Danielle Johnson, MD, FAPA
Lindner Center of HOPE/Chief Medical Officer
University of Cincinnati College of Medicine Adjunct Assistant Professor of Psychiatry

Medications are undoubtedly an important tool in the treatment of mental illnesses. Expert application of psychopharmacology is a game changer in improving symptoms of mental illness and helping individuals achieve a manageable baseline. Complex co-morbidities and severe mental illness make prescribing even more complex.

Psychiatric medications can stabilize symptoms and prevent relapse. They work by affecting neurotransmitters in the brain. Serotonin is involved in mood, appetite, sensory perception, and pain pathways. Norepinephrine is part of the fight-or-flight response and regulates blood pressure and calmness. Dopamine produces feelings of pleasure when released by the brain reward system.

One in ten Americans takes an antidepressant, including almost one in four women in their 40s and 50s. Women are twice as likely to develop depression as men.

Selective Serotonin Reuptake Inhibitors (SSRIs) Side Effects

Selective serotonin reuptake inhibitors (SSRIs) increase levels of serotonin. Fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro) treat depression, anxiety disorders, premenstrual dysphoric disorder, eating disorders, and hot flashes. Potential side effects include jitteriness, nausea, diarrhea, insomnia, sedation, headaches, weight gain, and sexual dysfunction.

Zoloft Side Effects in Women

Zoloft, also known by its generic name sertraline, is an antidepressant medication that can cause a range of side effects in women. Some of the common side effects of Zoloft include nausea, diarrhea, headache, dizziness, dry mouth, drowsiness, and difficulty sleeping. Women may also experience sexual side effects such as decreased libido, difficulty reaching orgasm, and erectile dysfunction. In some cases, Zoloft may cause weight gain or weight loss, and it can also affect blood pressure and heart rate. Rare but serious side effects of Zoloft in women may include seizures, serotonin syndrome, and suicidal thoughts or behavior.

Prozac Side Effects in Women

Prozac, also known by its generic name fluoxetine, is an antidepressant medication that can cause a range of side effects in women. Some of the common side effects of Prozac include nausea, diarrhea, headache, dizziness, dry mouth, drowsiness, and difficulty sleeping. Women may also experience sexual side effects such as decreased libido and difficulty reaching orgasm. Prozac may also cause weight gain or weight loss, and it can affect blood pressure and heart rate. Rare but serious side effects of Prozac in women may include serotonin syndrome, suicidal thoughts or behavior, and seizures.

Lexapro Side Effects in Women

Lexapro, also known by its generic name escitalopram, is an antidepressant medication that can cause a range of side effects in women. Some of the common side effects of Lexapro include nausea, diarrhea, headache, dizziness, dry mouth, drowsiness, and difficulty sleeping. Women may also experience sexual side effects such as decreased libido and difficulty reaching orgasm. Lexapro may also cause weight gain or weight loss, and it can affect blood pressure and heart rate. Rare but serious side effects of Lexapro in women may include serotonin syndrome, suicidal thoughts or behavior, and seizures.

Serotonin-norepinephrine Reuptake Inhibitors (SNRIs) Side Effects

Serotonin-norepinephrine reuptake inhibitors (SNRIs) increase levels of serotonin and norepinephrine. Venlafaxine (Effexor), duloxetine (Cymbalta), and desvenlafaxine (Pristiq) are used to treat depression, anxiety disorders, diabetic neuropathy, chronic pain, and fibromyalgia. Potential side effects include nausea, dry mouth, sweating, headache, decreased appetite, insomnia, increased blood pressure, and sexual dysfunction.

Tricyclic Antidepressants Side Effects

Tricyclic antidepressants (TCAs) also increase serotonin and norepinephrine. Amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), nortriptyline (Pamelor), doxepin (Sinequan), trimipramine (Surmontil), protriptyline (Vivactil), and imipramine (Tofranil) are used to treat depression, anxiety disorders, chronic pain, irritable bowel syndrome, migraines, and insomnia. Possible side effects include sedation, forgetfulness, dry mouth, dry skin, constipation, blurred vision, difficulty urinating, dizziness, weight gain, sexual dysfunction, increased seizure risk, and cardiac complications.

