Psychiatry Commons^™

Antipsychotics As Adjunct Therapy In Risk Reduction Of Crisis Admission: An Analysis Of Historical Patient Data, Slawomir Piela, Eduardo Espiridion

Transformative Medicine

Introduction: Antipsychotics are a broad class of medication used in the management of psychotic symptoms in various disorders. In recent years, they have been approved for use as adjunct therapy in patients with treatment resistant depression and bipolar disorder. An outcome of this therapy that has not been extensively investigated is the associated likelihood of crisis events that necessitate admission to an emergency department or crisis center. Methods: In this study, we reviewed historic patient data to determine the association of risk of crisis admission in patients prescribed antipsychotics as adjunct therapy in the context of treatment resistant depression or …

Recognizing Early Serotonin Syndrome From Ssri-Buspirone Combination: A Case Report, Jacob Moore, Barbara Gracious

South Atlantic Division GME Research Days 2026

No abstract provided.

Spravato® Fda-Approved As Monotherapy For Adults With Treatment-Resistant Depression, Rileigh Rahrig, Kennedy Kosikowski, Haylee Whyde, Kiley Devoll, Allie Honigford, Macy Davis, Joshua Honaker, Samantha Mccord, Manoranjan D'Souza

Pharmacy and Wellness Review

Treatment-resistant depression (TRD) is a challenging and possibly life-threatening condition that affects millions of people worldwide. Patients with major depressive disorder (MDD) are diagnosed with TRD once they have tried and failed to respond to two antidepressant treatments at the maximum dose for a full trial of six to eight weeks. Most traditional antidepressant therapies work by increasing the levels of monoamine neurotransmitters such as dopamine, serotonin, and norepinephrine in the brain. These medications have a delayed onset of action, ranging from two to eight weeks, and often fail to relieve depressive symptoms in a patient with TRD. Therefore, targeting …

Cobenfy(Xanomeline/Trospium) Vs. Clozapine For Treatment-Resistant Schizophrenia, Harmann Singh, Akash M. Patel, Abdullah Noory, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Background: Treatment-resistant schizophrenia (TRS) poses significant therapeutic challenges. Although clozapine remains the gold-standard pharmacologic treatment for TRS, its clinical utility is hampered by severe side effects and intensive monitoring requirements. KarXT (Cobenfy), a combination of xanomeline and trospium chloride, represents a novel antipsychotic approach by targeting muscarinic M1/M4 receptors instead of dopamine D2 pathways.

Hypothesis: KarXT offers comparable efficacy to clozapine with a more favorable safety and tolerability profile, making it a viable alternative for patients with TRS.

Methods: A systematic review was conducted to identify studies from 2015–2025 evaluating KarXT in schizophrenia. Sources included PubMed, ClinicalTrials.gov, FDA databases, ICER …

Kratom As A Therapeutic Option For Opioid Use Disorder​: A Comprehensive Review​, Harmann Singh, Abdullah Noory, Akash M. Patel, Kush C. Patel, Simran Gandhi

Rowan-Virtua Research Day

Kratom (Mitragyna speciosa) has gained significant attention for its potential role in managing opioid use disorder (OUD). This review examines kratom’s pharmacology, safety profile, addiction potential, and ethical considerations in research, while exploring its future as a therapeutic option. Kratom’s primary alkaloids, mitragynine and 7-hydroxymitragynine, act as partial mu-opioid receptor agonists, producing analgesic and sedative effects at higher doses and stimulant-like effects at lower doses. Preclinical and observational studies suggest kratom may alleviate opioid withdrawal symptoms and cravings, but concerns remain regarding its dependency potential and adverse effects, including gastrointestinal distress, hepatotoxicity, and withdrawal symptoms upon cessation. While kratom carries …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

Rowan-Virtua Research Day

Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.

