Bio

Dr. Matthew Gunther graduated with a BA in psychology from the University of Southern California in 2009. Afterwards, he pursued training as a Marriage and Family Therapist, earning a Master of Arts in Clinical Psychology at Pepperdine University in 2011. His career goals shifted from a focus on psychotherapy towards medicine, subsequently graduating from medical school from the University of California, Irvine in 2018. Dr. Gunther completed his general adult psychiatry residency at the University of Southern California/LAC+USC Medical Center in 2022 where he served as Chief Resident for the inpatient service. He subsequently completed his Consultation-Liaison Psychiatry fellowship at Stanford University in 2023.

Dr. Gunther has a passion for teaching and mentorship of medical trainees at all levels. Throughout all stages of training, he was actively involved in admissions, as well as program development. During residency, his particular focus was on curriculum development for inpatient psychiatry, as well as quality improvement projects focused on staff safety and accessibility of psychiatry services for the Los Angeles County population. His work on these areas, in addition to teaching efforts and scholarly work, earned him the Excellence in Residency award for each year of residency training.

Dr. Gunther joined the faculty as a Clinical Assistant Professor of Psychiatry at the Stanford University School of Medicine in July 2023 and currently serves as Assistant Program Director of the Consultation-Liaison Psychiatry Fellowship. His interests in psychiatry include critical care psychiatry, neuropsychiatry, medical education, psychopharmacology in the medically ill, and integrated care. Dr. Gunther works in the Integrated Behavioral Health program where he is Director of Education, with particular focus on resident-based primary care clinics. In addition, he is an attending on the Critical Care and Inpatient Consult-Liaison Psychiatry services.

Clinical Focus

  • Psychiatry
  • Consultation-Liaison Psychiatry
  • Critical Care Psychiatry
  • Neuropsychiatry
  • Psychopharmacology in the Medically Ill
  • Integrated Care

Academic Appointments

Administrative Appointments

  • Assistant Program Director, Consultation-Liaison Psychiatry Fellowship, Stanford School of Medicine (2024 - Present)
  • Director of Education, Integrated Behavioral Health Program (2023 - Present)

Boards, Advisory Committees, Professional Organizations

  • Member, American Psychiatric Association (2014 - Present)
  • Member, Academy of Consultation-Liaison Psychiatry (2019 - Present)

Professional Education

  • Board Certification: American Board of Psychiatry and Neurology, Psychiatry (2022)
  • Fellowship, Stanford University, Consultation-Liaison Psychiatry (2023)
  • Residency, University of Southern California/LAC+USC Medical Center (2022)
  • MD, University of California, Irvine (2018)
  • MA, Pepperdine University, Clinical Psychology with an Emphasis in Marriage and Family Therapy (2011)
  • BA, University of Southern California, Psychology (2009)

Contact

  • Academic
    guntherm@stanford.edu
    University - Academic staff Department: Psychiatry and Behavioral Sciences Position: Clinical Assistant Professor
  • Clinical (Primary)  Psychiatry 401 Quarry Rd Ste 2114 MC 5723 Stanford, CA 94305 (650) 725-3762 (fax)

Additional Clinical Info

Additional Info

All Publications

  • Dextroamphetamine as Adjunctive Pharmacotherapy for Aggression Secondary to Korsakoff Syndrome: A Case Report. Journal of the Academy of Consultation-Liaison Psychiatry Gunther, M., Jiang, S., Maldonado, J. R. 2024

    View details for DOI 10.1016/j.jaclp.2024.02.006

    View details for PubMedID 38417703

  • Nortriptyline-Induced Room Tilt Illusion CUREUS JOURNAL OF MEDICAL SCIENCE Sarmiento, B. A., Varghese, R., Vijayvargia, R., Gunther, M., Fusick, A., Jiang, S. 2024; 16 (1)

    View details for DOI 10.7759/cureus.52101

    View details for Web of Science ID 001154040100002

  • Herba Epimedii and Increased Opioid Cravings While on Buprenorphine: A Case Report. Cureus Burke, H., Sarmiento, B. A., Gunther, M., Czuma, R., Klippel, C., Jiang, S. 2024; 16 (1): e51886