Other Antidepressants Side Effects

Wellbutrin Side Effects in Women

Bupropion (Wellbutrin) increases levels of dopamine and norepinephrine. It treats depression, seasonal affective disorder, ADHD, and can be used for smoking cessation. It can also augment other antidepressants. Potential side effects include anxiety, dry mouth, insomnia, and tremor. It can lower the seizure threshold. There are minimal to no sexual side effects or weight gain.

Trazodone (Desyrel, Oleptro) affects serotonin and mirtazapine (Remeron) affects serotonin and norepinephrine. They are both used for depression and sleep. Mirtazapine has minimal sexual side effects.

Monoamine oxidase inhibitors (MAOIs) increase serotonin, norepinephrine, and dopamine. Isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), tranylcypromine (Parnate), and moclobemide are associated with more serious side effects than other antidepressants. There are dietary restrictions and numerous drug interactions. MAOIs are often used after other antidepressant classes have been tried. Other antidepressants need to be discontinued for a period of time prior to starting an MAOI.

Newer antidepressants include Viibryd (vilazodone) which affects serotonin, Fetzima (levomilnacipran) which affects serotonin and norepinephrine, and Brintellix (vortioxetine) which affects serotonin. Brintellix and Viibryd have mechanisms of action that make them unique from SSRIs. Viibryd is less likely to cause sexual side effects.

Excess serotonin can accumulate when antidepressants are used with other medications that effect serotonin (other antidepressants, triptans for migraines, certain muscle relaxers, certain pain medications, certain antinausea medications, dextromethorphan, St. John’s Wort, tryptophan, stimulants, LSD, cocaine, ecstasy, etc.) Symptoms of serotonin syndrome include anxiety, agitation, restlessness, easy startling, delirium, increased heart rate, increased blood pressure, increased temperature, profuse sweating, shivering, vomiting, diarrhea, tremor, and muscle rigidity or twitching. Life threatening symptoms include high fever, seizures, irregular heartbeat, and unconsciousness.

Estrogen Levels With Antidepressants in Females

Varying estrogen levels during the menstrual cycle, pregnancy, postpartum, perimenopause, and menopause raise issues with antidepressants and depression that are unique to women. Estrogen increases serotonin, so a decrease in estrogen at certain times in a woman’s reproductive life cycle can reduce serotonin levels and lead to symptoms of depression. Hormonal contraception and hormone replacement therapy can reduce or increase depressive symptoms; an increase in symptoms may be more likely in women who already had major depressive disorder. During pregnancy, antidepressants have a potential risk to the developing baby but there are also risks of untreated depression on the baby’s development. With breastfeeding, some antidepressants pass minimally into breast milk and may not affect the baby. The benefits of breastfeeding may outweigh the risks of taking these medications.   Antidepressant sexual side effects in women are vaginal dryness, decreased genital sensations, decreased libido, and difficulty achieving orgasm. Women should communicate with their psychiatrist and/or OB/GYN to discuss the risks and benefits of medication use vs. untreated illness during pregnancy and breastfeeding; the use of hormonal treatments to regulate symptoms associated with menses and menopause; and the treatment of sexual dysfunction caused by antidepressants.

It has been observed that some antidepressants can affect estrogen levels in women. For instance, selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac) and sertraline (Zoloft) have been shown to decrease estrogen levels in women. On the other hand, other antidepressants such as venlafaxine (Effexor) and duloxetine (Cymbalta) have been shown to increase estrogen levels. The exact mechanisms behind these effects are not fully understood, but it is thought to be related to the interactions between the medication and the hypothalamic-pituitary-gonadal (HPG) axis, which is responsible for regulating estrogen production. It is important for women to discuss any potential effects of antidepressants on estrogen levels with their healthcare provider, especially if they have a history of hormonal imbalances or are taking hormonal therapies.

