Medication Use and the Complexities of Shared Care in the Treatment of DID: Opportunities and Pitfalls
Psychotropic medications are widely used in the treatment of Dissociative Identity Disorder (DID), yet the literature to guide their use is almost nonexistent. The prescriber faces the challenge of distinguishing whether particular symptoms, such as dramatic mood shifts or auditory hallucinations, represent switches within the alter system, as opposed to co-occurring biological disorders such as bipolar disorder or schizophrenia. The task is even further complicated when the prescriber serves as medical backup to a primary therapist, who may be more or less knowledgeable about DID than the prescriber. Additionally, the prescriber’s engagement with the alter personalities may exert complex pressures on the treatment frame.
In this workshop, we review the literature on medication use for DID; examine the difficult differential diagnostic issues as well as the at times perplexing medication responses encountered with DID; and explore a variety of pitfalls (as well as opportunities) which can arise in the shared care situation. The presenters share a host of clinical examples to illustrate each of the above issues. The workshop is especially recommended for prescribers in their first few years of treating DID. Non-MD’s who want to be able to keep a watchful eye on their psychiatric colleagues may also be interested.
This session was originally presented as a live conference session in March 2019.
At the conclusion of this session participants will be able to:
- Name commonly used medication interventions for Dissociative Identity Disorder
- Explain several difficult diagnostic issues which influence medication strategies
- Identify several common pitfalls encountered when sharing care of the Dissociative Disorder patient
Presenter: Brad Foote, MD
Presenter Bio: Brad Foote, MD, is Clinical Associate Professor of Psychiatry at AECOM/Montefiore, and has worked as an Attending Psychiatrist in the Outpatient Psychiatry Department, Montefiore Medical Center, since 1992. He specializes in the treatment of Dissociative Identity Disorder, as well as Complex Post-traumatic Stress Disorder and Borderline Personality Disorder. He was intensively trained in Dialectical Behavior Therapy (DBT) and has published on adapting DBT for the treatment of Dissociative Identity Disorder. He teaches yearly courses to the Einstein Psychiatry residents in Dissociative Disorders, Complex PTSD, Introduction to Psychotherapy via Video, Brief Dynamic Psychotherapy, and Heinz Kohut’s Self-Psychology. He received the Irma Bland Award for Excellence in Teaching Residents from the American Psychiatric Association in 2009.
Dr. Foote has held various offices for the International Society for the Study of Trauma and Dissociation (ISSTD) since 2003, and became an ISSTD Fellow in 2012. He won the Morton Prince Award for Scientific Achievement from ISSTD in 2008 for his publication “Dissociative Disorders and Suicidality in Psychiatric Outpatients” in the Journal of Nervous and Mental Disease.
Dr. Foote has published, and presented at international meetings, his research concerning the prevalence of dissociative disorders; suicidality and dissociative disorders; the relationship between dissociative disorders and borderline personality disorder; and other related topics.
Presenter: Anthony Tranguch, MD, PhD
Presenter Bio: Anthony Tranguch, MD, PhD is a psychiatrist with two decades of experience in the clinical treatment of DID, PTSD, Addictions, and most psychiatric disorders. He is in private practice in Manhattan, and an Assistant Clinical Professor of Psychiatry at Columbia Univeristy, New York Presbyterian Hospital, and New York State Psychiatric Institute. In addition to meds and traditional psychotherapy approaches, he integrates a variety of alternative methods, including EMDR, hypnosis, NLP, EFT, Reiki, Sensorimotor & SE, IFS & Ego States, CES, and LENS Neurofeedback.
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