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

Death Ambivalence and Treatment Seeking: Suicidality in Opiate Addiction
AbstractPurpose of reviewRates of suicide and opiate overdose have recently skyrocketed in the USA. In light of impulsivity and impaired motivation common in people with substance use disorders, suicidality is common in addiction.Recent findingsChart review surveys indicate two primary suicidal populations that are important to distinguish for clinical practice and healthcare policy. One group is heavily composed of people with substance use disorders, in whom chronic compulsive use fosters a numbambivalence about death (low death intentionality). Many of these individuals with opiate use disorder (OUD) exaggerate suicidal...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research

Future Directions Incorporating Novel Medications to Reduce Repeat Overdose
AbstractPurpose of reviewThe use of opioids has risen dramatically in the USA and led to an increase in opioid use disorders and deaths due to opioid-related overdoses. Current treatments for opioid use disorder are not without drawbacks, so that new treatments may be helpful in reducing opioid use. This paper reviews current pharmacologic treatments for opioid use disorder as well as emerging novel treatments that may change or improve approaches to treatment.Recent findingsThe current treatments for opioid use disorder are methadone, buprenorphine, and naltrexone. Of the three, methadone has been the most studied and lon...
Source: Current Treatment Options in Psychiatry - September 1, 2018 Category: Psychiatry Source Type: research

Thyroid Hormone Treatment of Mood Disorders
AbstractPurpose of reviewBoth excess and insufficient thyroid hormones can lead to depression that is generally reversible with adequate thyroid treatment. On the other hand, major depression is associated with subtle chronobiological hypothalamic-pituitary-thyroid (HPT) axis dysregulation and thyroid hormones can be an effective adjunct to antidepressant treatment. However, the links between HPT axis status and efficacy of thyroid hormone supplementation in depression remain to be further clarified.Recent findingsWhile generally, depressed patients are chemically euthyroid, most exhibit a chronobiological HPT axis dysregu...
Source: Current Treatment Options in Psychiatry - August 30, 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 - July 25, 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 - July 16, 2018 Category: Psychiatry Source Type: research

Death Ambivalence and Treatment Seeking: Suicidality in Opiate Addiction
AbstractPurpose of reviewRates of suicide and opiate overdose have recently skyrocketed in the USA. In light of impulsivity and impaired motivation common in people with substance use disorders, suicidality is common in addiction.Recent findingsChart review surveys indicate two primary suicidal populations that are important to distinguish for clinical practice and healthcare policy. One group is heavily composed of people with substance use disorders, in whom chronic compulsive use fosters a numbambivalence about death (low death intentionality). Many of these individuals with opiate use disorder (OUD) exaggerate suicidal...
Source: Current Treatment Options in Psychiatry - July 9, 2018 Category: Psychiatry Source Type: research

Future Directions Incorporating Novel Medications to Reduce Repeat Overdose
AbstractPurpose of reviewThe use of opioids has risen dramatically in the USA and led to an increase in opioid use disorders and deaths due to opioid-related overdoses. Current treatments for opioid use disorder are not without drawbacks, so that new treatments may be helpful in reducing opioid use. This paper reviews current pharmacologic treatments for opioid use disorder as well as emerging novel treatments that may change or improve approaches to treatment.Recent findingsThe current treatments for opioid use disorder are methadone, buprenorphine, and naltrexone. Of the three, methadone has been the most studied and lon...
Source: Current Treatment Options in Psychiatry - July 7, 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 - July 6, 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 - July 3, 2018 Category: Psychiatry Source Type: research

Treatment Approaches for Opioid Use Disorders in Late Life
AbstractPurpose of reviewThe use of opioids and opioid-related deaths in the USA has risen to epidemic proportions. Until recently, the impact of this public health crisis in older adults has not been adequately emphasized. This paper reviews the extant literature for the management of opioid use disorder (OUD) in older adults, with a focus on both pharmacologic and non-pharmacologic interventions for OUD in older adults.Recent findingsOpioid prescriptions for older adults have dramatically increased since the 1990s. OUD in older adults is under recognized and under treated in clinical settings. Once identified, appropriat...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

