4.8 • 440 Ratings
🗓️ 3 April 2023
⏱️ 15 minutes
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0:00.0 | The DEA has deputized us to enforce regulations around controlled substances, but they haven't |
0:06.6 | exactly made those regulations clear. Today, we'll bring some need of clarity with the seventh |
0:11.7 | psychopharm commandment. Controlled substances shall be controlled. Welcome to the Carlite Psychiatry Podcast, keeping psychiatry honest since 2003. |
0:27.6 | I'm Chris Aiken, the editor-in-chief, and the author of the Depression and Bipolar Workbook. |
0:33.5 | And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue. |
0:40.0 | On May 11, 2023, the COVID-19 public health emergency will come to an end. |
0:47.3 | But there's another public health emergency that we're still in the middle of, the opioid crisis. |
0:53.3 | Both of these emergency states have impacted the |
0:55.8 | regulation of controlled substances, and we are on the front lines of that regulation. Today, |
1:02.2 | we're going to offer guidance on how to navigate controlled regulations in this emergency |
1:07.0 | climate with the seventh cycle farm commandment, but first, a replay of the previous six. |
1:14.1 | 1. Do not worsen mental illness with psych meds, like don't use antidepressants during mania or |
1:20.7 | psychostimulants in psychotic disorders. Two, avoid stopping meds abruptly, particularly benzodiazepines, serotonergic antidepressants, and lithium. |
1:32.1 | Patients rank withdrawal problems as one of their top concerns. Unless there's a dinee to get |
1:37.2 | off the med, like a Lomotrogen rash, we recommend stopping psych meds gradually over at least two weeks. |
1:44.4 | 3. Stop Lomotetrogen if any rash develops in the first three months of treatment with it. |
1:51.0 | Even mild rashes can progress to fatal ones, and you can't be sure which way this wind is blowing. |
1:57.6 | Four, watch out for lithium toxicity by staying on top of drug interactions, dehydration, |
2:03.8 | and your patient's age and renal function. |
2:06.6 | 5. Do not give benzodiazepines to patients who have an elevated risk of opioid overdose deaths. |
2:13.3 | Benzos increase the overdose risk fourfold. |
2:17.5 | Rewind to a September, November 2022 episode for more details on the first five, |
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