Clozapine is often prescribed for patients with treatment-resistant schizophrenia, but its use is sometimes discontinued if it is suspected of inducing neutropenia. In this podcast, author Laurent Béchard discusses a consecutive case series published in the July-August 2022 issue of the Journal of Clinical Psychopharmacology assessing the continuation or reintroduction of this drug despite a neutropenia episode. In addition to suggesting further research to better define severe vs. moderate cases, Dr. Béchard proposes the use of pharmacovigilance tools to assess possible causes of neutropenia so clinicians can better determine if this highly effective antipsychotic should remain part of a patient’s treatment plan.

In this podcast, Editor-in-Chief Anthony Rothschild discusses his editorial in the May-June 2022 issue about the use of antipsychotic medications for treatment of nonpsychotic patients. With four drugs approved by the FDA for use as augmentation for the treatment of nonpsychotic depression, and possibly a fifth soon, he advocates for more longitudinal studies to better understand the potential risks vs. benefits to this practice. While citing previous similar treatment approaches in the history of psychopharmacology, Dr. Rothschild advocates that until potentially serious adverse effects can be ruled out, the prescription of antipsychotic medications to nonpsychotic patients should be limited to those who are resistant to all other treatments.

The use of the combination of stimulants and antipsychotic medications is increasing in pediatric patients who suffer from Attention Hyperactivity Disorder (ADHD). In this podcast, Dr. Mohamed Mohamoud discusses how this combination may result in acute hyperkinetic movement disorder in children. Using the FDA Adverse Event Reporting System database, Dr. Mohamoud and his colleagues conducted a case series analysis and identified 36 instances where a pharmacodynamic drug-drug interaction may have resulted in the disorder. Their report is published in the May/June 2022 issue of the Journal of Clinical Psychopharmacology. Prescribing information has recently been updated and this podcast discusses the data upon which that information was changed. Dr. Mohamoud is being interviewed by FDA press officer Charlie Kohler.

Drs. Steve Dubovsky and Dori Marshall discuss their article reviewing the potential of calcium channel blockers for the treatment of mood disorders, an area of research that the authors assert has received too little attention. Their article, titled Calcium Channel Antagonists for Mood Disorders, appears in the March-April 2022 issue of the Journal of Clinical Psychopharmacology.

“Polypharmacy,” the simultaneous use of multiple medications, has been linked to an increased risk of treatment complications. An article in the March-April 2022 issue of the Journal of Clinical Psychopharmacology takes a systematic look at research studies that have tested interventions to optimize polypharmacy in psychiatric treatment and nursing homes. Improvement of drug-related outcomes can be achieved by interventions such as individualized medication review and educational approaches. Changes in clinical outcomes, however, are often not substantial. Drs. Philip Stötzner and Eva Brandl, two of the authors of the systematic review, discuss their findings and avenues for future research.

How can we improve psychopharmacology practice? This podcast features a lively discussion among the authors of two articles in the January-February 2022 issue of the Journal of Clinical Psychopharmacology in which they address that important topic. The participants discuss some weaknesses in current models of psychopharmacology training as well as the challenges clinicians face in keeping up with medication advances.

A large observational study from researchers at Washington University in St. Louis found an elevated risk of breast cancer in women who take some types of antipsychotic drugs – specifically, drugs that raise levels of the hormone prolactin. In this podcast, Dr. Tahir Rahman, lead author of the study, discusses the findings and their implications for patient care.

In the effort to prevent relapse in patients who have experienced depressive episodes, it has been common practice to have them continue long-term on antidepressant medications, including selective serotonin reuptake inhibitors (SSRIs) and serotonin noradrenaline reuptake inhibitors (SNRIs). In this author podcast, Giovanni A. Fava discusses his guest editorial that challenges that custom and suggests alternative approaches for preventing relapse. Dr. Fava’s Guest Editorial is published in the November-December 2021 issue of the Journal of Clinical Psychopharmacology.

The link between substance abuse, impulsivity,

and violence in psychotic patients remains unclear. In this author podcast, Gabriella Gobbi, MD, PhD, and Stefano Comai, PhD, discuss their study, which was designed to assess whether cannabis use disorder is associated with violent and/or psychotic behavior in patients who are hospitalized in a high-security hospital.

The findings show that cannabis and alcohol are often abused (by themselves or together) by psychotic patients with a propensity for violence, but only alcohol is associated with impulsive and violent behavior. The article is published in the November-December 2021 issue of the Journal of Clinical Psychopharmacology.

Individuals with major depressive disorder and suicidal ideation are particularly vulnerable and may not respond as well to standard treatment as patients without suicidal ideation. In this author podcast, Dr. Dong-Jing Fu and Dr. Carla Canuso discuss the results of a pooled analysis of data from the ASPIRE studies, randomized placebo-controlled trials of esketamine, plus comprehensive standard-of-care treatment. The results, published in the September-October 2021 issue of the Journal of Clinical Psychopharmacology, suggest that esketamine can provide rapid relief of depressive symptoms in patients with MDD and acute suicidal ideation or behavior, especially in those with a history of prior suicide attempt.