Top 5 Takeaways From the Real Psychiatry Conference

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CONFERENCE REPORTER

Through attending sessions and conducting exclusive interviews, we determined these are some of the top clinical pearls gleaned from this year's Real Psychiatry conference in Scottsdale, AZ.

1. Prescription digital therapeutics can help break down barriers to care for patients with schizophrenia.

Approximately 75% of patients with schizophrenia and 78% of caregivers report that residual negative symptoms are an ongoing concern despite treatment with antipsychotics.^1-3 Addressing that unmet need may lie with prescription digital therapeutics. These treatments can address cognitive and behavioral deficits via adjunctive potential by complementing medication and psychotherapy. They can also improve access and reduce barriers to care via remote delivery. As they are discreet, they may help reduce stigma associated with treatment. They reach underserved populations and provide expanded treatment options via scalable, personalized tools. Read more here.

2. Selecting an attention-deficit/hyperactivity disorder (ADHD) treatment should be based on the patient’s entire picture of health, not merely their symptoms.

Experts from Real Psychiatry recommend, when choosing an ADHD treatment, considering several factors, such as patient preference, co-occurring conditions, cost, access, and overall quality of life. Patients may wish to avoid stimulants as first-line treatment and they may exacerbate other disorders. Keeping issues of polypharmacy in mind is essential, especially if the patient is fearful or hesitant to start a new medication. Learn more here.

3. Patients with tardive dyskinesia may be embarrassed to talk about it, but designing an effective treatment strategy requires full awareness of the patient’s situation.

Before prescribing a medication with a risk of tardive dyskinesia, have an honest talk with patients about the potential for developing this disorder. Then, on subsequent visits, take note of their posture, clothes, dentition, and any movements they try and brush off as anxiety. Watch how they walk into the office or approach the building. Are they wearing slippers rather than tennis shoes because they can’t tie the laces anymore? Do they have a tooth missing due to involuntary mouth movements or grinding? Targeting this issue will drastically improve patient quality of life. Learn more here.

4. Bipolar disorder and ADHD frequently co-occur, necessitating careful management strategies for effective treatment.

Clinicians are seeing an increase in patients with comorbid bipolar disorder and ADHD. Obtaining a proper history is the first step to addressing this issue, along with careful management of psychopharmacology. Medication adherence remains a significant challenge, impacting treatment success and patient stability. Additionally, differentiating between unipolar and bipolar depression is essential for accurate diagnosis and effective management. Learn more here.

5. Zuranolone, the first oral treatment for postpartum depression (PPD), should be considered as first line treatment in the setting of moderate to severe depression.

Zuranolone (Zurzuvae) was approved in August of 2023, making it the first FDA-approved oral treatment for PPD.⁴ This 14-day, once-daily pill should be considered first by clinicians with patients struggling with PPD. The shorter course of treatment allows for mothers to get back to spending time with their newborn. It is important to note that patients taking zuranolone should use effective contraception and should notify clinicians right away if they become pregnant, as this medication can harm the fetus. Read more here.

What did you learn at Real Psychiatry? What would you like to see more of next year? Let us know at PTEditor@mmhgroup.com!

References

1. Buchanan RW. Persistent negative symptoms in schizophrenia: an overview. Schizophr Bull. 2007;33(4):1013-1022.

2. Fitzgerald HM, Shepherd J, Bailey H, et al. Treatment goals in schizophrenia: a real-world survey of patients, psychiatrists, and caregivers in the United States, with an analysis of current treatment (long-acting injectable vs oral antipsychotics) and goal selection. Neuropsychiatr Dis Treat. 2021;17:3215-3228.

3. Sicras-Mainar A, Maurino J, Ruiz-Beato E, Navarro-Artieda R. Impact of negative symptoms on healthcare resource utilization and associated costs in adult outpatients with schizophrenia: a population-based study. BMC Psychiatry. 2014;14:225.

4. O’Brien E. FDA approves first oral treatment for postpartum depression in adults. Psychiatric Times. August 4, 2023. https://www.psychiatrictimes.com/view/fda-approves-first-oral-treatment-for-postpartum-depression-in-adults