Treatment of Late-Life Psychosis
AbstractPurpose of reviewPsychosis in late life is a cause of significant distress, suffering, and decline in the quality of life for patients, caregivers, and family members. While psychotic symptoms in later life may be related to long-standing, chronic conditions, the new onset of delusions and hallucinations often presents a diagnostic dilemma to the clinician. This paper seeks to review the overall causes and conditions related to psychosis in later life and discuss available treatment options.Recent findingsThe paucity of new research in the areas of psychosis in late-life and the near absences of clinical drug trial...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

Position Paper —Transference-Focused Psychotherapy (TFP) for Narcissistic Personality
AbstractPurpose of reviewThe authors describe the application of a twice-weekly, exploratory psychotherapy, Transference-Focused Psychotherapy (TFP), to patients with Narcissistic Personality Disorder (NPD). The paper describes the pathology of object relations within which narcissistic pathology can be understood, and how TFP establishes a treatment framework to address narcissistic pathology. An outline of the assessment and treatment protocol is described along with a case example to illustrate the same.Current findingsThe application of TFP to patients with NPD follows from recent research demonstrating the effectivene...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

Recent Developments in the Management of Insomnia in Later Life
AbstractPurpose of reviewInsomnia impacts a significant proportion of older adults yet is not an inevitable consequence of aging and is amenable to intervention. The aim of this narrative review is to provide an overview of recent recommendations and empirical findings regarding the management of insomnia in older adults.Recent findingsThe treatment of insomnia with cognitive behavioral therapy for insomnia (CBT-I) continues to be empirically supported and the recommended first-line intervention for adults. Accumulating evidence indicates that other non-pharmacological therapies for insomnia, such as mindfulness-based ther...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

Treatment Approaches to Sexual Dysfunction in Late Life
AbstractPurpose of reviewThis review provides an overview of the latest treatment options for sexual dysfunction in the elderly, specifically the DSM-5 male and female sexual disorders, medication-induced sexual dysfunction, and inappropriate sexual behaviors in dementia. Despite the increasing prevalence of sexual dysfunction with age, various factors including ageism, misconceptions about sexual behavior in the elderly, and discomfort discussing these issues can lead to under-recognition and under-treatment. This review highlights the importance of sexual health at any age and the available pharmacologic and non-pharmaco...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

The Use of Electroconvulsive Therapy in Late-Life Psychiatric Disorders
AbstractPurposeTo review the current literature regarding the use and safety of electroconvulsive therapy (ECT) in the elderly population.Recent findingsElectroconvulsive therapy (ECT) is both a safe and effective treatment for geriatric patients with severe psychiatric illness. In an era of often inadequate or poorly tolerated pharmacologic treatments, ECT can provide life-saving treatment for depression, catatonia, movement disorders, and even mood and behavioral dysregulation in dementia syndromes. The Prolonging Remission in Depressed Elderly (PRIDE) study directed by Charles Kellner has provided clear and convincing e...
Source: Current Treatment Options in Psychiatry - June 1, 2018 Category: Psychiatry Source Type: research

Position Paper —Transference-Focused Psychotherapy (TFP) for Narcissistic Personality
AbstractPurpose of reviewThe authors describe the application of a twice-weekly, exploratory psychotherapy, Transference-Focused Psychotherapy (TFP), to patients with Narcissistic Personality Disorder (NPD). The paper describes the pathology of object relations within which narcissistic pathology can be understood, and how TFP establishes a treatment framework to address narcissistic pathology. An outline of the assessment and treatment protocol is described along with a case example to illustrate the same.Current findingsThe application of TFP to patients with NPD follows from recent research demonstrating the effectivene...
Source: Current Treatment Options in Psychiatry - May 4, 2018 Category: Psychiatry Source Type: research

