Že kočka není pes…

MUDr. Radkin Honzák, CSc.

Psychiatr. praxi. 2026;27(2):71

Safe psychopharmacotherapy in older age: a practical approach to polypharmacy and drug interactions

MUDr. Vanda Franková

Psychiatr. praxi. 2026;27(2):75-80 | DOI: 10.36290/psy.2026.013

Safe psychopharmacotherapy in older age does not begin with choosing the "gentlest" drug, but with a systematic review of the entire medication regimen, assessment of adherence, targeted somatic evaluation, and definition of the treatment goal. This article summarizes a practical approach to psychopharmacotherapy in geriatric psychiatry, with emphasis on anticholinergic burden, sedation, falls, delirium, hyponatremia, bleeding, and cardiovascular risks. It highlights the importance of psychosocial interventions and the need for individualized treatment in the context of multimorbidity and polypharmacy.

Adult ADHD in women: clinical presentation, diagnostic challenges, and the role of hormonal fluctuations

MUDr. Michal Vodička

Psychiatr. praxi. 2026;27(2):81-88 | DOI: 10.36290/psy.2026.014

ADHD in adult women often remains unrecognized for years and is frequently misdiagnosed as an anxiety and/or depressive disorder, or their difficulties are instead attributed to a primary disorder of emotion regulation or to nonspecific stress-related overload associated with family and caregiving responsibilities. Compared with men, women's clinical presentations are typically less externally conspicuous (with lower levels of disruptive motor hyperactivity) and more internalized, with prominent inattention, executive function impairments, chronic disorganization, and emotional dysregulation. Symptom expression may further fluctuate across the lifespan...

Current recommendations and new approaches in the treatment of patients with borderline personality disorder

Mgr. Bc. Pavla Horká Linhartová, Ph.D., Mgr. Martin Horký, MUDr. Pavel Theiner, Ph.D.

Psychiatr. praxi. 2026;27(2):89-93 | DOI: 10.36290/psy.2026.015

The article summarizes current recommendations for standard treatment modalities for patients with emotional dysregulation or borderline personality disorder and presents some innovative neuroscience-based treatment options. Standard treatment modalities include outpatient psychiatric treatment with pharmacotherapy, hospitalization, and psychotherapy. Pharmacotherapy should be prescribed sparingly in patients with emotional dysregulation and only as an adjunct to psychotherapy based on current symptoms, and its effectiveness should be continuously evaluated. Hospitalization is particularly appropriate for patients with emotional dysregulation in the...

Availability and future perspectives of psychopharmaceuticals in the Czech-Slovak context: what is and isn't available, and what could be

MUDr. Štefan Artim

Psychiatr. praxi. 2026;27(2):94-98 | DOI: 10.36290/psy.2026.016

Psychotropic drugs, together with psychotherapy, are a basic means of treating mental disorders. Their availability is varied and multifactorial, with legislation, market size and local specifics playing a role. In this review article, we present a summary of the availability of various psychotropic drugs in the Czech and Slovak regions. Despite the socioeconomic proximity, the differences are sometimes significant. The next section is devoted to groups of newer drugs that have various approvals, but are not yet available in our region or are currently in clinical trials. An interesting trend in the field may be, for example, the so-called fixed drug...

Insomnia in patients with personality disorders: connections, mechanisms, and therapeutic possibilities

prof. MUDr. Ján Praško, CSc., MUDr. Boris Dvořáček, MUDr. Kamila Bělohradová, MUDr. Jakub Vaněk, Ph.D., MUDr. David Pánek, Ph.D., doc. PaedDr. et Mgr. Marta Zaťková, PhD., doc. PhDr. Miloš Šlepecký, CSc., PhDr. Marie Ocisková, Ph.D.

Psychiatr. praxi. 2026;27(2):99-106 | DOI: 10.36290/psy.2026.017

Background: Personality disorders are often accompanied by significant sleep disturbances, particularly insomnia and nightmares. Despite their high prevalence, these sleep issues are frequently overlooked in clinical practice. This article aims to provide an overview of current knowledge regarding the prevalence, underlying mechanisms, and treatment options for insomnia across different personality disorders, with a focus on practical clinical applications. Methods: A narrative review was conducted using literature from PubMed and Web of Science, supplemented by summary tables and clinical recommendations. Results: Insomnia is common in various personality...

