexibility, cost-effectiveness, and stigma reduction.Recent FindingsRandomized controlled trials (RCTs) of short-term online interventions based on cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and...
Source: Current Treatment Options in Psychiatry - June 14, 2019 Category: Psychiatry Source Type: research

Brief Novel Therapies for PTSD: Written Exposure Therapy
AbstractPurpose of ReviewWritten exposure therapy (WET) is a five-session exposure-based intervention for the treatment of post-traumatic stress disorder (PTSD). WET was developed through a series of systematic evaluations of the expressive writing procedure. It is an efficient intervention, requiring limited patient and therapist time, and no between-session assignments. The treatment results in statistically and clinically significant symptom change among individuals, including veterans, with PTSD.Recent FindingsWET has been shown to be non-inferior to cognitive processing therapy (CPT), a more intensive form of PTSD tre...
Source: Current Treatment Options in Psychiatry - June 5, 2019 Category: Psychiatry Source Type: research

Dealing With Complexity and Comorbidity: Comorbid PTSD and Substance Use Disorders
AbstractPurpose of reviewPosttraumatic stress disorder (PTSD) and substance use disorders (SUD) are highly comorbid, and the presence of both disorders is associated with lower treatment effect sizes and higher dropout from treatment than one disorder alone. This review examines recent research on treatments for patients with comorbid PTSD/SUD, as well as recent work on psychological mechanisms that may contribute to both disorders.Recent findingsSeveral studies have shown that trauma-focused treatments, such as Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), are effective for redu...
Source: Current Treatment Options in Psychiatry - May 31, 2019 Category: Psychiatry Source Type: research

New-generation Antipsychotics and Cardiovascular Risk
AbstractPurpose of ReviewTo critically review the current landscape of literature on cardiotoxicity of “new-generation antipsychotics,” defined as those approved by the Food and Drug Administration in the last 10 years.Recent FindingsThere is a paucity of data regarding the cardiovascular risks of these medications. Based on the investigations that have been published, iloperidone appears to be the greatest risk of corrected QT prolongation followed by asenapine whereas lurasidone, cariprazine, and brexpiprazole were not found to have significant effects on corrected QT. However, the evidence was low quality. I...
Source: Current Treatment Options in Psychiatry - May 21, 2019 Category: Psychiatry Source Type: research

Brief Novel Therapies for PTSD —Treatment of PTSD in Primary Care
AbstractPurposeThe prevalence of posttraumatic stress disorder (PTSD) among patients in primary care clinics is higher than that of the general population and many people prefer to get mental health care in primary care, creating a unique opportunity to identify and treat the disorder. Current treatment guidelines recommend psychotherapy as a first-line treatment for PTSD; however, there is a limited amount of research examining effective psychotherapy treatment protocols for PTSD within primary care. This review aims to examine the existing literature for the treatment of PTSD in primary care and discuss ongoing dissemina...
Source: Current Treatment Options in Psychiatry - May 14, 2019 Category: Psychiatry Source Type: research

Augmenting the Treatment of PTSD with Ketamine —a Review
AbstractPurposePosttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder with a lifetime prevalence of 6.1% in the general adult population. Clinical guidelines for the treatment of PTSD suggest the use of trauma-focused psychotherapies such as prolonged exposure (PE) and cognitive-behavioral therapy (CBT). As a second-level intervention, these guidelines suggest the use of psychotropic medications, mainly selective serotonin reuptake inhibitors (SSRIs). To date, however, studies have shown that both psychotherapeutic and psychopharmacologic treatments have limited efficacy, with remission rates around 40...
Source: Current Treatment Options in Psychiatry - May 10, 2019 Category: Psychiatry Source Type: research

Dealing with Complexity and Comorbidity: Opportunity for Transdiagnostic Treatment for PTSD
AbstractPurpose of reviewThis review synthesizes literature on transdiagnostic treatments for PTSD and trauma-related psychopathology over the last 3  years and discusses their application across diverse contexts.Recent findingsGlobal and domestic studies suggest that a transdiagnostic approach has the potential to address many challenges providers encounter when treating traumatized populations. Existing research shows that transdiagnostic approaches (including the Unified Protocol, Common Elements Treatment Approach, and Modular Approach to Therapy for Children) are effective across low- and high-resourced settings,...
Source: Current Treatment Options in Psychiatry - May 9, 2019 Category: Psychiatry Source Type: research