It is important for women to discuss any potential side effects with their healthcare provider before starting any depression medication.

Lindner Center of HOPE’s Approach

Lindner Center of HOPE’s residential services employ full-time psychiatrists with expertise in psychopharmacology. These prescribing physicians are designated members of each residential client’s treatment team. Medication management within Lindner Center of HOPE’s residential programs is also supported by 24/7 psychiatry and nursing staff, onsite pharmacy and an innovative Research Institute.

In some cases, patients over the course of treatment for mental illnesses accumulate many prescriptions. In cases like this, Lindner Center of HOPE’s residential units can offer a safe environment for medication assessment and adjustment. While the client participates in appropriate evaluation and treatment, their psychiatrist can also work with them on reaching rational polypharmacy — in other words, medication optimization.

For patients with more severe, treatment-resistant mental illness, Lindner Center’s psychiatrists can implement the most complicated, and often hard to use, treatments, in a safe environment, while under their observation.

If medication adjustments result in decompensation on the residential units, a patient can be temporarily stepped up to an acute inpatient unit on the same campus.

REGISTER NOW! 1 CME/CEU OFFERED

Please join us March 12, 2024
5:30 – 6:30 p.m. EST

For a free webcast

Somatic and Parts Work in Trauma Treatment

 

PRESENTED BY:
Sidney Hays, MSW, LISW, DARTT, Outpatient Therapist

Participants in the webcast will be able to:

  1. Define trauma and limitations of current DSM trauma diagnoses.
  2. Identify physiological states of being and understand how these impact perception, mood, and behavior.
  3. Articulate how trauma causes fragmenting of parts and gain

Click here for flyer

Register here

Target Audience:
Psychiatrists, Primary Care Physicians, Non-psychiatric MDs, Nurse Practitioners, , Social Workers, Psychologists, Registered Nurses, and Mental Health Specialists and interested parties as well

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing
Medical Education (ACCME) through the joint providership of the University of Cincinnati and the Lindner Center of HOPE. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credits
commensurate with the extent of their participation in the activity.

The Ohio Psychological Association under approval number P099-311067501 (2010-2012) approves the University of Cincinnati College of Medicine
Department of Psychiatry for 1 mandatory continuing education credit for Ohio Licensed Psychologists.

The This activity has been approved for 1 clock hour of CEU by The State of Ohio Counselor, Social Work, Marriage and Family Therapist Board.

DISCLAIMER
The opinions expressed during the educational activity are those of the faculty and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the attendees’ professional development.

Feb 21, 2024  6P – 7:30P EST  Manor House – Mason or virtual

Megan Schrantz, EdD, LPCC, Therapist

Coping with Posttraumatic Stress:  Journey Toward Hope and Healing

Participants will:

  • Learn what posttraumatic stress is and how it can impact one’s mental health and overall functioning.
  • Learn therapeutic tasks for healing trauma.
  • Learn healthy strategies to manage symptoms and to move forward.

click here for registration

 

March 20, 2024  6p-7p EST Countryside YMCA – Lebanon or virtual

Chris Tuell, EdD, LPCC-S, LICDC-CS, Clinical Director of Addiction Services

The Internet and How to Have a Healthy Digital Diet

Participants will:

  • Learn the importance of having a healthy, balanced life of digital consumption.
  • Learn the relationship between the digital world and mental illness.
  • Learn the role of nature and nurture in the relationship in having a healthy digital diet.

Click here for registration

Team Members discuss final event plans for their Big Watch Party, “Touchdown for HOPE,” – Lindner Center of HOPE’s signature fundraising event, hosted each year at the Great American Ballpark.