Identifying Early Presentation Of Serotonin Syndrome In A 20-Year-Old Male Prescribed Clomipramine And Quetiapine: A Case Report, Veronica Alday, Justin Scarano, Jonathan Yuh, Christie Richardson

Rowan-Virtua Research Day

Serotonin syndrome, a potentially life-threatening condition, can be challenging to diagnose due to its diverse etiology and varied symptomatology. Despite its severity, serotonin syndrome may present from mild to fatal, with symptoms such as autonomic instability, altered mental status, and neuromuscular excitation (e.g. muscle rigidity, hyperreflexia). Here, we present a 20-year-old male with an extensive psychiatric history who was prescribed clomipramine and developed serotonin syndrome. Few cases of serotonin syndrome have been reported to date, exacerbating the difficulty in recognizing and quickly treating such cases. Cases of serotonin syndrome should continue to be reported, in order to familiarize clinicians with …

The Anxiolytic Effects Of Ashwagandha Supplementation In Adults With Autism Spectrum Disorder And Anxiety, Jessica Mitchell, Andrea Iannuzzelli, Wendy Aita

Rowan-Virtua Research Day

BACKGROUND: The neuroendocrine system activates the hypothalamus-pituitary-adrenal (HPA) axis during stress,1 and individuals with autism spectrum disorder (ASD) may have atypical stress responses linked to HPA axis dysregulation.2 Prolonged activation of this system increases cortisol secretion, the body’s primary stress hormone.3 Withania somnifera (Ashwagandha) is a traditional herbal remedy believed to reduce stress by modulating the HPA axis and lowering cortisol levels.5

HYPOTHESIS: Following four weeks of Ashwagandha supplementation, the treatment group is expected to exhibit reduced cortisol levels, improved Aberrant Behavior Checklist (ABC) scores, and decreased stress-related behaviors, reflecting its anxiolytic effects.

METHODS: Forty-two adult participants with ASD and …

Literature Review: Prazosin Used For Ptsd In Pregnancy, Afshan Khan, Natali Sharma, Rebekah M. Dietrich, Martin Forsberg

Rowan-Virtua Research Day

Posttraumatic Stress Disorder (PTSD) affects 3–4% of pregnant and postpartum individuals and is associated with complications such as preterm birth, low birth weight, and postpartum depression. Pharmacologic treatment options during pregnancy are limited by concerns about fetal safety.

Methods: A literature review was conducted focusing on studies reporting maternal or neonatal outcomes following prazosin exposure in pregnancy.

Results: One observational study of 11 pregnancies found 54.5% had uneventful outcomes, with rates of preterm birth, miscarriage, and preeclampsia similar to the general population. Hypotension and limited lactation data remain concerns.

Conclusion: Early evidence suggests prazosin may be a relatively safe and …

Polypharmacy As A Treatment Barrier In Autism Spectrum Disorder, Ahmed Aly

Rowan-Virtua Research Day

The purpose of the study is to assess the prevalence of polypharmacy in current literature in the Autism Spectrum Disorder (ASD) population. It is hypothesized to find patients with ASD over prescribed compared to the neurotypical counterparts.

The Correlation Between A Methylenetetrahydrofolate Reductase Deficiency In Autism Spectrum Disorder Patients And The Presence Of Mental Health Disorders, Hinal Joshi, Andrea Iannuzzelli

Rowan-Virtua Research Day

• Currently little literature exists on connection between Methylenetetrahydrofolate reductase (MTHFR) deficiency and mental health disorders

• Reduced enzyme activity associated with certain MTHFR variants contributes to altered folate metabolism, elevated homocysteine levels, and disrupted DNA methylation, all of which are implicated in mental health disorders

• Identifying genetic risk factors could facilitate earlier diagnosis and intervention, leading to improved outcomes

• Relevant results could help reduce stigma and promote greater understanding of challenges faced by patients on the spectrum

Case Report: Lamotrigine-Induced Rash In An Adult Patient, Dhruvin Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Lamotrigine (Lamictal®) is a commonly prescribed anticonvulsant and mood-stabilizing medication. One of the rare but serious adverse effects of lamotrigine is the development of a drug-induced rash, which can be potentially life-threatening. This case report highlights the occurrence of a drug-induced rash in a 33-year-old female patient who was prescribed lamotrigine for the management of bipolar disorder. The patient presented with a characteristic rash, and following timely intervention, the rash resolved without complications. This case emphasizes the importance of monitoring for early signs of rash in patients receiving lamotrigine and outlines management strategies.