Treatment Approaches for Opioid Use Disorders in Late Life
AbstractPurpose of reviewThe use of opioids and opioid-related deaths in the USA has risen to epidemic proportions. Until recently, the impact of this public health crisis in older adults has not been adequately emphasized. This paper reviews the extant literature for the management of opioid use disorder (OUD) in older adults, with a focus on both pharmacologic and non-pharmacologic interventions for OUD in older adults.Recent findingsOpioid prescriptions for older adults have dramatically increased since the 1990s. OUD in older adults is under recognized and under treated in clinical settings. Once identified, appropriat...
Source: Current Treatment Options in Psychiatry - May 1, 2018 Category: Psychiatry Source Type: research

Treatment Approaches to Sexual Dysfunction in Late Life
AbstractPurpose of reviewThis review provides an overview of the latest treatment options for sexual dysfunction in the elderly, specifically the DSM-5 male and female sexual disorders, medication-induced sexual dysfunction, and inappropriate sexual behaviors in dementia. Despite the increasing prevalence of sexual dysfunction with age, various factors including ageism, misconceptions about sexual behavior in the elderly, and discomfort discussing these issues can lead to under-recognition and under-treatment. This review highlights the importance of sexual health at any age and the available pharmacologic and non-pharmaco...
Source: Current Treatment Options in Psychiatry - April 25, 2018 Category: Psychiatry Source Type: research

Treatment of Late-Life Psychosis
AbstractPurpose of reviewPsychosis in late life is a cause of significant distress, suffering, and decline in the quality of life for patients, caregivers, and family members. While psychotic symptoms in later life may be related to long-standing, chronic conditions, the new onset of delusions and hallucinations often presents a diagnostic dilemma to the clinician. This paper seeks to review the overall causes and conditions related to psychosis in later life and discuss available treatment options.Recent findingsThe paucity of new research in the areas of psychosis in late-life and the near absences of clinical drug trial...
Source: Current Treatment Options in Psychiatry - April 23, 2018 Category: Psychiatry Source Type: research

The Use of Electroconvulsive Therapy in Late-Life Psychiatric Disorders
AbstractPurposeTo review the current literature regarding the use and safety of electroconvulsive therapy (ECT) in the elderly population.Recent findingsElectroconvulsive therapy (ECT) is both a safe and effective treatment for geriatric patients with severe psychiatric illness. In an era of often inadequate or poorly tolerated pharmacologic treatments, ECT can provide life-saving treatment for depression, catatonia, movement disorders, and even mood and behavioral dysregulation in dementia syndromes. The Prolonging Remission in Depressed Elderly (PRIDE) study directed by Charles Kellner has provided clear and convincing e...
Source: Current Treatment Options in Psychiatry - April 19, 2018 Category: Psychiatry Source Type: research

Recent Developments in the Management of Insomnia in Later Life
AbstractPurpose of reviewInsomnia impacts a significant proportion of older adults yet is not an inevitable consequence of aging and is amenable to intervention. The aim of this narrative review is to provide an overview of recent recommendations and empirical findings regarding the management of insomnia in older adults.Recent findingsThe treatment of insomnia with cognitive behavioral therapy for insomnia (CBT-I) continues to be empirically supported and the recommended first-line intervention for adults. Accumulating evidence indicates that other non-pharmacological therapies for insomnia, such as mindfulness-based ther...
Source: Current Treatment Options in Psychiatry - April 17, 2018 Category: Psychiatry Source Type: research

Combination Treatments in Borderline Personality Disorder: Bridging the Gap Between Clinical Practice and Empirical Data
Opinion statementPurpose of Review This paper presents an empirical basis for combination treatments in borderline personality disorder (PD), including medication combinations, psychotherapy combinations, and psychotherapy with medication. The goals are to synthesize empirical data evaluating combination treatments and to demonstrate gaps between research and clinical practice.Recent Findings The limited research supporting combination treatments displayed mixed results. There is minimal support for the frequent clinical practice of polypharmacy, with some evidence for the use of atypical antipsychotics with antidepressant...
Source: Current Treatment Options in Psychiatry - March 6, 2018 Category: Psychiatry Source Type: research

