Clinical Pearls presentations will be recorded and posted but are only available for live credit.
For the First Time in Forever: There's a New Drug-Drug Interaction with Lithium
Ericka L. Crouse, PharmD, BCPP, BCGP
The use of sodium glucose co-transporter 2 (SGLT2) inhibitors has been increasing in treatment of diabetes, heart failure, and renal disease. Patients treated for mental illness are increasingly being prescribed this class of medications. Recently, it has been recognized that SGLT2 inhibitors can have an impact on lithium excretion and lithium concentrations. This clinical pearl explores the mechanism and clinical impact of the drug-drug interaction between SGLT2 inhibitors and lithium.
The "Other Booster": Clozapine Augmentation with Fluvoxamine
Ashley Maister, PharmD, BCPP
Clozapine is a recommended treatment modality for patients with treatment resistant schizophrenia. Unfortunately, some patients do not adequately respond to an effective dose and duration of clozapine (defined as "ultra-treatment resistant schizophrenia"), at which point augmentation strategies with additional medications may be utilized. This clinical pearl explores the use of fluvoxamine to strongly inhibit clozapine's primary metabolic mechanism, which is thought to increase the overall effectiveness of therapy while minimizing intolerable adverse effects.
Pearls for Creating a Collaborative Practice Agreement
Christine M. Rarrick, PharmD, BCPP, BCPS, MBA
This clinical pearl will review key tips for creating a comprehensive, functional collaborative practice agreement. Content includes lessons learned from a current well-run collaborative practice based long-acting injectable medication clinic. A large focus will be placed on how to manage sustainable growth.
Consider making this session part of your BPS Continuing Professional Development plan! Please refer to the BPS Psychiatric Pharmacy Content Outline to see how this activity may align.
Target Audience
If you are a pharmacist, nurse practitioner, or other health care professional involved in the comprehensive medication management of individuals living with mental health and/or substance use disorders, we invite you to participate in this online course.
Course Requirements
To receive ACPE credit for this session, you must:
- Register for this course.
- Review the full content of the activity and reflect upon its teachings.
- Complete the evaluation at the end of the activity.
- Provide the necessary details in your profile to ensure correct reporting by AAPP to CPE Monitor.
Faculty Information
View biographical information
Ericka Crouse, PharmD, BCPP, BCGP
Associate Professor
Virginia Commonwealth University
Richmond, VA
Dr. Ericka Crouse is an Associate Professor at the Virginia Commonwealth University School of Pharmacy. She received her Doctor of Pharmacy degree at the University of Florida. Following graduation she completed a Geriatrics Pharmacy Residency at the Durham Veteran’s Affairs Medical Center in North Carolina and a Psychiatric Pharmacy Residency at VCUHealth. She practiced as a Clinical Pharmacist on the inpatient psychiatry unit at VCUHealth for 12 years prior to transitioning to a faculty member in 2017 where she teaches PharmD students psychopharmacology. Her clinical service includes rotating on inpatient psychiatry at VCUHealth and at the outpatient Substance Use Disorders Clinic.
Clinical Pharmacy Practitioner, Behavioral Health
Corporal Michael J. Crescenz VA Medical Center
Philadelphia, PA
Ashley Maister, PharmD, BCPP is a clinical pharmacy practitioner in the outpatient behavioral health clinic at the Corporal Michael J. Crescenz VA Medical Center in Philadelphia, PA. She received her Doctor of Pharmacy degree Thomas Jefferson University in 2018. She then completed her PGY-1 pharmacy residency at Penn Presbyterian Medical Center in Philadelphia, PA and PGY-2 psychiatric pharmacy residency at Ernest Mario School of Pharmacy at Rutgers University in Piscataway, NJ. Dr. Maister is a Board Certified in Psychiatric Pharmacy, and her clinical interests include serious mental illnesses and substance use disorders. She serves as a preceptor for both pharmacy students and residents, and was awarded her facility’s Preceptor of the Year award in 2022. She also contributes to the profession through research and involvement in local and national pharmacy organizations.
No Relevant Financial Relationships to Disclose
My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: Augmentation of clozapine with fluvoxamine
Clinical Pharmacy Specialist
Medical University of South Carolina
Charleston, SC
Christine Rarrick, PharmD, MBA, BCPS, BCPP is a clinical pharmacy specialist focusing in psychiatric pharmacy at the Medical University of South Carolina. She serves as the program director for MUSC’s PGY2 Psychiatric Pharmacy Residency. Her clinical practice in shared between the psychiatric emergency department and an outpatient long-acting injectable medication management. Dr. Rarrick completed her PharmD at the University of New Mexico.
