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ForwardSession 17: Managing Pharmacodynamic Drug Interactions for Improved Psychiatric Outcomes
Multiple studies have shown the increasing prevalence of polypharmacy, particularly in the prescription of psychiatric medications. As medication regimens get longer, the potential for drug drug interactions increases dramatically. Although there is abundant evidence on pharmacokinetic interactions, e.g. CYP P450, and pharmacodynamic interactions that are dangerous, e.g. prolongation of QTc, there is far less evidence to guide clinicians on functional pharmacodynamic interactions that may limit efficacy. Each of the pharmacodynamic interactions in this presentation will meet one of three basic criteria:
- Antagonism at the primary receptor of mechanism of action.
- Medications that do not share a primary receptor of medication of action, but have opposing clinical indication and side effect profile.
- Medications with unrelated indication, side effect profile and primary receptor of mechanism of action, but with clinical studies confirming the presence of an efficacy limiting interaction in humans, rats, or mice.
Although combinations of medications are increasing in clinical practice there are relatively few clinical studies to support their use. Due to the lack of studies as an evidence basis, prescribing software often does not alert clinicians to the presence of an efficacy limiting pharmacodynamic interaction. A working understanding of practical psychopharmacology is necessary to anticipate efficacy limiting interactions in both the medications we prescribe, but also prescribed by other medical specialists for our patients.
Psychology CE Credit Statement
The Medical College of Wisconsin is approved by the American Psychological Association to sponsor continuing education for psychologists. The Medical College of Wisconsin maintains responsibility for this program and its content.
This activity contains content or processes that may be potentially stressful.
Target Audience
- Physicians
- Nurse Practitioners
- Physician Assistants
- Nurses
- Pharmacists
- Psychologists
- Social Workers
- Psychiatry Residents
- Medical Students
- Allied Health Professionals
Learning Objectives
Participants who engage in this education intervention will be able to:
- List common efficacy limiting interactions for each major neurotransmitter in psychiatric practice
- List the medications primary care doctors and other specialists may be prescribing for your patients that will limit efficacy
- Distinguish between adjunctive medication to address side effects and efficacy limiting interactions
- Identify treatment alternatives that avoid efficacy limiting interactions
Thursday:
- Brief Review of Pharmacological Interactions
- Interactions involving Dopamine: Stimulants and D2 Blockers
- Interactions involving Epinephrine I: Atomoxetine and Beta Blockers
- Epinephrine II: SNRIs and Alpha I Blockers
- Epinephrine III: Mirtazapine and Alpha II Agonists
- Interactions involving Amphetamine and Benzodiazepines
Friday:
- Interactions involving Serotonin I: Clozapine and SSRIs
- Serotonin II: SSRIs and Serotonin Antagonists
- Serotonin III: Hallucinogens and Serotonin Antagonists
- Interactions involving Acetylcholine: Donepezil and Anticholinergic Medication
- Interactions only Evident In Vivo I: Opioid Blockers and Tricyclic Antidepressants
- Interactions only Evident in Vivo II: Opioid Blockers and Ketamine
Lodging in July and August is in great demand; you must make reservations early. A block of suites has been set aside at the Landmark Resort. These suites will be held until June 5th, 2026, or until they are filled.
From its site on the bluff, the Landmark offers outstanding views of the waters of Green Bay with 294 units comprised of 1, 2, and 3-bedroom suites. Facilities include the Carrington Pub and Grill, 1 indoor and 3 outdoor pools, 2 tennis courts, whirlpools, steam rooms, and a fitness center and game room. The Landmark Resort is Door County’s largest and best full-service facility.
The Landmark Resort
4929 Landmark Drive
Egg Harbor, Wisconsin 54209
Reservations: (800) 273-7877
http://www.thelandmarkresort.com
To book through our discounted group rate, please call the Landmark reservation line at (800) 273-7877 and state that you are attending the Door County Summer Institute. No group code is required.
Group rates cannot be booked online.
Disclosure
Consistent with ACCME policy, faculty for all MCW continuing education programs must disclose all relevant financial relationships with commercial organizations. MCW has a mechanism in place to identify and resolve conflicts in advance of the DCSI.