Use of Antipsychotic Medications in Non-Substance-Related Delirium —the Gap Between Research Findings and Clinical Practices
AbstractPurpose of the reviewGaps exist between the research knowledge base and clinical practices pertaining to the use of antipsychotics in delirium. We reviewed 19 major randomized studies on the use of antipsychotics in non-substance-related delirium to understand factors contributing to this gap.Recent findingsBased on limited literature, antipsychotics are not effective in treating delirium in patients who are mechanically ventilated intensive care unit patients and those in palliative care, but they may be effective in preventing delirium in high-risk patients after elective surgery. The literature on the use of ant...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Identifying and Treating the Prodromal Phases of Bipolar Disorder and Schizophrenia
Opinion statementPurpose of reviewThe goal of this paper is to review recent research on the identification and treatment of prodromal periods that precede bipolar and psychotic disorders. We also sought to provide information about current best clinical practices for prodromal youth.Recent findingsResearch in the areas of identifying prodromal periods has rapidly advanced. Calculators that can predict risk are now available for use during both bipolar and psychotic disorder prodromes. Cognitive behavior therapies have emerged as the gold standard psychosocial interventions for the psychosis prodrome, while several other t...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Symptom Dimensions in Obsessive-Compulsive Disorder as Predictors of Neurobiology and Treatment Response
AbstractPurpose of reviewSpecific symptom dimensions of obsessive-compulsive disorder (OCD) have been suggested as an approach to reduce the heterogeneity of obsessive-compulsive disorder, predict treatment outcome, and relate to brain structure and function. Here, we review studies addressing these issues.Recent findingsThe contamination and symmetry/ordering dimensions have not been reliably associated with treatment outcome. Some studies found that greater severity of sexual/aggressive/religious symptoms predicted a worse outcome after cognitive behavioral therapy (CBT) and a better outcome after serotonin reuptake inhi...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Treatment Implications for ADHD Youth with Mood and Anxiety Comorbidity
AbstractPurpose of ReviewThere are multiple pharmacological and psychosocial interventions that are tolerable and efficacious for the treatment of attention deficit hyperactivity disorder (ADHD). However, many youth with ADHD have elevated levels of mood and anxiety symptoms that can complicate treatment. In this review, we summarize the relevant treatment studies on the treatment of youth with ADHD and comorbid anxiety or mood disorders.Recent FindingsTreatment of ADHD, specifically CNS stimulants, often translates to reduced irritability in youth with ADHD, but appears to have limited impact on other mood or anxiety symp...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Use of Antipsychotic Drugs for Psychotic Disorders in Children
AbstractPurpose of reviewThis review aims to provide evidence-based guidance regarding the use of antipsychotic medications for treatment of children and adolescents with psychotic disorders. Research findings from the past 3  years are emphasized.Recent findingsA number of studies have demonstrated the efficacy of antipsychotic medications for use in children and/or adolescents with psychotic disorders, but there is also high potential for significant side effects. Atypical antipsychotic drugs are often preferred instead of typical antipsychotics due to reduced risk of extrapyramidal symptoms, but the risk for weight...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Psychosocial Treatment of Irritability in Youth
AbstractPurpose of reviewChronic, severe irritability is a common presenting problem in children and adolescents. Disruptive mood dysregulation disorder (DMDD) was added to the DSM-5 in recognition of this public health need. Currently, there are no well-established, evidence-based pharmacological or psychosocial treatments specifically for DMDD. Here, we focus on psychosocial interventions. In addition to reviewing published research, we present preliminary, open trial data on a novel exposure-based cognitive-behavioral therapy (CBT) targeting severe irritability, as is present in DMDD.Recent findingsIn the published lite...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Combination Treatments in Borderline Personality Disorder: Bridging the Gap Between Clinical Practice and Empirical Data
Opinion statementPurpose of Review This paper presents an empirical basis for combination treatments in borderline personality disorder (PD), including medication combinations, psychotherapy combinations, and psychotherapy with medication. The goals are to synthesize empirical data evaluating combination treatments and to demonstrate gaps between research and clinical practice.Recent Findings The limited research supporting combination treatments displayed mixed results. There is minimal support for the frequent clinical practice of polypharmacy, with some evidence for the use of atypical antipsychotics with antidepressant...
Source: Current Treatment Options in Psychiatry - March 1, 2018 Category: Psychiatry Source Type: research