This presentation will not include discussion of off-label, experimental, or investigational use of drugs or devices
Learning Objectives
For the First Time in Forever: There's a New Drug-Drug Interaction with Lithium
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Explain the mechanism of action of sodium glucose co-transporter 2 (SGLT2) inhibitors and the drug-drug interaction with lithium.
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Describe the clinical implications of the drug-drug interaction between SGLT2 inhibitors and lithium and effects on lithium concentrations.
The "Other Booster": Clozapine Augmentation with Fluvoxamine
- Review the role of clozapine and norclozapine levels in assessment of medication efficacy and tolerability.
- Identify appropriate clinical scenarios for utilizing fluvoxamine as an augmenting agent to clozapine.
Pearls for Creating a Collaborative Practice Agreement
- Describe key steps in creating a collaborate practice agreement.
- Discuss important aspects of a comprehensive collaborative practice agreement.
Continuing Education Credit and Disclosures
Activity Date: 04/09/2024
ACPE Contact Hours: 1
ACPE Number: 0284-0000-24-033-L01-P (Knowledge)
Nursing Credit Reminder: Note that ACPE credit is accepted for ANCC Certification Renewal and AANPCB advanced practice provider content. For specific questions related to your organization's acceptance of ACPE continuing education units, please contact your organization directly.
The American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
AAPP owns the copyright, is licensed or has received permissions for use of, or is otherwise permitted to use copyrighted materials within any CPE activity. Authors and speakers are required to obtain necessary copyright permissions for content in CPE activities. AAPP complies with copyright laws and regulations.
View planning committee disclosures
2024 Program Committee and Recertification Editorial Board
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Elayne D. Ansara, PharmD, BCPP, BCPS Mental Health Clinical Pharmacist Practitioner VISN23 Clinical Resource Hub Indianapolis, IN Non-Financial Interests: The Board of Pharmaceutical Specialties (Psychiatric Pharmacy Specialty Council) |
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Bridget Bradley, PharmD, BCPP |
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Katie L. Brase, MA Program Specialist American Association of Psychiatric Pharmacists Lincoln, NE No Relevant Financial Relationships to Disclose |
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Dana Chiulli, PharmD, BCPP Clinical Pharmacist Practitioner - Mental Health VISN 06 Mental Health Clinical Resource Hub Flower Mound, TX No Relevant Financial Relationships to Disclose |
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Marissa Cullen, PharmD, BCPP Clinical Pharmacist UPMC Western Psychiatric Hospital Pittsburgh, PA No Relevant Financial Relationships to Disclose |
 Beth DeJongh, PharmD, BCPS, BCPPDirector of Continuing Professional Development American Association of Psychiatric Pharmacists Lincoln, NE No Relevant Financial Relationships to Disclose |
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Chelsea N. Di Polito, PharmD, BCPP Assistant Director, Pharmacy Administration - Clinical Services University of Maryland School of Pharmacy Baltimore, MD No Relevant Financial Relationships to Disclose |
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Alisha D. Donat, PharmD, BCPP Clinical Pharmacy Specialist - Mental Health South Texas Veterans Health Care System San Antonio , TX No Relevant Financial Relationships to Disclose |
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Bennett J. Doughty, PharmD, BCPP, BCPS Clinical Assistant Professor Binghamton University School of Pharmacy and Pharmaceutical Sciences Binghamton, NY External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: PsychU- Speaker's Bureau |
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Traci M. Dutton, PharmD, BCPP, BCPS Clinical Pharmacy Specialist - Mental Health; Program Director - PGY2 Psychiatric Pharmacy Residency VA Tennessee Valley Healthcare System Murfreesboro, TN Employment: Tennessee Valley VA Healthcare System, Clinical Pharmacy Specialist - Mental Health, Member of VA PBM Educational Advisory Committee which oversees Board Certification Study Groups |
Megan J. Ehret, PharmD, MS, BCPP |
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Kimberly Ehrhard, PharmD, BCPP Clinical Pharmacist, Psychiatry The University of Kansas Health System Kansas City , KS No Relevant Financial Relationships to Disclose |
 Robert J. Haight, PharmD, BCPPProgram Committee Chair Clinical Pharmacist | Forensic Services Saint Peter Regional Treatment Center (SPRTC), Minnesota Department of Human Services Saint Peter, MN No Relevant Financial Relationships to Disclose |
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Abigail Hampton, PharmD, BCPP Clinical Pharmacy Practitioner- mental health Kansas City Veterans Affairs Kansas City, MO No Relevant Financial Relationships to Disclose |
