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DAY ONE OBJECTIVES

1. Address the key components associated with making a psychotropic medication referral.
2. Identify the clinical uses and various classes of antidepressants, how they work and their common side effects.
3. Explain the process of initiating antidepressant selection.
4. Examine the role of herbals and alternative remedies in the treatment of depression.
5. Integrate the use of the new diagnostic paradigm — the Bipolarity Index — into your assessment of bipolar disorder.
6. Discuss the myriad medication options for treating bipolar disorder.
7. Describe techniques and interventions for resolving common psychotropic medication dilemmas.

DAY TWO OBJECTIVES

1. Identify safe and effective medication approaches for anxiety and insomnia.
2. Examine the psychotic spectrum disorders and contrast the use of the first and second generation antipsychotics.
3. Discuss the appropriate and controversial use of psychotropics in youth with depression, bipolar, anxiety and psychosis.
4. Understand how ADHD is best treated pharmacologically.
5. Address the most recently published guidelines for psychotropic use during pregnancy.
6. Describe the challenges and concerns of psychotropic use with older adults.
7. Learn effective strategies for resolving medication resistance and fostering drug compliance.

DAY ONE

MAKING A MEDICATION REFERRAL

• The trinity: Observe, Listen, Ask
• Questions clients should be asking their prescribers

BIOLOGICAL PSYCHIATRY

• Neurotransmitters: Norepinephrine, serotonin, dopamine, GABA
• Reasons why neuroscience is more fascinating than practical

DEPRESSION

• Unipolar Depression
  • Why depression is not a diagnosis
• Discussion of the “cause and effect”
• Assessing depression, what’s important, what’s not
• Influences: Reactive, biological, medical, hormonal, substance abuse
• Depression as a clinical condition has become diluted

ANTIDEPRESSANT MEDICATIONS

• How they work? Do they work?
• Why neurotransmitter manipulation is a dicey proposition
• Are they any better than placebos for most users?
• Classes of Antidepressants:
  • Cyclic, SSRIs, SNRIs, NRIs, DNRIs, others
  • Why they’re prescribed for the wrong symptom set
• Antidepressant selection – the 5-step plan
  1. How the depression presents
  2. Family history
  3. Drug characteristics
  4. Reasonable expectations
  5. Integrated recovery
• Side effects, risk factors, non compliance, dosing
• “My antidepressant isn’t working the way it used to.” Have you heard that one before? Why this is

IF THE DEPRESSION CONTINUES, THEN WHAT?

• Augmentation strategies: Additive or combination protocols
• Mechanical strategies: ECT, transcranial magnetic stimulation

HERBALS AND ALTERNATIVE REMEDIES FOR DEPRESSION

• St. John’s Wort, Omega 3s, Vitamin D3, SAM-e
• Alternative remedies to avoid

BIPOLAR SPECTRUM DISORDERS

• Diagnosis is all over the place and so is medication management
• Is there really such a thing as a distinct manic phase and a distinct depressive phase?
• Mania: A mnemonic for the manic markers
• Bipolar depression: How to differentiate from unipolar
• Bipolar I and Bipolar II classifications are obsolete
• Diagnosing bipolar disorder – index it
• Myriad drug options: Lithium, anticonvulsants, new antipsychotics
• Recent advances
• Treatment-resistant bipolar: A formidable foe
• Medication side effects, non compliance, risk factors, dosing
• As Dr. House was fond of saying: “Everybody lies.” The importance of collateral information when assessing for this disorder

TIPS FOR RESOLVING PSYCHOTROPIC DRUG DILEMMAS

• Generic vs. Brand medications
• Polypharmacy: Friend or foe?
• Forming strong alliances with prescribers

DAY TWO

THE MANY MANIFESTATIONS OF ANXIETY:

• Panic, GAD, OCD, PTSD
• Worry vs. concern
• Medicating anxiety: What works best; what shouldn’t be medicated
• Benzodiazepines
• Non benzodiazepines: Buspar, antihistamines
• Rational approaches for managing insomnia and the placebo effect
• Sleep agents: Ambien, Lunesta, melatonin
• The micromanagement of insomnia: The new drug Intermezzo for early morning awakenings
• Side effects of the anxiolytics and sleep agents

