NEW MEXICO STATE UNIVERSITY

APA Designated Post-Doctoral Education & Training in Clinical Psychopharmacology


COURSE OUTLINE

Class #17


Course #: RXPP 604 & 605

Official Title: Clinical Psychopharmacology II & III


Topic(s): The Psychopharmacologic Treatment of Anxiety Disorders

The Psychopharmacologic Treatment of Sleep Disorder/Disturbances


Credit Hours: 3.0


Location: Live & Online

NMSU; 2915 McFie

Milton Hall, Room 085

Class Meeting Dates: Jan 26-27, 2019, 8:00am-6:00pm


Instructor(s): Marlin Hoover, PhD, MSCP, ABPP Prescribing Psychologist


Required Text/Readings(s): *Stephen M. Stahl, Prescriber's Guide: Stahl's Essential Psychopharmacology,

6th Edition (May 25, 2017)

Review: antidepressants, anxiolytics, hypnotics, Beta Blockers

*Hales, et.al. Textbook of Psychiatry. 6th Edition (March 18, 2014). Pages 391 – 454; 607 - 650. (Recommended!!!)


*Bezchlibnyk-Butler et. al. Clinical Handbook of Psychotropic Drugs, 22nd Edition (May 03, 2017) Antidepressants, anxiolytics, hypnotics, Beta Blockers will be reviewed online during class


*Bandelow, B., Michaelis, S., & Wedekind, D. Treatment of anxiety disorders. Dialogues in Clinical Neuroscience - Vol 19 . No. 2 . 2017

*Sateia, M., Buysse, D., Krystal, A., Neubauer, D. Jonathan, H. Clinical Practice Guideline for the Pharmacologic Treatment of Chronic Insomnia in Adults: An American Academy of Sleep Medicine Clinical Practice Guideline. Journal of Clinical Sleep Medicine, Vol. 13, No. 2, 2017


*Wang, Z., Whiteside, S., Sim, L.,  Farah, W., Morrow, A., Alsawas, B., Barrionuevo, P., Tello, T., Asi, N., Beuschel, B., Daraz, L., Almasri, J., Zaiem, F., Larrea-Mantilla, L., Ponce, O., LeBlanc, A., Prokop, L., & Murrad, M.  Comparative Effectiveness and Safety of Cognitive Behavioral Therapy and Pharmacotherapy for Childhood Anxiety Disorders A Systematic Review and Meta-analysis. JAMA Pediatr. 2017 Nov; 171(11): 1049–1056. 


*Bonnet, M., Arand, D., Benca, R., Eichler, A. Behavioral and pharmacologic therapies for chronic insomnia in adults Official reprint from UpToDate www.uptodate.com ©2018 UpToDate, Inc. and/or its affiliates. All Rights Reserved.


*Patel, D., Feucht, C., Brown., K., & Ramesy, J. Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners. Translational Pediatrics, 2018;7(1):23-35



Course Description: In this HYBRID RXPP 604 and 605 class we continue our study of clinical psychopharmacology through the study of anxiety disorders and disturbances in sleep from a Psychobiosocial Model of care. Significant emphasis will be placed on the psychopharmacology for the treatment of anxiety disorders. Diagnosis and treatment of broad-spectrum anxiety disorders (including general anxiety, OCD) will be discussed. Particular anxiety disorders of children will also be discussed. In Day 2 disturbances in sleep, treatment, and sleep hygiene will be covered.


This course is congruent with the College of Education's Conceptual Framework in that it provides a general knowledge background, addresses assessment competencies, and integrates content knowledge and professional knowledge.

Day One Objectives: Students/attendee will:

1.List three mechanisms of action of psychopharmacological interventions used in the treatment of anxiety disorders.

2.List and then match at least three anxiolytic drugs; as indicated for specific anxiety disorders, on the spectrum of anxiety disorders.

3.List three, FDA approved, pharmacological interventions for Generalized Anxiety Disorder.

4.List two, FDA approved, pharmacological interventions for Post-Traumatic Stress Disorder.

5.List two psychological interventions that should be used first for phobic behavior(s) BEFORE implementing a psychotropic agent. 

6.List and match two medications to be augmented with combined (modality) pharmacotherapy. 

7.List what type of an anxiety disorder(s) would Beta Blockers be indicated.

8.List three components of Hypothalamus-Pituitary -Adrenal Axis; and the difference between adaptive and maladaptive feedback loops. 

9. List three (Central Nervous System) subcortical correlates associated with anxiety disorders.

10. List three neuroimaging techniques/studies used to identity cell bodies synthesis and pathways associated with anxiety disorders.

11.List the presynaptic and postsynaptic (neurotransmission) activity involved in the specific primary neuroreceptors involved in excitatory vs. inhibitory/relaxation actions central to anxiety disorders.

12.For the following three drug classes (Serotonergic, Gabaminergic, Beta Blockers), the student will list two benefits and risks associated with their use.

13.List three signs/symptoms that an individual has develop tolerance on anti-anxiety medication.

14.List three signs/symptoms that an individual has develop withdrawal on anti-anxiety medication.

15.List two Empirically Based Treatments in the management of children/adolescents with anxiety disorders.

16.List three contraindications of the use of anxiolytics in the treatment of children/adolescents.

17. List three contraindications of the use of anxiolytics in the treatment of child bearing (age) women and elderly populations.

Day Two Objectives: Students/attendee will:

List three mechanisms of action of hypnotic medication and common sleep aids.

