They are some of the most effective antidepressants around, and they are pretty well tolerated.

But to use the MAOIs, you'll need to follow the sixth psychopharmacology commandment.

Honor thy MAOI interactions.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psych MP and a dedicated reader of every issue.

Psychiatry is a collaborative art. We work with people who have problems with judgment,

and we have to meet them where they're at while making sure the treatment doesn't steer too far off the road.

That's what the PsychoFarm Commandments are all about.

In this series, we are highlighting areas where the line between safe and unsafe is a sharp one,

and there's little room for compromise.

Let's recap the first five before we get into today's number six.

Number one, do not worsen mental illness with psych meds,

so don't give antidepressants during mania or psychostimulants to people with psychosis.

2. Avoid stopping meds abruptly, particularly benzodiazepines, serotonergic antidepressants and lithium.

Patients rank withdrawal problems as one of their top concerns with psych meds. Unless there's

a dire need to get off the med, like a le motrogen rash, we concerns with psych meds. Unless there's a dire need to get off the med,

like a Lamotrogen rash, we recommend stopping psych meds gradually over at least two weeks.

And that brings us to number three. Stop Lomotrogen if any rash develops in the first three

months of treatment with it. Four, watch out for lithium toxicity and prevent it by staying on top of drug interactions,

dehydration and your patient's age and renal function.

5. Do not combine benzodiazepines and opioids in patients who have an elevated risk of overdose.

...