Pictured L-R: Terry Ohnmeis, David Tasner, Mary Alexander, Carl Satterwhite, John Winch, Gary Mitchell, Brock Anderson, John Ryan, Graham Mercurio Not pictured: Chrissey Barrett Haslam, Greg Harmeyer, Jennifer Pierson, Scott Robertson, Ryan Rybolt, Joel Stone, and David Wyler

Lindner Center of HOPE congratulates Tracy Suzanne Cummings, MD, as a 2023 Cincy Best Doc in the Child & Adolescent Psychiatry category.

This is the premier medical award for all practitioners in the Greater Cincinnati region. Nominations were open to the community and allowed for nominations across many different categories, and the best in each category were chosen. Being named as a Cincy Best Docs physician is an exceptional honor.

The Harold C. Schott Foundation Eating Disorders Program at Lindner Center of HOPE to Host Free Webinar in Honor of National Eating Disorders Awareness Week National Eating Disorders Awareness Week is February 28, 2024 – March 5, 2024

Compassion for Ourselves: Addressing weight stigma and body shame during the journey to recovery.

Recovering from eating disorders often requires many different parts including therapy, work with a dietitian, groups, and a recovery community. A piece that often does not get addressed is the experience and trauma of weight stigma and shame around body size and weight. This talk will look at the history and internalization of both, the role they play for those with eating disorders and the necessary self-compassion and care required for recovery.

Guest presenter, Chevese Turner’s dedication to health equity began early in her career when she was part of a team working to ensure cancer patients had ongoing access to critical treatments. Driven by her own struggles and recovery, she founded the Binge Eating Disorder Association (BEDA) in 2008 to address the unmet needs of people with the most prevalent eating disorder and was integral to Binge Eating Disorder (BED) receiving its designation in the Diagnostic & Statistics Manual.
Currently, Chevese is an eating disorder and anti-weight discrimination advocate, educator and speaker, and the founder of the Body Equity Alliance in which she assists organizations and brands creating inclusive campaigns, policies and environments that feature and accommodate higher weight people. She is also a lived experience coach and a co-founder of Attune, an educational and coaching organization serving larger bodied individuals, with and without eating disorders, who want to put an end to diet dependency and weight cycling, and are seeking help navigating the healthcare system which is often biased and discriminatory toward larger bodied individuals.

 

 

Where?
This event will be run virtually through Zoom (details sent with RSVP email confirmation).

When?
Thursday, February 29, 2024
at 6:00PM EST.

Presented by the Harold C. Schott Eating Disorders Program.

RSVP at https://lindnercenter.ejoinme.org/compassion-for-ourselves
by Friday, February 22, 2024

Any questions, contact Pricila Gran at 513-536-0318 or [email protected].

Click here for flyer

FOUR 1HR CME/CEU CONTINUING EDUCATION CONFERENCE

A Four-Part Series To Discuss Strategies to Stabilize and Improve Lingering Challenges of Chronic/Sub-Acute Mental Illness and Substance Use

Brought to you by Williams House at Lindner Center of HOPE.
Join Lindner Center of HOPE residential team members as they offer four 1-hour presentations for a free CEU for each presentation attended.
Four consecutive Tuesdays at Noon ET.
Virtual Webcast Event

Target Audience:
Healthcare and Mental Health Professionals

PRESENTERS AND TOPICS OF DISCUSSION

January 30, 2024
The Clinical Benefits of an Extended Stabilization Evaluation

Post presentation the audience will be able to:
1. Outline the clinical benefits of an extended stabilization evaluation in residential treatment.
2. Identify patients who will benefit from an extended stabilization evaluation in residential care.
3. Identify the elements of an extended stabilization evaluation.

Presenters: Michael Groat, PhD, Chief Clinical Officer and Dr. William Hartmann, MD, FAPA, Medical Director of Williams House
Click here to register  (RSVP by Friday, Jan. 26th, 2024)


February 6, 2024
Concurrent Treatment of Schizophrenia and Mood Disorders

Post presentation the audience will be able to:
1. Describe symptom profile, evaluation and assessment processes, and basis of how people admit to Lindner Center of HOPE’s Williams House.
2. Describe Williams House services and how to identify treatment goals and tailor your approach to each individual.
3. Describe course of care, next steps, and discharge planning.