Investigating Prefrontal Cortex Neuronal Signatures Of Opioid-Induced Risk-Taking Behavior, Cana Quave

Dissertations and Theses (Open Access)

Opioid use disorder occurs alongside impaired risk-related decision-making, but the underlying neural correlates are unclear. We developed an approach-avoidance conflict task using a modified conditioned place preference procedure to study neural signals of risky opioid seeking in the prefrontal cortex, a region implicated in executive decision-making. Following morphine conditioned place preference, rats underwent a conflict test in which fear-inducing cat odor was introduced in the previously drug-paired side of the apparatus. While the saline-exposed control group avoided cat odor, the morphine group included two subsets of rats that either maintained a preference for the paired side despite the presence of …

A New Paliperidone Palmitate Formulation: How Is It Different And Where Does It Fit In Our Array Of Choices For Long-Acting Formulations Of Risperidone And Paliperidone?, Justin Faden, Leslie Citrome

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Long-acting injectable (LAI) antipsychotics have been shown to enhance treatment adherence and outcomes in individuals with schizophrenia, schizoaffective disorder, and bipolar disorder. In recent years, the U.S. Food and Drug Administration (FDA) has approved several LAIs with differing amenities of care, such as mode of administration, duration of oral medication supplementation, dosing frequency, needle gauge and size, and injection volume, amongst others. Additionally, several LAIs are distinct formulations of risperidone and paliperidone, making it difficult to distinguish between formulations, and many providers are unfamiliar with these newer agents. In 2024, a once-monthly LAI formulation of paliperidone palmitate, manufactured by Luye …

Hdac5 Enzymatic Activity Regulates Scn4b Expression To Control Relapse-Like Cocaine Seeking, Daniel J. Wood

MUSC Theses and Dissertations

Substance Use Disorder (SUD) is a relapsing disorder characterized by repeated seeking and use of psychoactive substances despite negative consequences to the individual. Epigenetic changes within the medium spiny neurons (MSNs) of the nucleus accumbens (NAc) are thought to underly the lasting propensity to relapse in SUD. The epigenetic enzyme histone deacetylase 5 (HDAC5) in NAc MSNs limits the formation of reward-cue associations in rodent models of drug seeking, but not sucrose seeking, leading to decreased relapse-like behavior. However, whether HDAC5 reduces drug seeking behavior through its own deacetylase activity or through the recruitment of co-repressors is unknown. Furthermore, these …

Nitrous Oxide Induced Psychosis: A Case Report, Brianne Kimmet, Barbara Gracious

South Atlantic Division GME Research Day 2025

No abstract provided.

The Chemical Straightjacket: Institutional Over-Use Of Psychotropic Drugs On Children In Lieu Of Therapeutic Community Mental Health Services, Marisa Leib-Neri

Indiana Journal of Law and Social Equality

This Article argues that the abysmal state of children’s mental health in America is in part due to an overreliance on and over prescription of psychotropic drugs inside psychiatric residential institutions in lieu of community based mental health services. This overreliance on residential institutions and psychotropic drugs has allowed a new form of chemical restraint to flourish—the chemical straitjacket. This Article uses the medication lists of twelve children in seven different North Carolina psychiatric residential treatment facilities to demonstrate how the chemical straitjacket operates: the prescription of drugs not approved for pediatric populations, counter to evidence-based practices for particular diagnoses, …

Weighted Family History Density Of Substance Use: Influence On Participant Substance Use Onset, Escalation, And Duration, Carleigh A. Litteral

Theses and Dissertations--Psychology

Substance use disorders impose a staggering toll on the United States (U.S.), straining healthcare systems, destabilizing communities, and profoundly impacting both individuals and families. Approximately one in six Americans aged 12 and older had a past-year substance use disorder in 2022 (Key Substance Use, 2022), and nearly one-third of adults experience a substance use disorder in their lifetime (Wu, 2010), contributing to an economic burden exceeding $400 billion annually (National Drug Threat Assessment, 2011). Family history of substance use disorders is a key predictor of vulnerability, with individuals who have affected relatives being 2–8 times more …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

