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
Continuing Education: 13.5 CE (Provided by SIAP, Sponsored by APA)
SIAP is approved by the American Psychological Association
to sponsor continuing education for psychologists.
SIAP maintains responsibility for the program and its content.
Location: Online Only: http://nmsu.adobeconnect.com/psypharm
Class Meeting Dates: Dec 5-6th, 2020
8:00am-6:00pm
Instructor(s): Marlin Hoover, PhD, MSCP, ABPP Prescribing Psychologist
Required Text/Readings(s): Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders.
Dialogues in clinical neuroscience, 19(2), 93-107.
Bonnet, M. H., Arand, D. L., Benca, R., & Eichler, A. F. (2018, December 11) Behavioral and pharmacologic therapies for chronic insomnia in adults. Retrieved from https://www.uptodate.com/contents/behavioral-and-pharmacologic- therapies-for-chronic-insomnia-in-adults
Benjamin Sadock, Virginia Sadock & Pedro Ruiz (2017) Kaplan & Sadock’s
Comprehensive Textbook of Psychiatry (10th ed). Wolters Kluwer.
Kindle online version recommended for reference through the remaining
Courses. Review Chapter 14 (Anxiety Disorders) & 23 (Sleep Disorders)
Patel, D. R., Feucht, C., Brown, K., & Ramsay, J. (2018). Pharmacological treatment of anxiety disorders in children and adolescents: A review for practitioners. Translational pediatrics, 7(1), 23-35.
Procyshyn, R. M., Bezchlibnyk-Butler, K. Z., & Jeffries, J. J. (2017). Clinical handbook of psychotropic drugs (22nd ed.). Boston: Hogrefe Publishing.
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). 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, 13(2), 307-349.
Stephen M. Stahl (2017). Prescriber's Guide: Stahl's Essential Psychopharmacology
(6th ed.). Cambridge. Kindle online version recommended. Review:
Anxiolytics and Hypnotics.
Wang, Z., Whiteside, S., Sim, L., Farah, W., Morrow, A. S., Alsawas, M., Barrionuevo, P., Tello, M., Asi, N., Beuschel, B., Daraz, L., Almasri, J., Zaiem, F., Larrea-Mantilla, L., Ponce, O. J., LeBlanc, A., Prokop,
L. J., & Murad, M. H. (2017). Comparative effectiveness and safety of cognitive behavioral therapy and pharmacotherapy for childhood anxiety disorders: A systematic review and meta-analysis. JAMA pediatrics, 171(11), 1049-1056.
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:
1. List three mechanisms of action of hypnotic medication and common sleep aids.
2. 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).
3. List two issues related to the development of dependence, means of avoiding dependence, and a means of minimizing dependence with the use of hypnotic medications.
4. 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.
5. Diagram the sleep wake cycle specific to the use of hypnotic agents.
6. List the three etiologies of sleep disorders.
7. List three general medical conditions that produce/manifest into comorbid sleep disorders.
8. List three psychiatric syndromes that produce/manifest into comorbid sleep disorders.
9. 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.)
10. Rank order sleep hygiene, psychological interventions, and hypnotics; as the first to last tier interventions in the treatment of disturbances of sleep.
11. List five practical applications of sleep hygiene.
12. 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. 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 @1 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.