Presenters: Megan Morrison, CNP, PMHNP-BC , Psychiatric Nurse Practitioner,, and Shelby Naghshineh, Residential Behavioral Health Care Coordinator
Click here to register  (RSVP by Friday, Feb. 2nd, 2024)


February 13, 2024

Schizo-Obsessive Disorder: Differential Diagnosis and Identifying Treatment Targets

Post presentation the audience will be able to:

1. Describe what stabilization and evaluation look like for an individual with obsessive-compulsive symptoms and concerns for psychosis.
2.Describe the evaluation process and diagnostic questions that are answered for these patients.
3.Describe the evaluation process, conceptualization, and treatment recommendations for a patient who presents with this disorder.

Presenters: Lindsey Collins Conover, PhD, Staff Psychologist, and Margot Brandi, MD, Medical Director of Sibcy House
Click here to register (RSVP by Friday, Feb. 9th, 2024)


February 20, 2024

Making the ‘Case’ for Stabilizing Evaluation and Restorative Treatment: Three Case Studies

Post presentation the audience will be able to:
1. Differentiate between inpatient care and stabilizing evaluation.
2. Recognize the benefits of integrated and interdisciplinary treatment with a seamless transition into further mental health services.
3. Identify a variety of specialized treatments offered within stabilizing evaluation.

Presenters: Michael Hill, Residential Behavioral Health Care Coordinator and Adan Liendo, LPCC-S, Residential Counselor
Click here to register  (RSVP by Friday, Feb. 16th, 2024)


ACCREDITATION STATEMENT

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing
Medical Education (ACCME) through the joint providership of the University of Cincinnati and the Lindner Center of HOPE. The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians.

The University of Cincinnati designates this live activity for a maximum of 4 AMA PRA Category 1 Credits™. Physicians should claim only the credits commensurate with the extent of their participation in the activity. Each activity has been approved for 1.0 AMA PRA Category 1 Credit™.

The Ohio Psychological Association under approval number P099-311067501 (2010-2012) approves the University of Cincinnati College of Medicine
Department of Psychiatry for 4 mandatory continuing education credits for Ohio Licensed Psychologists.

DISCLAIMER
The opinions expressed during the educational activity are those of the faculty and do not necessarily represent the views of the University of Cincinnati. The information is presented for the purpose of advancing the attendees’ professional development.


For questions Contact: Pricila Gran at 513-536-0318 or [email protected]

Click here to download flyer

Super Bowl Event, Feb. 11, 2024

Event Date: 02/11/24

 

Touchdown for HOPE is a classy and fun Super Bowl party with big screen televisions, plush seating, and signature Cincinnati food favorites and other upscale tailgate-style treats. All taking place in a sports fan’s dream location –overlooking the baseball field.  Tickets are $100 per guest, but a young professional’s ticket, for those 35 and under, is priced at $75. Reservations include free parking in Central Riverfront Garage and Cincinnati favorites such as LaRosa’s pizza, Skyline Chili, Montgomery Inn ribs and UDF ice cream food and much more.

Proceeds from this year’s event supports the Center’s Transforming HOPE Capital Campaign. Funding enables the Center to add treatment units, expand wellness facilities, and guarantee the recruitment and retention of high-quality clinicians.

VIEW EVENT DETAILS

WHEN: Thursday, January 18, 2024
9am-11am and 3pm-5pm (Bring your resume)

WHERE: Lindner Center of HOPE – gymnasium
4075 Old Western Row Road
Mason, OH 45040

We are currently hiring various positions. Check our website for openings:

Careers

Visit our website to view more information on these positions:
https://lindnercenterofhope.org/careers/or contact HR at [email protected]

LCOH Job fair flyer Jan. 2024