Internet CBT for panic disorder - a review

prof. MUDr. Ján Praško, CSc., MUDr. Jakub Vaněk, Ph.D., MUDr. Kamila Bělohradová, prof. PhDr. Tomáš Sollár, PhD., doc. PhDr. Miloš Šlepecký, CSc., Bc. Martin Mikula, PhDr. Marie Ocisková, Ph.D.

Psychiatr. praxi. 2026;27(2):E1-E7 | DOI: 10.36290/psy.2026.021

Objective: This review article summarizes the effectiveness and accessibility of Internet-based cognitive behavioural therapy (I-CBT) and psychoeducation for patients with panic disorder and agoraphobia. The aim is to provide an overview of the methods and strategies used in these programs to consider their cost-effectiveness and ability to overcome barriers to traditional treatment. Method: Randomized controlled trials, meta-analyses and systematic reviews published between 2000 and 2024 were included. The emphasis was on therapeutic feedback programs and self-help programs aimed at treating panic disorder and agoraphobia. The analysis also included...

Secondary catatonia - case report

MUDr. František Skakun

Psychiatr. praxi. 2026;27(2):108-111 | DOI: 10.36290/psy.2026.018

This article deals with the development of our understanding of catatonia, in the past as part of other psychiatric disorders and now as a separate nosological unit. The introduction summarizes the diagnostic criteria according to ICD-10 and ICD-11, current knowledge about etiopathogenesis, subtypes of catatonia and basic therapeutic options. The case report presents the case of a 72-year-old polymorbid patient with a history of oncological disease, who was originally admitted for spinal pain. She gradually developed apathy, mutism and other catatonic symptoms, which were initially interpreted as manifestations of depressive symptoms. The case report...

Clarithromycin induced mania with psychotic symptoms

MUDr. Dominik Korený, MUDr. Věra Šantrůčková

Psychiatr. praxi. 2026;27(2):112-114 | DOI: 10.36290/psy.2026.019

Clarithromycin is a widely used antibiotic known for its broad-spectrum antimicrobial activity, but it has some psychiatric side effects that are rare but can be serious. This article presents a case report when clarithromycin, a commonly prescribed macrolide antibiotic, was implicated in the development of mania with psychotic symptoms in a previously psychiatrically naive patient.

Understanding and communication in group schema therapy: training of empathy and conflict resolution for patients with borderline personality disorder

prof. MUDr. Ján Praško, CSc., doc. PaedDr. et Mgr. Marta Zaťková, PhD., MUDr. Jakub Vaněk, Ph.D., Bc. Martin Mikula, MUDr. Kryštof Kantor, Ph.D., doc. PhDr. Miloš Šlepecký, CSc., PhDr. Marie Ocisková, Ph.D.

Psychiatr. praxi. 2026;27(2):115-122 | DOI: 10.36290/psy.2026.020

Aim: This article presents a structured approach to training communication skills and mentalization in group schema therapy (GST) for patients with borderline personality disorder (BPD). The aim is to enhance empathy, the ability to identify one's own and others' needs, and to effectively resolve interpersonal conflicts. Methods: The GST methodology includes training communication skills through role-play, role-reversal, working with modes, discussing one's own and others' needs, and group discussions. Patients learn to identify their maladaptive schemas (Vulnerable Child, Critical Parent) and transition to the Healthy Adult mode. Special attention...

Zaznělo na 22. konferenci Psychiatrie pro praxi v Olomouci ve dnech 27.-28. listopadu 2025. A ještě dvakrát k trazodonu

MUDr. Zuzana Zafarová

Psychiatr. praxi. 2026;27(2):123-130

Zaznělo na 68. česko-slovenské psychofarmakologické konferenci, 14.-18. ledna 2026, Mariánské Lázně

Redakce

Psychiatr. praxi. 2026;27(2):131-134

Co bychom měli vědět o magneziu

MUDr. Zuzana Zafarová

Psychiatr. praxi. 2026;27(2):135-138