Perturbations In Risk/Reward Decision Making And Frontal Cortical Catecholamine Regulation Induced By Mild Traumatic Brain Injury, Christopher P Knapp, Eleni Papadopoulos, Jessica A Loweth, Ramesh Raghupathi, Stan B Floresco, Barry D Waterhouse, Rachel L Navarra

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Mild traumatic brain injury (mTBI) disrupts cognitive processes that influence risk taking behavior. Little is known regarding the effects of repetitive mild injury (rmTBI) or whether these outcomes are sex specific. Risk/reward decision making is mediated by the prefrontal cortex (PFC), which is densely innervated by catecholaminergic fibers. Aberrant PFC catecholamine activity has been documented following TBI and may underlie TBI-induced risky behavior. The present study characterized the effects of rmTBI on risk/reward decision making behavior and catecholamine transmitter regulatory proteins within the PFC. Rats were exposed to sham, single (smTBI), or three closed-head controlled cortical impact (CH-CCI) injuries and …

The Effects Of Psychedelic Microdosing On Mental Health: A Systematic Review, David F. Lo, Hasan Zia, Adarsh Thakur, Praneetha Rajkumar, Don D. Shamilov

Rowan-Virtua Research Day

This poster explores the effects of psychedelic microdosing on mental health conditions. Roughly 5.5 million individuals in the U.S. utilize psychedelics to treat their mental health issues. The primary substances used for microdosing currently include LSD and psilocybin, but mescaline, DMT, and amphetamines are used less commonly. This systematic review included 16 unique articles. The types of articles included: observational, placebo, self-reported, motivational, literature review, and comparative studies. The studies indicated lower levels of anxiety, depression, and stress among those that microdose. However, drawbacks such as difficulty sleeping and headaches were reported. Various studies have been published on the effects …

Using Fmri To Assess Effectiveness Of Olanzapine Treatment For Schizophrenia, William Kyle Copenhaver, David F. Lo, Hanna Rothenberg, Eeshan Khurana, Valerie Rome, Uzayr Wasif, Don D. Shamilov

Rowan-Virtua Research Day

Schizophrenia is a complex mental illness with neurobiological underpinnings and misconceptions about violence. Schizophrenia is associated with high levels of creativity and structural traits like fewer D2 receptors. Patients face reduced life expectancy due to cardiovascular diseases and cope through smoking and sedentariness. Treatment involves pharmacological antipsychotics like olanzapine and nonpharmacological approaches. Olanzapine works by antagonizing D2 receptors but has side effects like weight gain and diabetes risk. fMRI is used to study treatment mechanisms and predict response, but research on olanzapine's brain network effects is limited.

The Efficacy Of Baricitinib As A Treatment Option For Alopecia, In Terms Of Promoting Hair Regrowth And Improving Patient Reported Outcomes, Bhaumik Patel, Abhiram Gollapudi, Samrat Gollapudi, Srinidhi Banala, Brian Joseph Mathew, Prince Patel

Rowan-Virtua Research Day

Background: Alopecia, an autoimmune condition characterized by hair loss, significantly impacts millions globally, often leading to psychological distress such as anxiety and depression. Current treatments are variably effective and frequently associated with adverse effects that restrict long-term use. This study evaluates the efficacy of Baricitinib, a Janus Kinase inhibitor, in treating severe alopecia, focusing on hair regrowth and patient-reported outcomes.

Methods: This research synthesized data from recent publications (2018-2023) including clinical trials, reviews, meta-analyses, and systematic reviews, sourced from databases such as PubMed, Springer, and Elsevier. The inclusion criteria focused on recent studies in English evaluating Baricitinib's effectiveness in severe …

Efficacy Of Psilocybin In The Treatment Of Substance And Alcohol Use Disorders, Hanna Brancaccio

Rowan-Virtua Research Day

Introduction: Substance use disorder (SUD) and alcohol use disorder (AUD) are major public health crises, affecting millions of Americans. Current treatment options include behavioral therapies and medications. In this review, we explored psilocybin’s efficacy in treating SUD and AUD.

Methods: Key terms were used to search databases to identify articles that addressed psilocybin in the treatment of SUD. Included in the review were indexed, peer-reviewed, primary sources that were published within the last 10 years. Excluded studies were non-peer reviewed, not relevant to the thesis, and did not have an English translation.

