Cardiovascular Safety of Amphetamine/Dextroamphetamine versus Methylphenidate in Older Adults.

Recent epidemiological data has shown a sharp increase in stimulant use among older adults, which is notable as older adults may be especially vulnerable to their cardiovascular effects. Results of recent studies have shown an increase in cardiovascular events among older adults using stimulants; however, little data exists comparing cardiovascular safety of these agents head-to-head. To determine if the incidence of serious cardiovascular events, including myocardial infarction (MI), stroke/transient ischemic attack (TIA), or arrhythmia, are different in patients taking amphetamine/dextroamphetamine compared with patients taking methylphenidate.

A Review of Therapeutics for Treatment-Resistant Depression in the Older Adult.

One-third of older adults with depression meet criteria for treatment resistance, typically defined as a lack of response to two or more adequate trials of an antidepressant. Treatment resistance contributes to an unfavorable prognosis, compromised medical outcomes, heightened disability, accelerated cognitive decline, and an elevated risk of developing dementia. Despite this significant morbidity, evidence is sparse for how to proceed with treatment in this population.

An Evaluation of Nonacademic Predictors of Success in a Doctor of Pharmacy Program.

Pharmacy programs have struggled to predict who will be successful in their programs based solely on cognitive skills. The primary objective of this study was to determine which, if any, nonacademic factors are associated with on-time progression within the school of pharmacy curriculum. A survey was developed and offered to all Texas Tech University Health Sciences Center Jerry H.

Comparison of lithium to second generation antipsychotics for the treatment of bipolar disorder in older veterans.

Approximately 25% of all adults with bipolar disorder are over the age of 65. Literature in older age bipolar disorder is sparse and typically extrapolated from data in younger adults. This retrospective cohort study included patients 65-89 years of age with bipolar I or II disorder who were prescribed lithium or SGA treatment.

Pharmacologic management of behavioral and psychological symptoms of major neurocognitive disorder.

Behavioral and psychological symptoms of dementia (BPSD) occur in approximately 80% of patients who receive a diagnosis of major neurocognitive disorder. Nonpharmacologic strategies are the first-line treatment for BPSD. However, psychotropic medications are often necessary when nonpharmacologic methods are not effective in treating symptoms that are distressing or are causing behaviors that are dangerous to the patient or the patient's caregivers.

Antipsychotic discontinuation after the initiation of selective serotonin reuptake inhibitors therapy for the treatment of behavioral and psychological symptoms associated with dementia.

Introduction: Antipsychotics are used off label to treat behavioral and psychological symptoms of dementia (BPSD). Due to the emerging data of selective serotonin reuptake inhibitors (SSRIs) for treatment of BPSD, clinicians may choose to use this medication class instead of antipsychotics when pharmacologic therapy is necessary. The objective of this study was to evaluate the prevalence of antipsychotic discontinuation 6 months after SSRI initiation for the treatment of BPSD.

The Impact of Cholinesterase Inhibitors with or without Memantine on Antipsychotic Prescribing.

Background Alzheimer's disease (AD) medications have been suggested to positively affect behavior, though not universally in all studies. Their impact on antipsychotic use is not well-defined. Methods This cross-sectional, retrospective study evaluated residents with AD on cholinesterase inhibitors, memantine, both, or neither throughout multiple long-term care facilities during July 2014.

Antidepressant Exposure and Risk of Dementia in Older Adults with Major Depressive Disorder.

Objectives: To identify whether duration of antidepressant use in depressed elderly veterans differed between those who later developed dementia and those who did not.

Design: Single-center, retrospective, observational, electronic chart review.

Setting: Medical charts from a Veterans Affairs Mental Health Clinic.

Evaluation of QTc prolongation and dosage effect with citalopram.

Introduction: Recently, controversy has surrounded a 2011 Food and Drug Administration warning against using citalopram at doses >40 mg/day due to QTc prolonging effects.

Methods: Patients ≥18 years old at the VA North Texas Health Care System were included in this retrospective review if they had received at least 1 prescription for a 30-day supply of citalopram between January 1, 2007, and February 29, 2012, and had a baseline electrocardiogram (ECG) within 1 year before initiation or dose increase of citalopram and at least 1 repeat ECG within 3 months after citalopram initiation or dose increase. The primary endpoint was the prevalence of QTc prolongation (QTc interval ≥470 ms for men and ≥480 ms for women) after initiation or a dose increase of citalopram.

Effect of pharmacy students as primary pharmacy members on inpatient interdisciplinary mental health teams.

Purpose: The effect of pharmacy students as primary pharmacy members on inpatient interdisciplinary mental health teams was investigated.

Methods: This retrospective study used Veterans Affairs data from veterans who were admitted to an inpatient mental health unit from January 1, 2010, through December 31, 2012. Eligible veterans had to have been hospitalized for at least five days and treated with at least five scheduled medications during the hospitalization.

Visual hallucinations treated with the reinitiation of memantine in a patient with Lewy body dementia.

Objective: To report on a patient with Lewy body dementia who developed worsening of hallucinations with memantine withdrawal and significant improvement with reinitiation of the drug.

Case Summary: A 78-year-old man presented to a geriatric psychiatry clinic in March 2011. The patient had experienced gradual memory loss since 2007 and was diagnosed with dementia with Lewy bodies (DLB) in 2009.

Targeting treatment-resistant depression.

Only 50% of depressed patients achieve remission of symptoms after 2 trials of antidepressants. Therefore one half of patients are considered treatment resistant. Studies have shown that with each failed antidepressant, chances of remission continue to decline.

Incidence of abnormal metabolic parameters and weight gain induced by atypical antipsychotics in elderly patients with dementia.

Objective: To determine if atypical antipsychotic therapy leads to the development of abnormal metabolic parameters and weight gain in elderly patients with dementia.

Design: Retrospective chart review.

Setting: Veterans Affairs Medical Center.

Pharmacologic agents for the treatment of obesity.

Obesity guidelines state that pharmacologic therapy can be considered if a patient fails to lose 10 percent of their original body weight after 6 months of adhering to a low calorie diet, exercise, and behavior modification. Many published trials have shown sibutramine and orlistat to be effective for weight loss and weight maintenance when used with lifestyle modifications. However, few trials have studied the efficacy and safety of these medications in the elderly.