MAJOR PSYCHOTIC SPECTRUM DISORDERS

• The primary psychoses
• Symptom domains of schizophrenia
• How antipsychotics work: The dopamine model
• First generation antipsychotics
  • Thorazine, Haldol – still alive and kicking
• Second generation antipsychotics
  • Clozaril, Risperdal, Zyprexa, et al.
  • Ten of these all together; five too many
• Unapproved use of antipsychotics: A growing concern
• Is recovery attainable in schizophrenia; relapse issues
• Side effects, risk factors; poison and mind control issues

SPECIFIC POPULATION GROUPS

• Expectant mothers
  • Recent changes in psychotropic medication guidelines during pregnancy: a detailed discussion
  • There’s no such thing as a safe drug during pregnancy
• Older adults
  • Aging and mental health
  • Dosing concerns; safety issues; “self-medication” issues, mental status changes
  • Interventions to promote successful aging
• Children and adolescents
  • What’s new in child and adolescent psychopharmacology?
  • Maturational issues
  • Nature vs. nurture when it comes to diagnosing mood disorders
  • Depression, bipolar, anxiety, psychosis in youth
  • Why medication management is unpredictable and controversial
  • The veritable explosion of bipolar diagnosis in youth
  • Disruptive Mood Dysregulation Disorder: A setback for child psychiatry
  • ADHD and its new treatment guidelines
  • Medication use for ADHD – stimulants, non stimulants, antidepressants, anti-hypertensives
  • Side effects
  • Dosing and drug holidays

DSM-5^® AND PSYCHOTROPIC MEDICATION USE

• Will we all be deemed psychiatrically sick?
• Over-medicalization and runaway psychotropic drug use

TIPS FOR RESOLVING PSYCHOTROPIC DRUG DILEMMAS

• Overcoming psychotropic medication resistance
• 5 key reasons for non-compliance and how you can help

Joseph Wegmann, R.Ph., LCSW, is a licensed clinical pharmacist and a clinical social worker with more than thirty years of experience in the field of psychopharmacology. His diverse professional background in psychopharmacology and counseling affords him a unique perspective on medication management issues. In addition to consulting with numerous psychiatric facilities, he has presented psychopharmacology seminars to thousands of clinicians in 46 states.

Joe has also served as a Clinical Director of Pharmacy Services at a major metropolitan area hospital and as a Regional Director of Hospital Services for Premier Healthcare Corporation. He has served as Adjunct Professor of Psychopharmacology in the graduate School of Social Work at Southern University of New Orleans for 16 years and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety.

Joe is the author of Psychopharmacology: Straight Talk on Mental Health Medications, Third Edition (PESI, 2015) and Behavior Management Guide for the Classroom: Assessments, Best Practices and Interventions for Depression, Anxiety, Bipolar and Disruptive Behaviors (PESI, 2018).

Speaker Disclosures:

Financial: Joseph Wegmann is an author for PESI Publishing and receives royalties.

Non-financial: Joseph Wegmann has no relevant nonfinancial relationship to disclose.

For U.S. and Canadian customers, a CE test is available for $19.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Addiction Counselors

This self-study course has been approved by PESI, Inc., as a NAADAC Approved Education Provider, for 11.5 CE in the Counseling Services skill group. NAADAC Provider #77553. PESI, Inc. is responsible for all aspects of their programming. Full attendance is required; no partial credit will be awarded for partial attendance.

Connecticut Addiction Counselors: Provider #120924. This course has been approved as a CCB approved training and has been awarded 11.75 hours by the Connecticut Certification Board.

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Counselors
This intermediate self-study activity consists of 11.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from the activity and contact your state board or organization to determine specific filing requirements.

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Marriage & Family Therapists
This self-study activity consists of 11.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.

Illinois Marriage & Family Therapists: PESI, Inc. has been approved as a provider of continuing education by the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. Provider #: 168-000156. Full attendance at this self-study activity qualifies for 11.5 credits.