Results: The psychodynamic antidepressant effects of psilocybin mark …

Ketamine For Postpartum Depression: A Systematic Review, Jaylyn Thompson, David F. Lo, Alexis Foschini, Suvan Sundaresh, Don D. Shamilov

Rowan-Virtua Research Day

The purpose of this review is to explore perinatal ketamine’s potential for reducing postpartum depression after cesarean section. Articles reviewed from Pubmed, Cochrane, and Web of Science using specific search terms. 8 final papers were used for review after excluding duplicates and irrelevant titles and abstracts. Ketamine showed potential in reducing postpartum depression symptoms post C-section, although some studies reported no significant effects. All studies were randomized control trials. Ketamine may help prevent or lessen postpartum depression symptoms post C-section, but more research is needed to understand dosing and its casual relationship with PPD in this context.

Brain Connectivity Pattern Changes Associated With Psychedelic-Assisted Psychotherapy, Prince Patel, Samrat Gollapudi, Brian Joseph Mathew, Bhaumik Patel

Rowan-Virtua Research Day

Psychedelic-assisted psychotherapy (PAP) has shown promising therapeutic benefits for various psychiatric disorders, but the underlying neural mechanisms remain unclear. This study aimed to investigate the effects of psychedelics on brain connectivity patterns using functional magnetic resonance imaging (fMRI). A comprehensive literature search was conducted in PubMed and Google Scholar databases using relevant keywords related to psychedelics, connectivity, therapy, and fMRI. Only studies involving major psychedelic compounds (LSD, psilocybin, ayahuasca) and measuring outcomes via fMRI were included.

The findings from the reviewed studies suggest that psychedelics induce acute disruptions in normal large-scale brain network patterns, leading to a compromised modular but …

Doxazosin Immediate Release As Alternative Treatment For Nightmares In Post-Traumatic Stress Disorder: A Case Report, Danyaal Khan, Christie Richardson, Martin Forsberg

Rowan-Virtua Research Day

Nightmares and flashbacks are common debilitating symptoms of post-traumatic stress disorder (PTSD) that can disrupt daily functioning in patients. Prazosin, an alpha-1 adrenergic antagonist, has been commonly used off-label for the treatment of PTSD intrusion symptoms, although its short half-life is limiting. Doxazosin, another alpha-1 antagonist, is starting to be investigated in the treatment of PTSD-related nightmares due to its smaller side effect profile and longer half-life. In our case report, we present a case of a patient with PTSD-related nightmares who was successfully treated with doxazosin following relapse of symptoms after discontinuation of prazosin. The success of doxazosin immediate …

Selective Serotonin Reuptake Inhibitors And Pharmacological Resetting Of The Mind, Ion G. Motofei, David L. Rowland

Journal of Mind and Medical Sciences

Mental activity is capable of processing analytical data (mathematics, physics, socio-political science, philosophy, etc.) similar to computer software. At the same time, mental activity largely depends on the brain, which works like a hard component of a computer. While the computer stores data on a physical medium, mental activity and data are supported by physiological mechanisms that are constantly operating (both in wakefulness and sleep). For this reason, the lack of brain oxygenation even for short periods of time (5-10 minutes) causes the loss of all data, including the disappearance of the individual's existence as a mental entity. This means …

Doxazosin Immediate Release As A Novel Treatment For Nightmares In Posttraumatic Stress Disorder., Danyaal Khan, Christie Richardson, Martin Forsberg

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Nightmares and flashbacks are common debilitating symptoms of posttraumatic stress disorder (PTSD) that can disrupt daily functioning. Prazosin, an alpha-1 adrenergic antagonist, has been commonly used off-label for the treatment of these intrusion symptoms, although its short half-life makes it so that often multiple doses are needed. Doxazosin, another alpha-1 antagonist, is starting to be investigated in the treatment of PTSD-related nightmares due to its lesser side effect profile and longer half-life. In our case series, we present three cases of patients with PTSD-related nightmares who were successfully treated with doxazosin following a relapse of symptoms after discontinuation of prazosin …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …