Psychopharmacology for the Clinician

Psychopharmacology for the Clinician Columns summarize the evidence on a topic of clinical interest. The columns are usually based on a case report in clinical psychopharmacology. The information in the columns is not intended as a definitive treatment strategy but as a suggested approach for clinicians treating patients with similar histories. Individual cases may vary and should be evaluated carefully before treatment is provided.

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Binge eating disorder hidden behind a wall of anxiety disorders
A. Pipe, B. Patterson, M. Van Ameringen

Elevated clozapine levels and toxic effects after SARS-CoV-2 vaccination
D. Thompson, C.M. Delorme, R.F. White, W.G. Honer

The antipsychotic potential of cannabidiol: clinical implications for patients with psychosis and comorbid cannabis use disorder
N. Garel, K.T. Greenway, R. Joober


Treating anxious syndromes with pregabalin in patients with psychosis
N. Garel, D. Bloom, R. Joober

Long-acting injectable antipsychotics: choosing the right dose
D. Carlone, N. Delva

Consensus statement on the use of clozapine during the COVID-19 pandemic
D. Siskind, W.G. Honer, S. Clark, C. U. Correll, A. Hasan, O. Howes, J.M. Kane, D.L. Kelly, R. Laitman, J. Lee, J.H. MacCabe, N. Myles, J. Nielsen, P.F. Schulte, D. Taylor, H. Verdoux, A. Wheeler, O. Freudenreich

Mu-opioid antagonism in the treatment of cannabis use disorder
O. Kebir, X. Laqueille, F. Mouaffak

Kleptomania treated with naltrexone in a patient with intellectual disability
F. Mouaffak, S. Hamzaoui, O. Kebir, X. Laqueille


Treatment of first-episode psychosis in patients with autism-spectrum disorder and intellectual deficiency
N. Garel, R. Joober

Management of sexual adverse effects induced by atypical antipsychotic medication
L. Downing, D.D. Kim, R.M. Procyshyn, P. Tibbo

N-Acetylcysteine augmentation in refractory obsessive–compulsive disorder
S. Bhaskara

Treating resistant depression with 2 forms of convulsive therapy: a clinical case study
A.A. Daskalakis, Z.J. Daskalakis

Clozapine-induced obsessive–compulsive symptoms: mechanisms and treatment
D.D. Kim, A.M. Barr, R.F. White, W.G. Honer, R.M. Procyshyn


Social anxiety disorder in schizophrenia: a neglected, yet potentially important comorbidity
M. Roy, M. Demers, A.M. Achim

Managing disruptive behaviour in autism-spectrum disorder with guanfacine
L. Propper

Covert dysphagia and recurrent pneumonia related to antipsychotic treatment
J.T. Stewart

Pharmacological management of neuropsychiatric symptoms in patients with major neurocognitive disorders
D. Elie, S. Rej

Clozapine, elevated heart rate and QTc prolongation
D.D. Kim, R.F. White, A.M. Barr, W.G. Honer, R.M. Procyshyn


Treatment of ADHD in patients with bipolar disorder
R. Girard, R. Joober

Treating delayed sleep–wake phase disorder in young adults
D.B. Boivin

Recognition and management of antidepressant discontinuation syndrome
V. Bhat, S.H. Kennedy

Pharmacotherapy of trichotillomania
V. Sharma

Generic formulations of psychotropic medications and treatment response
V. Bhat, H.C. Margolese

Refractory social anxiety disorder
M. Van Ameringen, B. Patterson


Clozapine for the management of persistent catatonia
K. Tabbane, S. Halayem, R. Joober

Managing the comorbidity of schizophrenia and ADHD
A. Gough, J. Morrison

Elevated clozapine plasma concentration secondary to a urinary tract infection: proposed mechanisms
L.H.N. Lee, R.F. White, A.M. Barr, W.G. Honer, R.M. Procyshyn

Breakthrough symptoms after switching long-acting injectable paliperidone palmitate from the gluteal to the deltoid site of administration
R.M. Procyshyn, J.L. Banasch, A.M. Barr, W.G. Honer

Treating comorbid premenstrual dysphoric disorder in women with bipolar disorder
M. Smith, B.N. Frey

Successful management of clozapine adverse effects with extended (alternate day) antipsychotic dosing in a patient with schizophrenia
V. Kumar, L. Sharma, S. Madival, G. Venkatasubramanian


Treatment-resistant depression in later life
H. El Bayoumi, Z. Ismail

Topiramate augmentation in a patient with obsessive–compulsive disorder
M. Van Ameringen, B. Patterson

Acute renal and neurotoxicity in older lithium users: How can we manage and prevent these events in patients with late-life mood disorders?
V. Laliberté, C. Yu, S. Rej

Inappropriate benzodiazepine use in elderly patients and its reduction
C. Tannenbaum

Adjunctive treatment with melatonin receptor agonists for older delirious patients with the sundowning phenomenon
T.-C. Yeh, C.-B. Yeh, N.-S. Tzeng, W.-C. Mao

Add-on lithium for the treatment of unipolar depression: Too often forgotten?
F. Jollant


Clozapine augmentation with amisulpride
S. Porcelli, A. Serretti, O. Bianchini

Major depressive disorder and cognitive impairment
R.S. McIntyre

The treatment of bipolar patients with elevated impulsivity and suicide risk
M.E. Sloan, A. Iskric, N.C. Low