Symptom Dimensions in Obsessive-Compulsive Disorder as Predictors of Neurobiology and Treatment Response
AbstractPurpose of reviewSpecific symptom dimensions of obsessive-compulsive disorder (OCD) have been suggested as an approach to reduce the heterogeneity of obsessive-compulsive disorder, predict treatment outcome, and relate to brain structure and function. Here, we review studies addressing these issues.Recent findingsThe contamination and symmetry/ordering dimensions have not been reliably associated with treatment outcome. Some studies found that greater severity of sexual/aggressive/religious symptoms predicted a worse outcome after cognitive behavioral therapy (CBT) and a better outcome after serotonin reuptake inhi...
Source: Current Treatment Options in Psychiatry - February 23, 2018 Category: Psychiatry Source Type: research

Novel Therapeutics in Bipolar Disorder
Opinion statementRecent findingsExisting pharmacological treatments for bipolar disorder have demonstrated insufficient efficacy, delayed onset of action, and significant side effects. Emerging evidence suggest that rapid antidepressant activity can be achieved in humans, and findings from the use of glutamatergic and anticholinergic drugs, for instance, reveal promising results.Purpose of reviewIn the present article, we review evidence supporting the use of novel therapies in bipolar disorder, with focus on drugs acting in the glutamatergic system. In addition, anticholinergic drugs, melatonergic agonists, glucocorticoid...
Source: Current Treatment Options in Psychiatry - February 17, 2018 Category: Psychiatry Source Type: research

Psychosocial Treatment of Irritability in Youth
AbstractPurpose of reviewChronic, severe irritability is a common presenting problem in children and adolescents. Disruptive mood dysregulation disorder (DMDD) was added to the DSM-5 in recognition of this public health need. Currently, there are no well-established, evidence-based pharmacological or psychosocial treatments specifically for DMDD. Here, we focus on psychosocial interventions. In addition to reviewing published research, we present preliminary, open trial data on a novel exposure-based cognitive-behavioral therapy (CBT) targeting severe irritability, as is present in DMDD.Recent findingsIn the published lite...
Source: Current Treatment Options in Psychiatry - February 9, 2018 Category: Psychiatry Source Type: research

Use of Antipsychotic Drugs for Psychotic Disorders in Children
AbstractPurpose of reviewThis review aims to provide evidence-based guidance regarding the use of antipsychotic medications for treatment of children and adolescents with psychotic disorders. Research findings from the past 3  years are emphasized.Recent findingsA number of studies have demonstrated the efficacy of antipsychotic medications for use in children and/or adolescents with psychotic disorders, but there is also high potential for significant side effects. Atypical antipsychotic drugs are often preferred instead of typical antipsychotics due to reduced risk of extrapyramidal symptoms, but the risk for weight...
Source: Current Treatment Options in Psychiatry - January 27, 2018 Category: Psychiatry Source Type: research

Treatment Implications for ADHD Youth with Mood and Anxiety Comorbidity
AbstractPurpose of ReviewThere are multiple pharmacological and psychosocial interventions that are tolerable and efficacious for the treatment of attention deficit hyperactivity disorder (ADHD). However, many youth with ADHD have elevated levels of mood and anxiety symptoms that can complicate treatment. In this review, we summarize the relevant treatment studies on the treatment of youth with ADHD and comorbid anxiety or mood disorders.Recent FindingsTreatment of ADHD, specifically CNS stimulants, often translates to reduced irritability in youth with ADHD, but appears to have limited impact on other mood or anxiety symp...
Source: Current Treatment Options in Psychiatry - January 26, 2018 Category: Psychiatry Source Type: research