Current State of the Problem: Opioid Overdose Rates and Deaths
AbstractPurpose of reviewOverdose deaths have increased significantly over the last 5  years. This review analyzes the severity and nature of the epidemic, its impact on society, factors driving the increase in mortality, special populations disproportionately affected, and solutions to decrease overdose deaths. A thorough understanding of opioid overdose rates and deaths position t he reader to respond most effectively in their sphere of influence.Recent findingsFinal statistics for 2017 show a continued worsening of the epidemic. Recent studies focus on the evolving role of synthetic fentanyl, risk factors for fatal...
Source: Current Treatment Options in Psychiatry - May 8, 2019 Category: Psychiatry Source Type: research

Adjusting the Timeframe of Evidence-Based Therapies for PTSD-Massed Treatments
This article will review the existing literature on massed psychotherapies for PTSD, including only the treatments highly recommended by the current PTSD treatment guidelines that have been modified to an intensive format.Recent FindingsThe literature supporting massed treatment formats for PTSD is limited to date. Two randomized clinical trials (RCTs) provide the strongest evidence for efficacy for prolonged exposure and cognitive therapy for PTSD, and preliminary studies of cognitive processing therapy and eye movement desensitization and reprocessing are promising.SummaryCurrent results suggest that massed formats of ex...
Source: Current Treatment Options in Psychiatry - May 7, 2019 Category: Psychiatry Source Type: research

Augmenting Treatment for Posttraumatic Stress Disorder and Co-Occurring Conditions with Oxytocin
AbstractPurpose of ReviewThe goal of this manuscript is to review the extant literature examining the neurobiological and behavioral mechanisms underlying the potential utility of intranasal oxytocin as a novel pharmacologic intervention for the treatment of posttraumatic stress disorder (PTSD) and for the treatment of comorbid PTSD and alcohol and substance use disorders.Recent FindingsResearch indicates that intranasal oxytocin is a low-cost and easily accessible medication with an excellent safety profile. Oxytocin holds promise for facilitating more effective PTSD treatment, particularly when used in combination with e...
Source: Current Treatment Options in Psychiatry - April 29, 2019 Category: Psychiatry Source Type: research

Multidisciplinary Treatment for Individuals at Clinical High Risk of Developing Psychosis
AbstractPurposeOne of the goals of identifying youth identified, based on clinical symptoms, as being at risk for developing psychosis, is to find ways to prevent or even delay the onset of the illness. Over the past 20  years, relatively few randomized control trials (RCTs), including both pharmacological and psychosocial interventions, have been conducted and often with inconsistent results. Several recent meta-analyses suggest that there are few treatments if any that might be effective and that no one treatmen t is seen as being more effective than any other treatment. This review aims to examine the existing RCTs...
Source: Current Treatment Options in Psychiatry - January 31, 2019 Category: Psychiatry Source Type: research

Use of Antipsychotic Drugs During Pregnancy
AbstractPurpose of reviewAntipsychotics are frequently prescribed to women of childbearing age and are increasingly prescribed during pregnancy. A small, but growing, body of research on implications for pregnancy and infant outcomes is available to inform the risks and benefits of in utero exposure to antipsychotics. This review examines the existing published research on the use of common typical and atypical antipsychotics in pregnancy and the implications for pregnancy and infant outcomes.Recent findingsThe majority of studies do not show associations with major malformations and antipsychotic use in pregnancy, with th...
Source: Current Treatment Options in Psychiatry - January 30, 2019 Category: Psychiatry Source Type: research

Advances in the Treatment of Psychotic Depression
AbstractPurpose of reviewOur aim was to update the current understanding of effective treatment strategies for major depression with psychotic features (MDPSY).Recent findingsMost treatment guidelines recommend either the combination of an antidepressant with an antipsychotic or electroconvulsive therapy (ECT) for the treatment of an acute episode of MDPSY. The optimal maintenance treatment after a person responds to either the antidepressant/antipsychotic combination or ECT is unclear particularly as it pertains to length of time the patient needs to take the antipsychotic medication. Further investigation into possible u...
Source: Current Treatment Options in Psychiatry - January 30, 2019 Category: Psychiatry Source Type: research

