Winter Seminars Week 2:
February 24 - 28

Psychopharmacology: A Master Class

Course Director: Carl Salzman, MD

An updated review of neurobiology and brain function will take the learner through neurotransmission sequence from neurotransmitter synthesis to synaptic function and gene transcription. The clinical usefulness of epigenetic mechanisms and the uncertain role for genetic testing in psychiatric diagnosis will be reviewed and in the selection of specific psychiatric medications. Specific categories of treatment will include: schizophrenia, bipolar disorder, depression, and anxiety spectrum disorders. The evidence-based effectiveness and of antipsychotic medications will be emphasized. Identification and treatment of prodrome and early onset psychotic disorders will be discussed. Bipolar disorder and its treatment will be examined with particular treatment of bipolar depression. A comprehensive review of depression in psychiatric patients, as well as co-morbid with medical illnesses, will be emphasized along with the use of antidepressants for all treatment classes for co-morbid depressions. The role of depression in cardiovascular illness and the necessity for treatment as well as the interaction between endocrine disorders (especially diabetes) and depression will be highlighted. New data regarding the interaction between inflammation and mood disorders will be discussed. An up to date review of ketamine for depression will be emphasized as well other strategies for treatment resistant depression. The neurobiological mechanisms and treatment of anxiety and anxiety-spectrum disorders, as well as their treatment, will be reviewed, including, panic disorder, social anxiety disorder, post-traumatic stress disorder (PTSD), and generalized anxiety disorder. Problems with uses of all psychiatric medications for the elderly will be discussed with clinical examples. Data regarding early life traumatic or separation experiences, as precursors to later-life mood disorders, will be introduced.

This master class will also address the neurobiological theories of addiction and their treatment as well as reviewing the neurobiology and potential clinical use of cannabis. Mechanisms of sleep disorders and their effective psychopharmacologic treatment will be detailed as well as the use psychotropics in women through the course of their lifecycle. The potential usefulness of stimulant medications for adults with ADD, binge eating disorders, and treatment-resistant depression will be noted Psychopharmacological treatment of the geriatric individual will be emphasized. The overall course will emphasize the establishment and importance of therapeutic alliance when prescribing all psychotropic medications. This seminar is designed for the experienced clinician. Course participants will be expected to have had clinical experience, familiarity with the neurobiological and genetic contributions to psychiatric illnesses as well as an understanding of the basic therapeutic mechanisms of psychotropic medications.

Exercise and Other Medical and Complementary Ground Breaking Techniques for the Treatment of ADHD, Addictions, Social Disorder, Pain, Anorexia, Sleep Disorders, Anxiety and Mood Disorders

Course Director: John Ratey, MD

This evidenced based state of the art course focuses on the latest medical and non-medical approaches and interventions for patients with ADHD, Aggression, the Addictions, Social Disorders, Pain, Anorexia, Sleep Disorders, Anxiety and Mood Disorders. There is a special section on autism, based on new research and the instructor’s experience with disruptive adolescents with Autism Spectrum Disorder. The course will explore the results of an ongoing study of balance and coordination training on autistic adolescents and its effect on behavior and social skills. The course will also address the uses and dangers of medical marijuana and look at the growing evidence of the clinical usefulness of Cannabidiol, (also known as CBD) the non-psychoactive phytochemical of the hemp plant. The ground breaking work of using CBD to treat seizures and behaviors in this population will be studied. In addition to new medications, the course will explore the proven effects of exercise, yoga, play, diet, and other alternative strategies that are shown to be effective in these psychiatric problems. Special emphasis will be placed on the burgeoning research on exercise and ADHD, with tips on how to integrate exercise prescriptions into your practice. The course will also do a deep dive into the Default Mode Network and how its troubled connectivity within the brain explains ADHD, Autism, and other psychiatric diagnoses better than most models and can point to rational treatments. The course will review the effects of sleep, being in nature, and, movement on brain health in general and specifically with ADHD and Autism Spectrum Disorder. It will review the latest information on the amount and type of movement necessary to attain and maintain optimal brain function. In addition, the course looks at the growing awareness of the “microbiome” when it comes to diet, and the effect of gluten and probiotics on the gut and brain/behavior connection will be emphasized. We will follow the latest studies showing the possible link of the microbiome and Parkinson’s disease. To put it all together, the course takes an understandable journey into the brain and the synapse to fully learn about these conditions. The important area of diagnosis will also be looked at, covering the controversies and challenges associated with making the right call with psychological disorders: 1. Bipolar or ADHD or both and what this means for treatment; 2. Asperger’s or Autism or Social Dyslexia – does it matter and are there any relevant medications and behavioral interventions for these developmental differences; 3. Relevancies of DSM-5 to the real world and the issue of sub-threshold diagnoses or the “Shadow Syndromes”.