More Psychopharm...

I know, I know, the conference was over more than a week ago.  I'm writing these posts more for myself, as a way to review what I learned and stabilize it in my head. Thanks for bearing with me. 

Dr. Alpert on Drug Interactions:

There are online drug interaction checkers.  
~Prozac interacts with Coumadin. 
~ Geodon needs to be taken with meals or it doesn't get absorbed.  ~Some medications decrease the efficacy of oral contraceptives including carbamazepine (Tegretol), Provigil, St John's Wort).  
~Oral contraceptives can also increase the levels of valproate and lamotrigine.
~Some SSRI's decrease the efficacy of Tamoxifen.  

Dr. Henderson on Managing Side Effects of Antipsychotic Agents
~Interventions for weight gain: Switch agents
~Exercise/Diet
~ add: sibutramine, orlistat, topirimate, buproprion, metformin
~worry about prolactin levels and tardive dyskinesia.
~Omega 3 Fatty acids (1-2 grams of EPA =DHA) may reduce cardiac risk

Dr. Perlis on Emerging Treatments in Bipolar Disorder
What we know: Not very much
~Brexpiprazole (Rexulti) is similar to Abilify.  There is no data for its use in bipolar disorder.
~New for bipolar depression: Lurasidone (Latuda); Armodafinil (Nuvigil)-- not FDA approved.  rTMS.  Ketamine--effects fade in days.  
~?Low frequency magnetic stimulation, after an MRI tech noted that people got happy during their MRIs.
~Pregnenolone (a steroid hormone precursor)
~Pioglitazone (Actos) as a lithium add-on

Dr. Papakostas on New Treatments for Major Depression
~Vortioxetine (Brintillix).  Start at 10mg, back down to 5mg if side effects (nausea is common, also sleep disturbance), can go to 20mg.
~Executive dysfunction is often seen in mood disorders.  
~Both duloxitine andvortioxetine improved memory
~Geodon for augmentation (ziprasidone, better than placebo)