Treatment of Clozapine Nonresponders
This article attempts to review the available evidence for management of patients with schizophrenia, who do not respond adequately to clozapine and require augmentation of clozapine with another treatment strategy.Recent findingsMany treatment strategies have been evaluated for management of this group of patients. Commonly used pharmacological augmentation strategies which have been evaluated include addition of a second antipsychotic, mood stabilizer, and antidepressant. Other pharmacological agents such as memantine, donepezil, amino acids, omega-3 fatty acids etc. have also been tried. Among the somatic treatments, el...
Source: Current Treatment Options in Psychiatry - January 23, 2019 Category: Psychiatry Source Type: research

Correction to: The Role of Oxytocin in Early Life Adversity and Later Psychopathology: a Review of Preclinical and Clinical Studies
The original publication of this article is missing a disclosure statement for Dr. Amalia Londono Tobon. (Source: Current Treatment Options in Psychiatry)
Source: Current Treatment Options in Psychiatry - January 10, 2019 Category: Psychiatry Source Type: research

Essential Pharmacotherapies for Bipolar Disorder
AbstractPurpose of ReviewThe evidence basis for treatment of bipolar disorder, both for adults and children, is fairly varied and while Federal Drug Administration (FDA) approval provides one marker of evidence, many psychotropic medications are used for off-label indications. Primary care providers are increasingly at the forefront of initiating treatment for patients with mental health disorders. The purpose of this review is to discuss the current state of evidence for medications treating bipolar disorder, highlighting the evidence, exploring contraindications, side effects, and monitoring requirements for each of the ...
Source: Current Treatment Options in Psychiatry - January 2, 2019 Category: Psychiatry Source Type: research

Bipolar Disorder in Primary Care: Considerations in Management
AbstractPurpose of reviewBipolar disorder is a chronic mental illness that has significant morbidity and mortality implications globally. Increasingly, as with many mental health disorders, patients are being identified in primary care settings.Recent findingsIn this overview, we discuss screening and case identification, making the case for judicious use of screening tools coupled with follow-up clarifying questions. We review the main modalities of treatment including pharmacother-apy and the evidence for non-pharmacotherapy adjunctive approaches. We discuss recommendations and cautions regarding the use of antidepressan...
Source: Current Treatment Options in Psychiatry - December 12, 2018 Category: Psychiatry Source Type: research

Management of Bipolar Disease in Pregnancy and Lactation
AbstractPurpose of reviewBipolar disorder is a psychiatric disorder that commonly affects women of reproductive age. Many women with bipolar disorder require treatment during pregnancy and the post-partum period to optimize their health. The following review examines recent evidence regarding the risks and benefits of using commonly prescribed medications for bipolar disorder in pregnancy and lactation.Recent findingsCurrent research has not found significant and consistent risks with use of atypical antipsychotics compared to other psychotropic agents, and some previously established teratogens, such as lithium, appear to...
Source: Current Treatment Options in Psychiatry - December 1, 2018 Category: Psychiatry Source Type: research

Inflammation and Depression: the Neuroimmune Connection
AbstractPurposeTo update clinicians on the field of psychoneuroimmunology with respect to depression.Recent findingsA significant subset of patients with depression may have illness to which dysfunction of the immune system, typically viewed as inflammation, makes a significant contribution. Normal sickness behavior may sometimes manifest abnormally as mood episodes. Early evidence suggests that interventions that reduce inflammation may improve symptoms in these patients and that they may also respond differently to standard pharmacotherapy.SummaryTreatment of patients with depression should consider inflammatory status, ...
Source: Current Treatment Options in Psychiatry - October 22, 2018 Category: Psychiatry Source Type: research

