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Clinical Pearls

Registration Options

Activity Date: 04/18/2023

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Session Time and Location

The live session is complete.

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.

Session Summary

Clinical Pearls presentations will be recorded and posted but are only available for live credit.

Beyond Benzos: Treatment of Refractory Catatonia
Emily Thacker, PharmD

Treatment of catatonia is largely reliant on high-dose benzodiazepines, such as lorazepam, or the use of electroconvulsive therapy (ECT). Despite their widespread use, these treatments are not universally effective and have demonstrated lower response rates in chronic catatonia and in patients with schizophrenia. Refractory catatonia presents a significant clinical challenge, and an alternative treatment algorithm is needed. This presentation explores evidence-based strategies for refractory catatonia including NMDA antagonists, mood stabilizers, antipsychotics, and other agents.

Using Midazolam for Managing Acute Agitation
Stefanie Schwab, PharmD

In June 2022, the Food and Drug Administration announced a nationwide shortage of parenteral lorazepam, an agent commonly used to treat acute unspecified agitation. Agitation is a common presentation to many emergency departments at both psychiatric and medical hospitals. With parenteral lorazepam on shortage, hospitals were tasked with identifying alternative agents and strategies for managing patients presenting with agitation. One option that many turned to was midazolam, a benzodiazepine with potentially favorable kinetics for treating agitation. This clinical pearl explores the current evidence supporting midazolam for managing agitation and its application at a psychiatric teaching hospital for this purpose.

Autoimmune Encephalitis: What Psychiatric Pharmacists Should Know
Janie Ferren, PharmD

On the Consultation-Liaison Psychiatric Service it is common to see patients with new onset psychosis and behavioral changes admitted to rule out autoimmune encephalitis (AE). Full neurological workup can take days to weeks to result. In the interim, a variety of psychiatric manifestations of AE, including psychosis, delirium, catatonia, and agitation, may warrant pharmacologic treatment. In order to make informed therapeutic recommendations, psychiatric pharmacists must be familiar with the typical clinical manifestations and treatment course of AE. This clinical pearl addresses the role of psychotropic medications in patients with AE and how psychiatric pharmacists can contribute to the acute and chronic management of patients with AE.

Course Requirements

To receive ACPE credit for the live session at the Annual Meeting, you must:

  • Sign in (or create a FREE account).
  • Register for this course.
  • Attend and participate in the entire session 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.

Upon successful completion, ACPE credit is reported within 24 hours to CPE Monitor although transcripts can be retrieved by participants online in their ACPE Transcript.

Faculty Information

Emily Thacker, PharmD
Stefanie Schwab, PharmD
Janie Ferren, PharmD

View biographical information

Learning Objectives

Beyond Benzos: Treatment of Refractory Catatonia
  1. Explain the pathophysiology, etiology, and clinical presentation of catatonia.
  2. Discuss the traditional treatment of catatonia, including the use of benzodiazepines and ECT.
  3. Describe alternative treatment options for catatonia that can be used when traditional therapies fail.
Using Midazolam for Managing Acute Agitation
  1. Review treatment recommendations and pharmacologic options for managing acute agitation.
  2. Discuss alternative medication options for managing acute agitation when parenteral lorazepam is not available.
  3. Evaluate the existing evidence for midazolam as a safe and effective agent for managing acute agitation.
Autoimmune Encephalitis: What Psychiatric Pharmacists Should Know
  1. Differentiate the clinical presentation of autoimmune encephalitis from schizophrenia spectrum and other psychotic disorders.
  2. Review first-line treatment options for autoimmune encephalitis.
  3. Identify the role of psychotropic medications and psychiatric pharmacists in acute and chronic management of autoimmune encephalitis.

Continuing Education Credit and Disclosures

Activity Date: 04/18/2023
ACPE Contact Hours: 1
ACPE Number: 0284-0000-23-040-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.

ACPEThe American Association of Psychiatric Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

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