Public & Community Psychiatry

Questions discussed in this category

How do you discuss lithium with patients who are hesitant due to concerns about side effects or monitoring requirements?

How do you frame lithium's risk-benefit profile compared with other mood stabilizers or atypical antipsychotics? How do you address patient fears abou...

3 Answers available

How would you decide between escalation to clozapine vs xanomeline-tropsium (Cobenfy) for treatment-resistant schizophrenia?

5 Answers available

When do you consider using Uzedy, the subcutaneous long-acting injectable version of risperidone?

1 Answer available

How long do you continue benzodiazepines in patients who have recovered from catatonia?

3 Answers available

When do you order brain imaging in young adults presenting with first-episode psychosis in the absence of clear neurologic red flags?

1 Answer available

How do you decide whether to request a welfare check (police or mobile crisis) when a typically responsive outpatient becomes suddenly unreachable?

How do you balance concern for patient safety with the potential harms of an intrusive intervention, including trauma or loss of therapeutic alliance?...

2 Answers available

How do you approach firearm safety counseling for outpatients with elevated suicide risk who do not meet the criteria for involuntary psychiatric hospitalization?

3 Answers available

How do you decide when and how often to reach out to patients with serious mental illness who are disengaging from care due to psychosocial stressors?

How do balance concern for safety with patient autonomy? What factors do you take into consideration when determining whether to proactively reach out...

2 Answers available

Which patients do you think would benefit most from xanomeline-tropsium (Cobenfy) monotherapy?

How does the general goal of reducing anticholinergic burden in schizophrenia play into your decision?

3 Answers available

What opportunities do you see for combining xanomeline-tropsium (Cobenfy) with other anti-psychotic agents?

E.g. LAIs, clozapine

2 Answers available

What are the most effective strategies for managing weight gain associated with antipsychotic medications?

16 Answers available

What strategies have you found effective for obtaining insurance approval for xanomeline-tropsium (Cobenfy)?

1 Answer available

How do you approach titration or transitioning to Cobenfy in patients currently on an antipsychotic?

Are there any special concerns for antipsychotics with a higher anticholinergic burden?

2 Answers available

What strategies have you found helpful to manage SSRI associated night sweats?

5 Answers available

How do you assess and adjust treatment in patients who develops hypothyroidism after being on lithium for several years?

1 Answer available

When do you use seizure prophylaxis in patients on clozapine?

7 Answers available

How do you facilitate access to interventional treatments such as TMS for patients with difficult-to-treat depression who are on Medicaid?

1 Answer available

How do you monitor patients who are symptomatically well-managed on clozapine with supratherapeutic drug levels?

2 Answers available

When do you consider pharmacogenetic testing to assist in the selection of antipsychotic medications?

In light of publication from Gras et al., PMID 40662264

1 Answer available

What strategies have you found effective in reducing intake no-show rates among patients with severe and persistent mental illness?

2 Answers available

When do you consider using multiple antipsychotic medications for chronic management of psychosis?

Does your approach change when using a long-acting injection antipsychotic with oral antipsychotic medication?

2 Answers available

When do you choose to switch to antidepressants vs augmentation in treatment-resistant depression?

4 Answers available

How do you approach a treatment relationship with a patient who is non-adherent to recommendations and also is not interested in transfer to another practitioner?

10 Answers available

What strategies have you found helpful for balancing telehealth and in-person appointments to reduce bottlenecks?

1 Answer available

How do you transition patients between different long-acting injectable antipsychotics?

2 Answers available

Is there a benefit to augmenting treatment for schizophrenia by adding aripiprazole (a partial D2 agonist) to a full D2 antagonist such as haloperidol?

1 Answer available

How will you use xanomeline-trospium (KarXT, Cobenfy) for patients with schizophrenia?

4 Answers available

How do you handle elevated blood calcium levels from lithium?

1 Answer available

In a woman with bipolar disorder with a menstrual component would lamotrigine itself worsen the condition given that it interacts with prescribed estrogen?

Does lamotrigine interfere with baseline estradiol levels in a woman who is not prescribed estrogen otherwise?

1 Answer available

How do you manage antipsychotic-induced prolactinemia?

1 Answer available

What approach to antipsychotics do you take with patients with primary thought disorder who are now geriatric?

e.g. for schizophrenia. What would be the best treatment options to minimize long term impacts related to cognition?

1 Answer available

What do you do for patients who have received accidental extra dosages of long-acting injectable antipsychotics?

3 Answers available

Papers discussed in this category

Psychiatry research, 2024 Mar 20

Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial.

Indian journal of psychological medicine, 2019 Mar-Apr

Use of Stimulants in Patients with Psychosis Having Past History of or Co-occurring Attention Deficit Hyperactivity Disorder: Is it Safe?

International journal of molecular sciences, 2022 Mar 04

Neuroinflammation in Schizophrenia: The Key Role of the WNT/β-Catenin Pathway.

Translational psychiatry, 2023 Oct 11

Metformin improves cognitive impairment in patients with schizophrenia: associated with enhanced functional connectivity of dorsolateral prefrontal cortex.

Neurology, 1991 Mar

Clozapine-related seizures.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 2013 Aug 31

Use of anticonvulsants as prophylaxis for seizures in patients on clozapine.

CNS drugs, 2022 Jun 27

A Guideline and Checklist for Initiating and Managing Clozapine Treatment in Patients with Treatment-Resistant Schizophrenia.

Expert opinion on pharmacotherapy, 2023 Jun 27

Switching to long-acting injectable antipsychotics: pharmacological considerations and practical approaches.

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