Paul Zarkowski, MD, is a Senior Psychiatric Supervisor at Sound Behavioral Health in Seattle and serves as Clinical Associate Professor in the Department of Psychiatry and Behavioral Sciences at the University of Washington. There Dr Zarkowski sees patients in the Psychiatric Emergency Service at Harborview Medical Center and lectures on mood and anxiety disorders as well as the evaluation of geriatric patients.
He has published journal articles and book chapters on improving suicide assessment, addressing the clinical needs of special populations, and using EEG in psychiatric applications. Ongoing research interests include strategies for improving psychiatric medication regimens for optimum outcomes.
Activity Director:
Carlyle H Chan, MD
Professor of Psychiatry and
the Institute for Health and Equity-Bioethics and Humanities
Medical College of Wisconsin
Planning Committee Members:
Ellen Leitner, MSW, LCSW
Department of Psychiatry and Behavioral Medicine
Medical College of Wisconsin
Kevin Bozymski, PharmD, BCPS, BCPP
Assistant Professor, Department of Clinical Science
Medical College of Wisconsin School of Pharmacy
Assistant Professor, Department of Psychiatry and Behavioral Medicine
Medical College of Wisconsin
Kylie Lenz, PA-C
Physician Assistant
Department of Psychiatry and Behavioral Medicine
Medical College of Wisconsin
Heather M. Smith, PhD, ABPP
Lead Psychologist
Director of Psychology Training
Milwaukee VA Medical Center
Associate Professor
Department of Psychiatry and Behavioral Medicine
Medical College of Wisconsin
Marisa Stich, APNP
Department of Psychiatry and Behavioral Medicine
Medical College of Wisconsin
In accordance with the ACCME® Standards for Integrity and Independence in Accredited Continuing Education, Standard 3, all persons in control of content must disclose any relevant financial relationships. It is the policy of the Medical College of Wisconsin to identify, mitigate and disclose the absence or presence of all relevant financial relationships with ineligible companies held by the speakers/presenters, authors, planners, and other persons who may influence content of this accredited continuing education. The following in control of content had no relevant financial relationships to disclose.
- Carlyle H Chan
- Ellen Leitner
- Kevin Bozymski
- Kylie Lenz
- Heather M. Smith
- Marisa Stich
- Paul Zarkowski
ACCME Accreditation Statement
The Medical College of Wisconsin is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Designation of Credit Statement
The Medical College of Wisconsin designates this live activity for a maximum of 8 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Hours of Participation for Allied Health Professionals
The Medical College of Wisconsin designates this live activity for up to 8 hours of participation for continuing education for allied health professionals.
American Academy of Physician Assistants Credit Statement
This activity has been reviewed by the American Academy of Physician Associates Review Panel and is compliant with AAPA CME Criteria. This activity is designated for 8 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation. Approval is valid from 7/20/2026 to 8/7/2026. AAPA reference number: CME-2015202.
Available Credit
- 8.00 AMA PRA Category 1 Credit(s)™AMA PRA Category 1 Credit(s)™
- 8.00 APAAPA credit.
- 8.00 Hours of ParticipationHours of Participation credit.
- 8.00 NASW
- 8.00 NP Contact Hours
- 8.00 PAPA credit.
Price
Credit MUST be claimed before November 30, 2026.
We highly encourage you to complete the evaluation and credit steps before leaving on your last day!
Early Bird Tuition for 2-day sessions (4 hrs/day) is $430. After June 1st, the price will increase to $455. Graduate and medical students and resident physicians will have a discounted rate, so please contact Caimen at [email protected] to inquire about this discount. A $1 fee is added during checkout to cover the PayPal transaction fee.
To receive a refund, the request must be made at least 15 days before the requested session begins, and a $50 cancellation fee will be deducted from the refund amount. If the refund request is received less than 15 days before the session begins, the full registration fee will be forfeited.
2-Day Pricing | 2-Day Pricing |
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$430 | $455 |
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Registration scams:
Registration for courses managed by MCW Office of Continuing Professional Development can only be completed through our portal at https://ocpe.mcw.edu/. Course registrations made through other sites cannot be honored. MCW Office of Continuing Professional Development is not able to refund fees paid through unaffiliated registration sites, such as eMedEvents.com, MedConfWorld.com, EventEgg.com, and 10times.com. Please report any unauthorized websites or solicitations for registrations to [email protected].