To manage metabolic problems, Cutler, who is clinical associate professor in the Department of Psychiatry at SUNY Upstate Medical University in Syracuse, New York, recommended monitoring metabolic parameters, weight gain, and appetite changes encouraging a healthy diet and active lifestyle choosing agents with lower incidence of weight gain when possible (eg, aripiprazole, lurasidone) considering the incorporation of metformin when initiating treatment with olanzapine or clozapine or using olanzapine with samidorphan instead of olanzapine alone.Īntipsychotic Dose-Response in Acute Phase SchizophreniaĪntipsychotics and New-Onset Obsessive-Compulsive Disorder in Schizophreniaįor movement disorders, he suggested some specific strategies for drug-induced Parkinsonism and akathisia, which both may be mitigated by reducing dosage or switching to medications with lower risk (eg, clozapine, iloperidone, lumateperone) when possible. In “Safety First: A Comparison of the Safety and Tolerability of Antipsychotics,” Cutler discussed these adverse effect -metabolic problems, movement disorders, sedation, and sexual dysfunction 1-as well as the treatment strategies medical providers can use to optimize the management of these adverse effects according to individual patient needs. Cutler, MD, presented on the clinical management of the 4 most common adverse effects associated with antipsychotic medications that can negatively affect treatment adherence. Managing the 4 Most Common Adverse Effects of Antipsychotics Erin O’BrienĪndrew J. Prevalence and correlates of benzodiazepine use, misuse, and use disorders among adults in the United States. Patterns in outpatient benzodiazepine prescribing in the United States. However, older patients and children, as well as those who concurrently use opioids, have a history of substance use disorder, are at risk of falling, or operate heavy machinery, should be carefully monitored because they the risk-benefit ratio is not as strong.ġ. The agents could be beneficial when a patient has breakthrough symptoms, rapid onset is needed (eg, for panic attacks), or a patient is experiencing acute expected anxiety (eg, phobias). Tolerance data are mixed, although benzodiazepines should be used carefully in patients who have a history of substance use. 2 Factors that increase risk of misuse, use disorders, and harms include younger age, male gender, socioeconomic disadvantage, and current or history of substance use disorders, as well as being divorced, separated, or never married.ĭespite these issues, Strawn said, “Benzodiazepines have a role in treating anxiety disorders, but they require monitoring and consideration of risks/benefits.”
1 Unfortunately, the agents are misused by 5.2 million adults, of whom 0.5 million have benzodiazepine use disorder and 0.3 million have benzodiazepine dependence. Disadvantages include initial sedation, memory impairment, falls, possible increased risk of fracture, and possible abuse dependence and withdrawal.īenzodiazepines: It’s Time to Prescribe Cautionīenzodiazepine Use and the Risk of DementiaĪccording to Strawn, recent findings show that approximately 7.4% of patients seen in psychiatric care are receiving benzodiazepines. Advantages include rapid onset, reasonable tolerability, usefulness for breakthrough symptoms, and possible usefulness for acute and chronic anxiety. To begin, Strawn discussed the advantages and disadvantages of benzodiazepine use. Strawn playfully asked the audience, “How many of you are like me-you have that love-hate relationship with the benzodiazepines?” About 90% of the in-person audience raised their hands. Is there any class of medications probably other than opiates that evokes that same visceral reaction? I don’t think so,” said Jeffrey R. Benzodiazepines: Opiates That Evoke a Visceral Reaction Leah Kuntz Psychiatric Times TM, your go-to source for what is relevant and important in the field, is pleased to share the following highlights. Psychopharmacology across the lifespan, cultural competency, and clinical challenges were among the topics discussed in live and poster sessions. Psychiatric Times TM attended the 2021 Neuroscience Education Institute Congress in November, which welcomed both live and virtual attendees to their 4-day conference.
0 kommentar(er)