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Suzanne C. Harris, PharmD, BCPP Associate Professor/Director of Well-being and Resilience/Clinical Pharmacist Practitioner UNC Eshelman School of Pharmacy Chapel Hill, NC No Relevant Financial Relationships to Disclose |
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Jordan Haygood, PharmD, BCPP Clinical Pharmacy Specialist - Psychiatry Medical University of South Carolina Charleston, SC No Relevant Financial Relationships to Disclose |
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Courtney A. Iuppa, PharmD, BCPP Clinical Pharmacy Manager & Residency Program Director Center for Behavioral Medicine Kansas City, MO No Relevant Financial Relationships to Disclose |
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Archana R. Jhawar, PharmD, BCPP Clinical Pharmacist Jesse Brown VAMC/ UIC College of Pharmacy Chicago, IL No Relevant Financial Relationships to Disclose |
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Kayla D. Johnson, PharmD, BCPP, BCPS Clinical Pharmacist Specialist Vanderbilt University Medical Center Thompsons Station, TN External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Pharmacy Times Continuing Education Speaker |
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Dongmi Kim, PharmD, BCPP, BCPS Assistant Clinical Professor Fairleigh Dickinson University School of Pharmacy Florham Park, NJ No Relevant Financial Relationships to Disclose |
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Jamie C. Kneebusch, PharmD, BCPP, BCPS Assistant Clinical Faculty UC San Diego, Skaggs School of Pharmacy La Jolla, CA No Relevant Financial Relationships to Disclose |
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Erin D. Knox, PharmD, BCPP Director of Experiential Education UCI School of Pharmacy & Pharmaceutical Sciences Irvine, CA Non-Financial Interests: Santa Ana Community College, Pharmacy Technology Program, Advisory Committee |
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Lauren E. Leiby, PharmD, BCPP Behavioral Health Patient Care Pharmacist Nationwide Childrens Hospital Columbus, OH No Relevant Financial Relationships to Disclose |
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Linda D. Logan, PharmD, BCACP, BCPP, BCPS Public Service Associate University of Georgia Athens, GA Educational Grants, Research Grants or Contracts: HRSA Graduate Psychology Education Grant, UGA Mental Health Seed Grants for MHFA and Virtual Dementia Tour, UGA College Pharmacy Ansel Fund |
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Megan Maroney, PharmD, BCPP Clinical Associate Professor Ernest Mario School of Pharmacy at Rutgers, the State University of New Jersey Long Branch, NJ External Consultant Activities, Advisory Panels, Speakers Bureaus, etc.: Pharmacy Times - speaker and medical writing honoraria, Otsuka Pharmaceuticals - Excel Speakers Bureau (former, through March 2022), Novus Medical Education - consultant/medical writing, Boehringer Ingelheim - advisory board, Sunovion Pharmaceuticals – consultant/advisory board, Biogen and Sage Therapeutics - advisory board |
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Monica Mathys, PharmD, BCGP, BCPP Professor Texas Tech University School of Pharmacy Dallas, TX Non-Financial Interests: AAPP Foundation Board member |
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Maren McGurran, PharmD, BCPP, BCPS Clinical Pharmacist, Psychiatry Northwest Missouri Psychiatric Rehabilitation Center MO No Relevant Financial Relationships to Disclose |
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Lindsey N. Miller, PharmD, BCPP |
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Breanna L. Moody, PharmD, BCPP Clinical Pharmacy Specialist - Mental Health Clinic Lexington VA Health Care System Lexington, KY Non-Financial Interests: BPS - BCPP Item Writer for 2022 cycle |
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Brianne Mosley, PharmD, BCPP, BCPS Psychiatric Clinical Pharmacist McLean Hospital Belmont, MA No Relevant Financial Relationships to Disclose |
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Jessica L. Mulhollan, PharmD, BCPP Clinical Pharmacy Specialist, Substance Use Disorders and Mental Health Clinical Pharmacy Supervisor Louis Stokes Cleveland VA Medical Center Cleveland, OH No Relevant Financial Relationships to Disclose |
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Kristen Neumeister, PharmD, BCPP Clinical Pharmacist North Texas State Hospital Fort Worth, TX No Relevant Financial Relationships to Disclose |
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Megan O'Connell, PharmD, BCPP Clinical Pharmacy Specialist - Psychiatry and Neurology Michigan Medicine Ann Arbor, MI No Relevant Financial Relationships to Disclose |
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Melissa C. Palmer, PharmD, BCPP, BCPS Clinical Pharmacy Specialist - Mental Health Alaska VA Healthcare System Anchorage, AK No Relevant Financial Relationships to Disclose |
