John J. Miller, MD

John J. Miller, MD

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This article reviews the reasons for measuring serum levels of psychotropics and provides optimum serum levels for various psychotropic agents to optimize their effectiveness and safety.

Most often, psychiatric medications are discontinued unilaterally by the patient, without the psychiatrist’s input or consent. Setting the stage early with a discussion about medication discontinuation is time well spent. More in this CME.

As the debate continues regarding possible revisions for the DSM-IV, 1 we recommend renewed attention to the designation Borderline Intellectual Functioning. This condition is listed as a V code in the DSM-IV and is defined as an IQ falling between 71 and 84. It is considered one of several “conditions that may be the focus of clinical attention.” As such, Borderline Intellectual Functioning is rarely included in clinical reports and case/treatment team reviews except indirectly when, as part of the mental status examination, mention is sometimes made that the patient’s intellect appears to fall below average limits.

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