Clinical Associate Professor, Psychiatry and Behavioral Sciences - Medical Psychiatry
Board Certification: American Board of Psychiatry and Neurology, Consultation-Liaison Psychiatry (2013)
Medical Education: Aga Khan University Medical College (2005) Pakistan
Board Certification: American Board of Psychiatry and Neurology, Psychosomatic Medicine (2013)
Fellowship: New York Presbyterian Hospital - Columbia University (2012) NY
Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2011)
Residency: Mayo Clinic School of Medicine (2011) MN
ACLP Best Practice Guidance: Evaluation and Treatment of Depression in Solid Organ Transplant Recipients.
Journal of the Academy of Consultation-Liaison Psychiatry
We present Academy of Consultation Liaison Psychiatry (ACLP) best practice guidance on depression in Solid Organ Transplant (SOT) recipients which resulted from the collaboration of ACLP's Transplant Psychiatry Special Interest Group (SIG) and Guidelines and Evidence-Based Medicine Subcommittee. Depression (which in the transplant setting may designate depressive symptoms or depressive disorders) is a frequent problem among SOT recipients. Following a structured literature review and consensus review process, the ACLP Transplant psychiatry SIG proposes recommendations for practice: all organ transplant recipients should be screened routinely for depression. When applicable, positive screening should prompt communication with the mental health treating provider or a clinical evaluation. If the evaluation leads to a diagnosis of depressive disorder, treatment should be recommended and offered. The recommendation for psychotherapy should consider the physical and cognitive ability of the patient to maximize benefit. First-line antidepressants of choice are escitalopram, sertraline, and mirtazapine. Treating depressive disorders prior to transplantation is recommended to prevent post-transplant depression. Future research should address the mechanism by which transplant patients develop depressive disorders, the efficacy and feasibility of treatment interventions (both pharmacological and psychotherapeutic, in person and via telemedicine), and the resources available to transplant patients for mental health care.
View details for DOI 10.1016/j.jaclp.2023.03.007
View details for PubMedID 37003570
OUTCOMES OF PATIENTS EVALUATED FOR LIVER TRANSPLANT WITH LESS THAN 6 MONTHS OF ABSTINENCE FROM ALCOHOL
WILEY. 2022: S979-S980
View details for Web of Science ID 000870796603104
Cannabinoids and solid organ transplantation: Psychiatric perspectives and recommendations.
Transplantation reviews (Orlando, Fla.)
2022; 36 (4): 100715
Cannabinoid use in patients seeking solid organ transplantation (SOT) is an important and unsettled matter which all transplantation clinicians regularly encounter. It is also a multifaceted, interprofessional issue, difficult for any specialty alone to adequately address in a research article or during clinical care. Such uncertainty lends itself to bias for or against cannabinoid use accompanied by inconsistent policies and procedures. Scientific literature in SOT regarding cannabinoids often narrowly examines the issue and exists mostly in liver and kidney transplantation. Published recommendations from professional societies are mosaics of vagueness and specificity mirroring the ongoing dilemma. The cannabinoid information SOT clinicians need for clinical care may require data and perspectives from diverse medical literature which are rarely synthesized. SOT teams may not be adequately staffed or trained to address various neuropsychiatric cannabinoid effects and risks in patients. In this article, authors from US transplantation centers conduct a systematized review of the few existing studies regarding clinician perceptions, use rates, and clinical impact of cannabinoid use in SOT patients; collate representative professional society guidance on the topic; draw from diverse medical literature bases to detail facets of cannabinoid use in psychiatry and addiction pertinent to all transplantation clinicians; provide basic clinical and policy recommendations; and indicate areas of future study.
View details for DOI 10.1016/j.trre.2022.100715
View details for PubMedID 35853383
Substance use screening in transplant populations: Recommendations from a consensus workgroup.
Transplantation reviews (Orlando, Fla.)
2022; 36 (2): 100694
Transplant patients are frequently treated with substances that have dependence potential and/or they may have a history of substance use disorders. The Psychosocial and Ethics Community of Practice of the American Society of Transplantation formed a Drug Testing Workgroup with participation from members of the Pharmacy Community of Practice and members of the Academy of Consultation-Liaison Psychiatry. The workgroup reviewed the literature regarding the following issues: the role of drug testing in patients with substance use disorders, for patients prescribed controlled substances, legal, ethical and prescription drug monitoring issues, financial and insurance issues, and which patients should be tested. We also reviewed current laboratory testing for substances. Group discussions to develop a consensus occurred, and summaries of each topic were reviewed. The workgroup recommends that transplant patients be informed of drug testing and be screened for substances prior to transplant to ensure optimal care and implement ongoing testing if warranted by clinical history. While use of certain substances may not result in the exclusion for transplantation, an awareness of the patient's practices and possible risk from substances is necessary, allowing transplant teams to screen for substance use disorders and ensure the patient is able to manage and minimize risks post-transplant.
View details for DOI 10.1016/j.trre.2022.100694
View details for PubMedID 35537285
PSYCHOSOCIAL PREDICTORS OF ALCOHOL RELAPSE AMONG LIVER TRANSPLANT CANDIDATES WITH ALCOHOL-RELATED LIVER DISEASE
WILEY. 2021: 246A-247A
View details for Web of Science ID 000707188001150
STANFORD INTEGRATED PSYCHOSOCIAL ASSESSMENT FOR TRANSPLANT (SIPAT) IS SUPERIOR TO SALT AND HRAR IN IDENTIFYING LT CANDIDATES WITH ALD AT LOW RISK OF RELAPSE
WILEY. 2021: 253A-254A
View details for Web of Science ID 000707188001162