Managing ADHD and disruptive behaviour disorders with combination psychostimulant and antipsychotic treatment
D. Elbe, A.M. Barr, W.G. Honer, R.M. Procyshyn

Assessment of adult attention-deficit/ hyperactivity disorder
V. Bhat, J. Paris

Off-label antipsychotic use and tardive dyskinesia in at-risk populations: new drugs with old side effects
G. Remington, M. Hahn


Mixed depression in the postpartum period: diagnostic and treatment issues
V. Sharma

Management strategies for SSR-Iinduced sexual dysfunction
S. J. Rizvi, S.H. Kennedy

Management of clozapine-induced fever: a case of continued therapy throughout fever
N. Martin, R. Williams

Diagnosis and management of periodic catatonia
W.M. Hervey, J.T. Stewart, G. Catalano

Antidepressants and QTc prolongation
R.W. Lam

SSRIs in a case of selective mutism
K. Manassis, D. Avery


Management of comorbid Tourette syndrome and attentiondeficit/ hyperactivity disorder: Are psychostimulants an option?
T. Pringsheim

Antidepressant medication to treat anxiety in patients with bipolar disorder
S. Hassel, G. MacQueen

Prophylaxis and treatment of bipolar disorder in older adults
C.L. Allan, K.P. Ebmeier

Will lithium damage my kidneys?
T.J. Raedler

Managing pathologic aggression in people with psychotic disorders
D. Bourget, A. Labelle

Adverse events associated with switching antipsychotics
J. Su, A.M. Barr, R.M. Procyshyn


Discontinuation of lithium because of side effects
T. Hajek, M. Alda, P. Grof

Bright light for nonseasonal depression?
S.N. Young

Managing anxiety and depressive symptoms in adults with autism-spectrum disorders
K. Boyd, M. Woodbury-Smith, P. Szatmari

Identification and management of cryptic bipolarity in patients with TRD
V. Sharma

Treatment of ADHD in patients unresponsive to methylphenidate
L. Hechtman

Myoclonus as an indicator of infection in patients with schizophrenia treated with clozapine
C.-S. Liang, T.-H. Hsieh


Is there a role for estrogen in treating depression during menopause?
C.N. Soares, B.N. Frey

Autism spectrum disorders, schizo phrenia and diagnostic confusion
M.R. Woodbury-Smith, K. Boyd, P. Szatmari

Options for the treatment of febrile catatonia
G. Northoff

The overdiagnosis of bipolar disorder
I. Iordache, N.C. Low

Tryptophan for refractory bipolar spectrum disorder and sleep-phase delay
R.G. Cooke, R.D. Levitan

Treatment of bipolar disorder with comorbid migraine
A. Ortiz, M. Alda


Should we treat patients with very mild Alzheimer disease with a cholinesterase inhibitor?
S. Gauthier

Treatment of insomnia in posttraumatic stress disorder
N.J. Coupland

Bariatric surgery in patients with bipolar disorder: an emerging issue
V.H. Taylor, M. Misra

Treatment of comorbid tobacco use in people with serious mental illness
K. Lising-Enriquez, T.P. George

Do serum lipids predict response to clozapine treatment?
R.M. Procyshyn, W.G. Honer, A.M. Barr

Optimal use of antidepressants: When to act?
P. Blier


Implementing antiobesity treatment in a patient with a mood disorder
V.H. Taylor

Smoking cessation: the psychiatrist’s role
N.J. Delva

Treating depression during pregnancy
M. Steiner

Subacute alteration in level of consciousness in a woman with psychotic depression
Z. Samaan, G. MacQueen

Combined antidepressants and CBT for panic disorder with agoraphobia
N.J. Coupland

Fish oils for depression?
S.N. Young


Sitting on the edge: when to treat symptoms of inattention without the full DSM-IV criteria of ADHD
R. Joober

Pharmacological treatment of poststroke pathological laughing and crying
P. Giacobbe, A. Flint

Using psychostimulants for treating residual symptoms in major depression
M.T. Berlim, G. Turecki

L-Tyrosine to alleviate the effects of stress? 
S.N. Young

Onset of confusion in the context of late-life depression
B.H. Mulsant

Management of conventional antipsychotic-induced tardive dyskinesia
H.C. Margolese, F. Ferreri


Metabolic syndrome: relevance to antidepressant treatment
P. Chokka, M. Tancer, V.K. Yeragani

Psychopharmacology of smoking cessation in patients with mental illness
P. Selby

Treating depression with selective norepinephrine reuptake inhibitors
P. Blier

The rational use of medications in acute psychotic presentations — the case for less is more
A.G. Awad

Treatment guidelines for mania
S.H. Kennedy

Managing discontinuation syndrome in patients with dementia
S. Gauthier


What is the role of pharmacotherapy in the treatment of anorexia nervosa?
M. Israël

What is the best way to treat bipolar depression?
P. Silverstone

On the selection and use of atypical antipsychotics in the management of nonpsychotic mood and anxiety disorders
P. Blier

What are the treatment options for comorbid alcohol abuse and depressive disorders?
M. Dongier

Selective serotonin reuptake inhibitors (SSRIs) and depression after myocardial infarction (MI)
J.M. Le Mellédo, J. Perez-Parada

What is the optimal implementation of bright light therapy for seasonal affective disorder (SAD)?
Robert D. Levitan