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Rajnish Mago, MD

Rajnish Mago, MD

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Lamotrigine is an important option in bipolar disorders. However, many clinicians also use it in patients with a (unipolar) depressive disorder who have not responded adequately to conventional antidepressants.

It appears that the risk is greater with antidepressant use during late pregnancy but may be elevated with use during early pregnancy as well.

While SSRIs and SNRIs are valuable in the treatment of major depression, partial response or nonresponse occurs in many patients. Research has found that bupropion was the most frequently chosen agent for addition to an SSRI after inadequate response.

This is the second installment of a new series in which clinically relevant research is briefly discussed and, perhaps more important, a few tips on how to read and interpret research studies are presented. Your feedback, suggestions, and questions are eagerly solicited at rajnish.mago@jefferson.edu.

The suggestions given below are simple but powerful. They can work as well as or better than using a sleeping pill (although they can be used with or without a sleeping pill). Also, the improvement in sleep that can come from following these suggestions can be long-lasting.

More than a thousand articles on mental disorders are published in medical journals each month! Also, clinicians have limited training, time, and inclination to keep up with reading research articles critically on a regular basis. Thus, a disturbing disconnect (for which there are no easy solutions) exists between clinical research and usual clinical practice.

Heavy smoking and caffeine intake are highly prevalent in patients with psychiatric disorders, both of which significantly impact the metabolism of a number of psychotropic medications. Hence, these factors should be routinely considered in making prescribing decisions.

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