  1. List two short and two long acting hypnotic agents/sleep aids; and able to select the most appropriate hypnotic for different types of sleep disorders (such as early morning awakening versus phase disorders).

  2. List two issues of dependence, means of avoiding dependence, and a means of minimizing dependence with the use of hypnotic medications.

  3. List one neuroimaging technique and one neurological study used to identity activity and stimulations (or lack thereof) associated with disturbances in sleep and the sleep wake cycle.

Diagram the sleep wake cycle specific to the use of hypnotic agents.

List the three etiologies of sleep disorders.

List three general medical conditions that produce/manifest into comorbid sleep disorders.

List three psychiatric syndromes that produce/manifest into comorbid sleep disorders.

  1. In a written paragraph, explain how the psychobiosocial model is applicable in the treatment of sleep disorders, (from acute care to long term; including best practices in sleep hygiene.)

  2. Rank order sleep hygiene, psychological interventions, and hypnotics; as the first to last tier interventions in the treatment of disturbances of sleep.

List five practical applications of sleep hygiene.

  1. List three contraindications of the use of hypnotics in the treatment populations of child/adolescent, child bearing (age) women, the elderly.

Homework: The students will be presented with one or more complex case(s) and will be asked to respond to questions about that case. At times, students will also be expected to read journal assignments; and respond in class or discussion threads (in Canvas).

Evaluation: Student participation, preparation, and attendance is observed. There will be a test (multiple choice, short answer or true/false) which, depending on the plan of the Instructor, may be given to students before class. If the test is given to the students before class, then students should come to class with the test completed because the content will be reviewed during the lecture(s). The exam will be graded after it is taken as a closed-book, time limited test at the end of the weekend of didactic training. Case studies presenting patients with dual diagnoses of medical and psychological problems will be distributed. Students will be expected to formulate a comprehensive analysis of the case(s) utilizing clinical judgment, course materials, and any necessary references. During the pathophysiology and physical examination sequence, students will be evaluated on their proficiency in interpreting lab/radiology/imaging studies, taking vital signs, physical assessment, and differential diagnosis. Instructors may also elect to include reading (e.g. journal) assignments for discussion and/or written assignments that demonstrate clinical documentation which meets the standard of care for patient care documentation. Additional assignments will be factored into a weighted or alternative point value system leading to the determination of a letter grade using the rubric below. Typically, students have two weeks to complete all assignments. All submissions must be made by 11:59 pm on the day of the announced deadline.


Standard Grading Assignments Points Possible

Test (30 questions @ 2 pts each) Case Study Analysis/Vignette Participation/Attendance (live or via AdobeConnect)


Course grades:

90-100 pts total = “A”

80-89 pts total = “B”

70-79 pts total = “C”

30 pts.

60 pts.

10 pts.


Students with Disabilities: If you have or believe you have a disability, you may wish to self-identify. You can do so by providing documentation to the Office of Student Accessibility Services (SAS), located at the Corbett Center Student Union, Room  208  (Telephone   575-646-6840,   Fax   575-646-5222,   E-Mail:   sas@nmsu.edu).   Appropriate   accommodations may then be provided for you. If you have a condition which may affect your ability to exit from the premises in an emergency or which may cause an emergency during class, you are encouraged to discuss this in confidence with the instructor and/or the Director of SAS, Trudy Luken. If you have questions about the Americans with Disabilities Act (ADA), call 575-646-3635. Students should contact the Office of Institutional Equity (575-646-3635) only

if they feel they have been discriminated against in any category. 53

Student complaints: If students have a complaint about a course, they are advised to discuss their concerns directly with the instructor whenever possible. If that does not resolve the problem or if they cannot approach the instructor, students should either access NMSU’s online complaint system at https://dos.nmsu.edu/concerns/ or seek out the department head (bgormley@nmsu.edu) for help resolving the problem. Both of these processes provide opportunities for the department head to know about issues that need attention and for instructors to receive information about student concerns so that they can respond.


Further Notice: Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act Amendments Act (ADAAA) covers issues relating to disability and accommodations. If a student has questions or needs an accommodation in the classroom (all medical information is treated confidentially), contact:


Trudy Luken, Director

Student Accessibility Services (SAS) - Corbett Center Student Union, Rm. 208 Phone: (575) 646-6840 E-mail: sas@nmsu.edu

Website: http://sas.nmsu.edu/


NMSU policy prohibits discrimination on the basis of age, ancestry, color, disability, gender identity, genetic information, national origin, race, religion, retaliation, serious medical condition, sex, sexual orientation, spousal affiliation and protected veterans status. Furthermore, Title IX prohibits sex discrimination to include sexual misconduct: sexual violence (sexual assault, rape), sexual harassment and retaliation.


For more information on discrimination issues, Title IX, Campus SaVE Act, NMSU Policy Chapter 3.25, NMSU's complaint process, or to file a complaint contact:


Lauri Millot, Director and Title IX Coordinator

Agustin Diaz, Associate Director, Title IX Deputy Coordinator

Office of Institutional Equity (OIE) - O'Loughlin House, 1130 University Avenue Phone: (575) 646-3635 E-mail: equity@nmsu.edu

Website: http://eeo.nmsu.edu/



Other NMSU Resources:

NMSU Police Department:
(575) 646-3311 www.nmsupolice.com

NMSU Police Victim Services:
(575) 646-3424

NMSU Counseling Center:
(575) 646-2731

NMSU Dean of Students:
(575) 646-1722

For Any On-campus Emergencies:
911



The Instructor of Record reserves the right to make announced changed in the syllabus; as feasible, changes will be made with student input.