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Haley Pals, PharmD, BCPP Substance Use Disorder/Psychiatric Clinical Pharmacist Tomah VA Medical Center Tomah, WI No Relevant Financial Relationships to Disclose |
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Brittany L. Parmentier, PharmD, MPH, BCPS, BCPP Clinical Pharmacy Specialist in Psychiatry The Harris Center for Mental Health and IDD Houston, TX No Relevant Financial Relationships to Disclose |
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Jake R. Peters, PharmD, BCPP, BCPS Assistant Professor of Pharmacy Practice/Clinical Pharmacy Specialist - Psychiatry Butler University College of Pharmacy/Indiana University Health Indianapolis, IN No Relevant Financial Relationships to Disclose |
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Sarah J. Popish, PharmD, BCPP VA PBM Academic Detailing Services, Program Manager Department of Veterans Affairs Sarasota, FL No Relevant Financial Relationships to Disclose |
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Devon A. Sherwood, PharmD, BCPP |
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Rosana Steavenson, PharmD, BCPP, BCPS Program Manager, Mental Health Clinical Pharmacy Programs; Mental Health Clinical Pharmacy Specialist South Texas Veterans Health Care System San Antonio, TX No Relevant Financial Relationships to Disclose |
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Abby Stocks, PharmD, BCPP Inpatient Behavioral Health Pharmacist Inova Fairfax Medical Campus Falls Church, VA Educational Grants, Research Grants or Contracts: College of Psychiatric and Neurologic Pharmacists "Defining the Future" research grant |
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Nina Vadiei, PharmD, BCPP Clinical Associate Professor University of Texas at Austin San Antonio, TX No Relevant Financial Relationships to Disclose |
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Heidi J. Wehring, PharmD, BCPP Adjunct Associate Professor of Psychiatry Maryland Psychiatric Research Center, University of Maryland School of Medicine Baltimore, MD No Relevant Financial Relationships to Disclose |
 Kara R. Wong, PharmD, BCPPRecertification Editorial Board Chair Clinical Pharmacist Practitioner, Mental Health Minneapolis VA Health Care System Minneapolis, MN No Relevant Financial Relationships to Disclose |
All relevant relationships have been mitigated.
View disclaimer and disclosure of off-label use
Off-Label Use: This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA (see faculty information). The opinions expressed in the educational activity do not necessarily represent the views of AAPP and any educational partners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer: Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Presentation-Specific Disclosure: Ashley Maister - My presentation will include discussion of off-label, experimental, and /or investigational use of drugs or devices: Augmentation of clozapine with fluvoxamine Ericka Crouse - This presentation will include discussion of brand names of antidiabetic medications: The use of brand names is included on an introduction slide since many of these products are still available brand only, and psychiatric pharmacists may be less familiar with the available dosage forms or brand names of products as monoproduct and combination products exist. Christine Rarrick: This presentation will not include discussion of off-label, experimental, or investigational use of drugs or devices
View fair balance and integrity statement
It is the policy of AAPP to ensure independence, balance, objectivity, scientific rigor, and integrity in continuing education activities. Those involved in the development of this continuing education activity have made all reasonable efforts to ensure that information contained herein is accurate in accordance with the latest available scientific knowledge at the time of accreditation of this continuing education activity. Information regarding drugs (e.g., their administration, dosages, contraindications, adverse reactions, interactions, special warnings, and precautions) and drug delivery systems is subject to change, however, and the reader is advised to check the manufacturer’s package insert for information concerning recommended dosage and potential problems or cautions prior to dispensing or administering the drug or using the drug delivery systems.
Fair balance is achieved through ongoing and thorough review of all materials produced by faculty, and all educational and advertising materials produced by supporting organizations, prior to educational offerings. Approval of credit for this continuing education activity does not imply endorsement by AAPP for any product or manufacturer identified.
View nursing education availability
ACPE approved contact hours are accepted for ANCC Certification Renewal: At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:
- Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
- Continuing medical education (CME) approved for CME hours
- Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration
All relevant relationships have been mitigated.