In a guest editorial in the Journal of Clinical Psychopharmacology, authors Eric G. Smith and Kushani M. Patel discuss how case series and case reports can contribute to psychiatric treatment decisions. Their article in the March-Apil 2024 issue is titled “The Role of Case Series and Case Reports in Evidence-Based Medicine.” Dr. Smith is from the VA Bedford Healthcare System and the UMass Chan Medical School. Dr. Patel is from the Boston University Chobanian & Avedisian School of...

“Rapid cycling” in bipolar disorder is defined by the occurrence of at least 4 episodes of mania, hypomania, depression, or mixed states during the preceding 12 months. Episodes are demarcated by partial or full remission for at least 2 months or a switch to an episode of opposite polarity. In this podcast, Dr. Ross J. Baldessarini of McLean Hospital and Harvard Medical School discusses the prevalence of rapid cycling and the challenges in its treatment. Rapid cycling is more common in...

Two articles in the March-April 2024 issue of the Journal of Clinical Psychopharmacology present research on glucagon-like peptide-1 receptor agonists (GLP-1 RAs),  a class of medications that has drawn considerable media attention in recent months for their ability to promote significant weight loss. The articles in JCP consider their use in specific populations of patients: individuals with bipolar disorder or eating disorders (in this case, atypical anorexia nervosa). This podcast...

In 1954, Dr Heinz Lehmann published the first clinical article on the use of chlorpromazine. Chlorpromazine was the first synthetic drug used to control states of mania and psychomotor excitement, marking the birth of modern psychopharmacology. Seventy years later, the Journal of Clinical Psychopharmacology is highlighting the anniversary of Dr Lehmann’s publication. The January-February 2024 issue of the journal includes a guest editorial that offers a brief history lesson on Dr Lehmann’s...

We have all seen the television commercials imploring viewers to “ask your doctor” about Drug X, Y, or Z. The authors of a study in the Journal of Clinical Psychopharmacology were interested in finding out how such advertising might affect the prescribing of psychotropic medicines. In this podcast, the authors discuss their research with Dr. Julia A. Koretski, Digital Editor for JCP. The authors of the study are Drs. Bennett Wechsler, Richard Balon, Richard Shader; and Anthony Rothschild....

Replacement therapy is a key tool in the treatment of individuals who abuse opioids. The idea is to replace heroin or morphine with less euphoric and longer-acting substances, such as methadone, under a medication management protocol. The goals of medical-assisted replacement treatment include reducing an individual's craving for abused opioids, preventing medical complications, decreasing criminal behavior and its consequences, and utimately, hopefully, helping the individual become...

Clozapine is an important drug in the treatment of schizophrenia, and adherence is generally thought to be as good as, if not better than, other antipsychotics. Nonadherence, however, is difficult to detect and potentially dangerous. Tolerance to the cardiovascular effects of the drug is easily lost; restarting at a “normal” dose can prove fatal after a period of abstinence. Nonadherence also increases the risk of self-harm. In this podcast, Dr. Robert Flanagan, a now-retired clinical...

Much has been written in recent months regarding the growing use of artificial intelligence (AI) in medicine and the potential benefits and risks of its use. In this podcast, Anthony J. Rothschild, MD, Editor-in-Chief of the Journal of Clinical Psychopharmacology, highlights a paper in the journal by Drs. Jose de Leon and Carlos De Las Cuevas that reports their experiment to see how ChatGPT3 would respond to various questions about clozapine metabolism. The generated text proved to be...

The COVID-19 pandemic and associated public health measures shifted the way people access health care. In this podcast, Dr. Christine Leong, Associate Professor at the University of Manitoba College of Pharmacy, discusses the research she and her colleagues conducted to study the effects of the pandemic on psychotropic medication adherence. The data were drawn from a claims repository that contains information on health service and medication use for almost all Manitoba residents. The study...

The July-August 2023 issue of the Journal of Clinical Psychopharmacology features a helpful tutorial written by Drs. Eric G. Smith and Hannah L. Grigorian. Their article is titled “A System for Rapidly Yet Rigorously Evaluating the Quality of Randomized Controlled Trials.”  The article should be of particular interest to busy clinicians, researchers, and trainees, who must grapple with the never-ending task of keeping up with the medical literature. In this podcast accompanying the...

Hyperammonemia is an adverse effect that poses clinical uncertainty regarding the prescription of valproic acid (VPA) use. The prevalence of symptomatic and asymptomatic hyperammonemia and its relationship to VPA concentration is not well established. In this podcast, clinical pharmacists Michelle Gnrya and Yiu-Ching Jennifer Wong of St. Paul’s Hospital in Vancouver discuss their systematic review that summarizes evidence available regarding VPA-associated hyperammonemia and its...