    Abstract

    Herba Epimedii, commonly known as yin yang huo, inyokaku, and horny goat weed, is a traditional Chinese herbal medicine utilized for treating osteoporosis and enhancing libido. Studies conducted in vitro have demonstrated that Herba Epimedii interacts with the enzyme cytochrome P450 3A4 (CYP3A4). This interaction poses a potential risk for drug-drug interactions, particularly with medications metabolized by CYP3A4, such as buprenorphine. This paper presents a case of a patient experiencing exacerbated opioid cravings following the initiation of Herba Epimedii. This is the first reported case supporting this interaction, emphasizing the necessity of screening for alternative medicines in patients undergoing medication-assisted treatments for opioid use disorder.

    View details for DOI 10.7759/cureus.51886

    View details for PubMedID 38327958

    View details for PubMedCentralID PMC10849866

  • Nortriptyline-Induced Room Tilt Illusion. Cureus Sarmiento, B. A., Varghese, R., Vijayvargia, R., Gunther, M., Fusick, A., Jiang, S. 2024; 16 (1): e52101

    Abstract

    Room tilt illusion (RTI) is a rare and transient perceptual disturbance in which an individual perceives their surroundings as having been rotated or tilted, usually at 90 or 180 degrees. Primarily linked with vestibular disorders and neurological lesions, this report details the only reported occurrence of the RTI phenomena in nortriptyline use for treatment-refractory depression. The patient developed RTI six days after starting the medication and the disturbance resolved after medication cessation. Although the mechanism behind such a phenomenon with medication use has not been elucidated, its etiology may rest on the effect of tricyclic antidepressants on the vestibulo-thalamo-cortical system and visual-vestibular integration. Clinicians should be aware of the potential for such a medication-induced perceptual disturbance, especially in the workup for more serious etiologies in elderly patients with co-morbidities.

    View details for DOI 10.7759/cureus.52101

    View details for PubMedID 38344625

    View details for PubMedCentralID PMC10858726

  • Irreversible Lithium Neurotoxicity: A Review and Case of Toxicity Leading to Bilateral Globus Pallidus Injury Gunther, M., Jiang, S., Maldonado, J. ELSEVIER SCIENCE INC. 2023: S129

    View details for DOI 10.1016/j.jaclp.2023.11.260

    View details for Web of Science ID 001161339100244

  • Delayed-Onset Psychosis After Lung Transplant Secondary to Tacrolimus Neurotoxicity Gunther, M., Sher, Y., Jiang, S. ELSEVIER SCIENCE INC. 2023: S99

    View details for DOI 10.1016/j.jaclp.2023.11.667

    View details for Web of Science ID 001161339100187

  • Delayed-Onset Psychosis Secondary to Tacrolimus Neurotoxicity After Lung Transplant: A Case Report and Systematic Review. Journal of the Academy of Consultation-Liaison Psychiatry Gunther, M., Jiang, S., Banga, A., Sher, Y. 2023

    Abstract

    Tacrolimus is the most common immunosuppressant used after transplant, yet it can result in moderate-to-severe neurotoxicity in up to 32% of patients. Signs of neurotoxicity can vary from mild (tremor or headache) to severe (posterior reversible encephalopathy syndrome or psychosis. Prompt recognition and management is needed to lead to symptom resolution.The objective of this study is to describe the clinical presentation of tacrolimus-induced psychosis, a type of tacrolimus-inducted neurotoxicity, and distinguish it from other central nervous system disturbances, including delirium.We present a case of delayed onset tacrolimus-induced psychosis with focus on unique clinical features and management strategies. We conducted a systematic review of cases of tacrolimus-induced psychosis using the PubMed database and included 15 manuscripts in our review.Tacrolimus-induced psychosis is a unique presentation of tacrolimus-related neurotoxicity and can present without the cardinal symptoms of delirium. The data on isolated psychotic symptoms are limited with current literature focusing on more common presentations of tacrolimus-induced neurotoxicity, such as delirium and tremor. Development of psychosis can occur later in the treatment course and at normal tacrolimus serum levels. It can improve with antipsychotic therapies, but primary management should include cross-titration to an alternate immunosuppressant regimen.