Neurosteroids in the Pathophysiology and Treatment of Mood and Anxiety Disorders
AbstractPurpose of reviewNeurosteroids have been implicated in the pathophysiology of mood, anxiety, and trauma-related disorders, as well as syndromes specific to women such as premenstrual syndrome, premenstrual dysphoric disorder, postpartum depression, peri- and post-menopausal depression. This review summarizes the role of neurosteroids in the neurobiology of stress and that of pharmaceuticals that modulate neurosteroids in the treatment of these disorders.Recent findingsNeurosteroids may provide novel treatments of mood and anxiety disorders. While endogenous neurosteroids have poor bioavailability, there are other m...
Source: Current Treatment Options in Psychiatry - October 20, 2018 Category: Psychiatry Source Type: research

The Role of Oxytocin in Early Life Adversity and Later Psychopathology: a Review of Preclinical and Clinical Studies
AbstractPurposeOxytocin is a peptide hormone integral in parturition and milk let-down, and is increasingly recognized as an important regulator of human social behaviors including bonding, trust, fear, and stress. There is an increasing evidence that oxytocin is intricately involved in a broad array of neurophysiological functions and may be a common system implicated in multiple psychiatric disorders. This review examines the putative role of oxytocin in early life adversity-mediated risk for later development of subtypes of psychiatric conditions. Several lines of evidence are reviewed including oxytocin levels, respons...
Source: Current Treatment Options in Psychiatry - October 20, 2018 Category: Psychiatry Source Type: research

Estrogen-Based Hormone Therapy for Depression Related to Reproductive Events
AbstractPurposeIn this review, we provide an overview of recent literature on the use of estrogen-based hormone therapy to treat depression related to reproductive events, like postpartum and perimenopause. Women are two to four times more likely to become depressed in the perimenopausal stage of life and as many as 14.5% of women develop postpartum depression. It is hypothesized that these depressive symptoms are a result of fluctuations in hormone levels during these windows of vulnerability. To broaden treatment options beyond psychotherapy and antidepressants, researchers considered the role that estrogen-based hormone...
Source: Current Treatment Options in Psychiatry - October 17, 2018 Category: Psychiatry Source Type: research

Mobile App Tools for Identifying and Managing Mental Health Disorders in Primary Care
AbstractPurpose of ReviewMental health apps are intriguing yet challenging tools for addressing barriers to treatment in primary care. In the current review, we seek to assist primary care professionals with evaluating and integrating mental health apps into practice. We briefly summarize two leading frameworks for evaluating mental health apps and conduct a systematic review of mental health apps across a variety of areas commonly encountered in primary care.Recent FindingsExisting frameworks can guide professionals and patients through the process of identifying apps and evaluating dimensions such as privacy and security...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research

Update on Current Treatment of Acute Opioid Overdose
AbstractPurposeOpioid use, misuse, and abuse are now a rapidly evolving epidemic in the USA. This review aims to update changes in the dosing of naloxone, describe new strategies in prehospital management, and examine in more detail the diverse pathophysiology of opioids beyond respiratory depression.Recent findingsThere are no comparative studies of old or new antidotes or procedures elucidating the superiority of one therapy. Abuse and misuse of over-the-counter loperamide and non-FDA approved tianeptine, using the herbal product kratom, and gambling with powerful fentanyl analogues are recent trends that will impact cli...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research

Risk Factors for Opioid Overdose
AbstractPurpose of ReviewOpioid overdoses have risen starkly over the last two decades in the USA and are now among the leading causes of overall mortality. This review summarizes the current literature on risk factors for overdose as well as public health solutions.Recent FindingsAlthough opioid overdose mortality is highest among men and non-Hispanic whites, the rate of death is rising more rapidly now among women and non-Hispanic blacks. Incarceration remains a significant risk factor for overdose death, especially in the first weeks upon reentry reflecting the absence of treatment in prisons and jails despite strong ev...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research

Financing for Collaborative Care —a Narrative Review
Opinion statementPurpose of reviewCollaborative care (CoCM) is an evidence-based model for the treatment of common mental health conditions in the primary care setting. Its workflow encourages systematic communication among clinicians outside of face-to-face patient encounters, which has posed financial challenges in traditional fee-for-service reimbursement environments.Recent findingsOrganizations have employed various financing strategies to promote CoCM sustainability, including external grants, alternate payment model contracts with specific payers, and the use of billing codes for individual components of CoCM. In re...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research