PALTC23 Conference Recordings TH09 Medication Confusion: How to Reduce Multiple Categories of Brain Active Medications

Medication Confusion: How to Reduce Multiple Categories of Brain Active Medications

This session will discuss how to evaluate indications, efficacy, and side effects for and individual patient, who is prescribed multiple CNS medications. Specific talking points will be presented to assist providers in conversations with consultants, patients, and family members. Algorithms will be utilized to demonstrate how and when to reduce medications. Case-based scenarios for commonly used CNS medications (gabapentin, tramadol, sertraline, amitriptyline) will be utilized for an interactive session discussing best approaches to drive medication optimization. A geropsychiatrist and pharmacist will provide additional perspectives.

Learning Objectives:

At the completion of this session, learners will be able to:

  • Identify talking points for CNS active medications that will resonate with consultants such as psychiatrists.
  • Utilize deprescribing algorithms to taper and discontinue CNS active medications such as gabapentin, tramadol, sertraline, and amitriptyline.
  • Demonstrate one approach to determining which CNS active medication to taper first based on specific patient characteristics/responses.

Jay Tillman, MD

Jay Tillman, MD, is currently the Optum Psychiatric Medical Director in Rhode Island and Connecticut. He has over twenty years of experience providing psychiatric care in a variety of settings including LTC and AL facilities, as well as a community-based general outpatient psychiatric practice. Currently, he is also the psychiatrist for a leading group home system based in Hartford, Connecticut.

Jaclyn Michelle Graham, PharmD BCPS

J. Michelle Graham, PharmD BCPS, is Director of Clinical Pharmacy Patient Care at Optum Home and Community.  She is Board Certified in Pharmacotherapy.  She completed a residency in Ambulatory Care in the VA HealthCare System. She leads a team of clinical pharmacists who specialize in implementing clinical initiatives that focus on optimizing our members medication regimens to reduce risk.  She has been employed at Optum for 8 years.  She resides in Franklin, Tennessee.

Todd Sobol, MD, CMD

Todd Sobol, MD, CMD, has 26 years of private practice experience as a general internist specializing in geriatric medicine. During his tenure, he served as a medical director in long-term care facilities, assisted living, managed care, and hospice. Dr. Sobol served as an enthusiastic educator for students and residents, including recognition as a Preceptor All Star by The Ohio State University College of Medicine. He has supported the Ohio Medical Directors Association as Program Chairman for their annual conference, Board of Directors member, and President. Dr. Sobol is currently senior medical director for Optum Complex Population Management in Ohio.

  • 1.5 CME
  • 1.5 CMD Clinical
  • 1.5 MOC
  • 1.5 Pharmacology Hour


Release Date: 03/29/2023   |   Expiration: 03/01/2026

Credit Statements:

Accreditation: Post-Acute and Long-Term Care Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 

CME Designation: Post-Acute and Long-Term Care Medical Association designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CMD Credit Hours: This CME activity has been pre-approved by the American Board of Post-Acute and Long-Term Care Medicine (ABPLM) for up to 1.5 clinical hours toward certification or recertification as a Certified Medical Director (CMD) in post-acute and long-term care medicine. Each physician should claim only those hours of credit actually spent on the activity.

The CMD Program is administered by the ABPLM. Each physician should claim only those credit hours that he/she actually spent in the activity. For further information, contact ABPLM at 410-992-3117 or at cmd@paltc.org.

ABIM Maintenance of Certification (MOC): Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.5 Medical Knowledge MOC points and patient safety credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program.

Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Pharmacology: This activity satisfies the requirements for 1.5 Pharmacology Hour(s) for Nurse Practitioners.

Financial Disclosure Statement:

The Association requires the disclosure of all speaker/faculty/planner’s relevant financial relationships; presence of off-label use of a device or medication; and discussion of any experimental, new or evolving topic prior to each accredited education activity.

If the learner perceives any bias toward a commercial product or service, advocation of unscientific approaches to diagnosis or therapy, or recommendation, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients please report this to the Association's staff.


The following speaker(s) disclosed relevant financial relationship(s): 

  • Julie Gammack, MD, CMD (Planner & Speaker): Stockholder: Amarin
  • Kenya Rivas Velasquez, MD, CMD, FAAFP (Planner & Speaker): OptumRx: Stockholder
  • All other planners, speakers, and AMDA staff have no relationships with ineligible companies.

All relevant financial relationships have been identified and mitigated.

Components visible upon registration.