    View details for DOI 10.1016/j.jaclp.2023.09.002

    View details for PubMedID 37778461

  • Bilateral Globus Pallidus Injury in the Setting of Lithium Toxicity: A Case Report JOURNAL OF THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY Gunther, M., Jiang, S., Maldonado, J. R. 2023; 64 (5): 484-485

    View details for Web of Science ID 001073580400001

    View details for PubMedID 37689462

  • Accelerated-Onset Diabetes Insipidus Secondary to Lithium Use. The primary care companion for CNS disorders Gopisetty, D. D., Gunther, M., Jiang, S. 2023; 25 (3)

    View details for DOI 10.4088/PCC.22cr03427

    View details for PubMedID 37347676

  • Bilateral Globus Pallidus Injury in the Setting of Lithium Toxicity: A Case Report. Journal of the Academy of Consultation-Liaison Psychiatry Gunther, M., Jiang, S., Maldonado, J. R. 2023; 64 (5): 484-485

    View details for DOI 10.1016/j.jaclp.2023.04.008

    View details for PubMedID 37689462

  • Management of Neuropsychiatric Manifestations of Susac Syndrome Using Valproic Acid JOURNAL OF THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY Gunther, M., Cho, S. 2023; 64 (1): 92-93

    View details for Web of Science ID 000967841000001

    View details for PubMedID 36764750

  • Antipsychotic Safety in Liver Disease: A Narrative Review and Practical Guide for the Clinician JOURNAL OF THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY Gunther, M., Dopheide, J. A. 2023; 64 (1): 73-82

    Abstract

    Clinicians treating psychiatric disorders in medically ill patients need a comprehensive resource for comparing the risk and types of liver injury associated with antipsychotic therapy.We conducted a narrative review aimed at developing a comprehensive resource comparing antipsychotics with regard to risk of inducing or worsening liver injuries, types of liver injury, associated pharmacokinetic changes, dosing, monitoring, and patient counseling recommendations.We conducted database searches of LiverTox.nih.gov, DailyMed.nlm.nih.gov, and PubMed through June of 2022. Sources describing premarketing data, observational studies, case reports and case series of antipsychotic-induced liver injuries, types of hepatic dysfunction, interventions, recovery, and treatment for 15 antipsychotics were included. Duplicate reports were excluded. Antipsychotics were graded as low, low to moderate, moderate, moderate to high, or high risk for causing or worsening a liver disease.Of the 1861 publications, 21 papers met criteria and were included. Evidence shows antipsychotic-induced liver dysfunction is uncommon to rare. Chlorpromazine, clozapine, and olanzapine pose the greatest risk of hepatoxicity; quetiapine and risperidone pose a moderate risk with haloperidol considered to pose low to moderate risk. Paliperidone, aripiprazole, lurasidone, and loxapine are lower-risk agents with no reports of liver failure. Transaminitis that is mild and self-limiting is the most common antipsychotic-induced liver injury followed by hepatocellular disease, steatosis, and mixed liver injury. A careful risk-benefit analysis should guide the decision to discontinue the antipsychotic in cases of severe liver disease. Dose adjustments and careful monitoring are recommended for a mild to moderate disease when the benefits of treating psychosis outweigh the risks. Patients without an existing liver disease initiating a treatment with a higher-risk antipsychotic should be counseled to report symptoms of liver injuries along with regular lab monitoring.Antipsychotic selection, dosing, monitoring, and counseling should be individualized based on whether a patient has an existing liver disease and if they are receiving an agent that poses a higher risk of liver injury. The consultation-liaison psychiatry provider can guide the primary team in management through thoughtful integration of the known pathophysiologic changes in hepatic disease and risk-benefit analysis of antipsychotic safety profiles.

    View details for Web of Science ID 000967822100001

    View details for PubMedID 36180017

https://orcid.org/0000-0001-7952-6782