Among individuals with schizophrenia, an estimated 50% to 80% have a partial or even total lack of insight into the presence of their mental disorder. This condition, known as anosognosia, has also been observed in people with other diagnoses, such as bipolar disorder, major depression with psychotic features, obsessive-compulsive disorder, and eating disorders. The May-June 2023 issue of the Journal of Clinical Psychopharmacology features two articles on this topic, a commentary by Rachel...

For individuals with treatment-resistant depression, ketamine can be an effective fast-acting alternative to conventional antidepressants. It has been hypothesized that it partly exerts its antidepressant effects by modulating the opioid system. In this podcast, Dr. Brandi Quintanilla discusses her study that explored baseline plasma levels of κ-opioid and dynorphin peptides and changes after ketamine infusion. Participants in this randomized trial included individuals with major depressive...

Clozapine is a unique antipsychotic with superior efficacy in treatment-resistant schizophrenia (TRS). Unfortunately, approximately 40% to 70% of patients on clozapine continue to experience psychotic symptoms. Nevertheless, there is a concern about how high of a dose to prescribe because adverse effects are related to plasma levels of the drug. In this podcast, Dr. Jan Bogers discusses his research involving stepwise increases in clozapine doses in severely ill, long-stay patients with TRS. ...

Lithium is considered a standard treatment for bipolar disorder, but it remains underprescribed, in part because of its association with kidney dysfunction. In this podcast, Dr. Balwinder Singh discusses an article he and his colleagues published in the January-February 2023 issue of the Journal of Clinical Psychopharmacology on “real-world” clinical practice involving patients with bipolar disorder (BD) and chronic kidney disease (CKD). In their study, patients with BD and CKD who...

In a commentary published in the Journal of Clinical Psychopharmacology, Dr. Rishab Gupta (Brigham and Women's Hospital/Harvard Medical School) and Dr. Swarndeep Singh (Government Medical College and Hospital, Chandigarh, India) cast a critical eye on India’s regulatory approval for the use of endoxifen for the treatment of manic episodes in patients with bipolar disorder type 1. In their article and in this podcast, they suggest that there are important deficiencies in the research that was...

Psychedelics as a potential treatment for depression is an irresistible topic in the mainstream press, but what is the evidence base for their use? In this podcast, psychiatrist and journal Digital Editor Dr. Julia Ann Koretski (of Mass General Brigham Newton-Wellesley Hospital) leads Dr. Ishrat Husain and Dr. Richard Balon through an illuminating discussion of where we stand in clinical trials research and the important limitations of current findings. Dr. Husain is the senior author of “A...

In this podcast, Dr. Jonathan Leung discusses the article, “The Modernization of Clozapine: A Recapitulation of the Past in the United States and the View Forward,” published with several colleagues in the November-December 2022 issue of the Journal of Clinical Psychopharmacology (Volume 42, Issue 6). Dr. Leung, lead author of the review article, is a psychiatric pharmacist at the Mayo Clinic in Rochester, MN, and faculty member at the Mayo Clinic College of Medicine. Clozapine is a unique...

In small-scale studies, 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for posttraumatic stress disorder has shown some promise, but exploratory analyses have suggested that recent use of selective serotonin reuptake inhibitors (SSRIs) can dampen the efficacy of this novel therapy. In this podcast, Dr. Collin M. Price, a psychiatric resident at UCLA, and Dr. Allison Feduccia, a neuropharmacologist and CEO of a company that curates CME courses on psychedelics, discuss their new...

In this podcast, Dr. Melvin McInnis discusses lithium toxicity in individuals with bipolar disorder who were infected by the SARS-CoV-2 virus. Lithium is an effective long-term management strategy for treating bipolar disorder, but because acute kidney damage can be a complication of COVID-19, the body’s ability to process lithium may be affected. Based on his case report study, coauthored by Dr. Anastasia Yocum and published in the September-October 2022 issue of the Journal of Clinical...

Panic disorder is a common psychiatric disorder, with generally effective pharmacologic treatments for most patients. However, a subset of patients do not respond,  and roughly 25% of patients have adverse effects. In this podcast, based on his guest editorial published in the September-October 2022 issue of the Journal of Clinical Psychopharmacology, Dr. Antonio Nardi makes the case that the next era of treatments may be inhibitor specific. Because of the amygdala’s essential role in the...