Texas Marriage & Family Therapists: PESI, Inc. has been approved as a continuing education sponsor through the Texas State Board of Examiners of Marriage and Family Therapists. Provider #: 503. This self-study activity qualifies for 11.5 continuing education credits.

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Nurses, Nurse Practitioners, and Clinical Nurse Specialists
This intermediate activity consists of 11.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please contact your licensing board to determine if they accept programs or providers approved by other national or state licensing boards. A certificate of attendance will be awarded at the end of the program to participants who are in full attendance and who complete the program evaluation.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 11.5 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 11.5 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 14.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Pharmacology Nurse Practitioners
This self-study program offers 715 instructional minutes of pharmacology content which is designed to qualify for 11.75 contact hours toward your pharmacology requirement.

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Psychologists
This self-study activity consists of 11.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline and the certificate of completion you receive from this self-study activity. Contact us for more information on your state board or organization specific filing requirements.

Canadian Psychologists: PESI, Inc. is approved by the Canadian Psychological Association to offer continuing education for psychologists. PESI, Inc. maintains responsibility for the program. This program is approved for 11.5 self-study continuing education hours. Full credit statement at: https://catalog.pesi.com/page/ceinformation#psychologists

Florida Psychologists: PESI, Inc., is an approved provider with the Florida Board of Psychology. Provider Number 50-399. This product qualifies for 11.9 self-study continuing education credits. Please make sure to bring your license number to the seminar so that we can report your attendance to CE Brokers.

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Social Workers
PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 11.75 Clinical Practice continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation.

Canadian Social Workers: PESI, Inc., #1062, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved as ACE providers. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. PESI, Inc. maintains responsibility for this self-study course. ACE provider approval period: January 27, 2017 - January 27, 2020. Social Workers completing this course receive 11.75 Clinical continuing education credits. Course Level: Intermediate. Full attendance is required; no partial credits will be offered for partial attendance. A certificate of attendance will be awarded at the end of the program to social workers who complete the program evaluation. Canadian provinces may accept activities approved by the ASWB for ongoing professional development.

Illinois Social Workers: PESI, Inc. is an approved provider with the State of Illinois, Department of Financial and Professional Regulation, Division of Professional Regulation. License #: 159-000154. Successful completion of this self-study activity qualifies for 11.5 contact hours.

Minnesota Social Workers: PESI, Inc. is an approved provider with the State of Minnesota, Board of Social Work. Provider #: CEP-140. This self-study course has been approved for 11.5 continuing education hours. A certificate will be issued upon successful completion of a post-test.

California Social Workers/ Counselors/Marriage & Family Therapists/Licensed Educational Psychologists: The California Board of Behavioral Sciences accepts CE programs that are approved by other approval agencies, including several that approve PESI and its programs. A full list of approval agencies accepted by the BBS can be found at www.bbs.ca.gov/licensees/cont_ed.html under “Where to find CE Courses.” This intermediate level activity consists of 11.0 clock hours of continuing education instruction.

Florida Social Workers, Marriage & Family Therapists, and Mental Health Counselors: PESI, Inc. is an approved provider with the Florida Board of Clinical Social Work, Marriage and Family Therapy and Mental Health Counseling. Provider Number 50-399. This self-study course qualifies for 11.75 continuing education credits.

Ohio Social Workers, Counselors, and Marriage & Family Therapists: PESI, Inc. is an approved provider with the State of Ohio Counselor, Social Worker and Marriage & Family Therapist Board. Provider approval #: RCST071001. Successful completion of this self-study course meets the qualifications for 11.75 clock hours of continuing education credit.

Pennsylvania Social Workers/Counselors/Marriage & Family Therapists: This intermediate activity consists of 11.5 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please contact your licensing board to determine if they accept programs or providers approved by other national or state licensing boards. A certificate of attendance will be awarded at the end of the program to participants who are in full attendance and who complete the program evaluation. Full attendance is required, variable credits may not be awarded per the Pennsylvania State Board.

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Other Professions
This self-study activity qualifies for 11.75 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Psychologists, Counselors, Social Workers, Case Managers, Addiction Counselors, Marriage & Family Therapists, Nurses and other Mental Health Professionals