The Clinical and Treatment Implications of Co-Occurring Mania and ADHD in Youths
December 17th 2013The relationship between bipolar disorder and ADHD remains unclear; however, this combined condition may represent an important genetic and clinical subtype with distinct psychopathology, familiality, and treatment response.
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More Than Meets the Eye: Spotting Medical Mimics
December 2nd 2013As practicing physicians, we constantly ask ourselves when and where to alert patients to bad possibilities that may occur in the future. More in this installment of "Why Psychiatrist Are Physicians First," by Sharon Packer, MD.
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“Switching” of Mood From Depression to Mania With Antidepressants
Mood switching is not uncommon and it is much more prevalent in depressed juveniles than in depressed adults, and there is a large apparent excess of antidepressant-associated switching over reported spontaneous diagnostic changes to bipolar disorder. Details here.
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Conduct Disorder, ADHD-or Something Else Altogether?
October 12th 2013This child's behaviors suggested ADHD-combined or primarily hyperactive type and conduct disorder. However, there was a strong history of trauma and affective disturbance. A structured interview format indicated that he formally met criteria for both PTSD and mixed episode. Without this format, features defining these disorders might have been missed and the child treated only for ADHD.
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Warning: Antidepressants May Cause Bank Robbery
September 27th 2013Some attorneys have argued that SSRIs cause serious adverse events, capable of compelling defendants to engage in strikingly complex criminal behavior. On close examination, however, these phenomena may be clearly distinguished from criminal behavior.
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Natural Products Used to Treat Depressed Mood as Monotherapies and Adjuvants to Antidepressants
September 23rd 2013Most persons who use CAM modalities to self-treat a mental health problem take prescription antidepressants concurrently. Combined use can result in serious supplement-drug interactions.
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Special Issues in Menopause and Major Depressive Disorder
September 11th 2013A risk to benefit ratio of treatment must be established to determine the optimal treatment for perimenopausal depression. Untreated depression during the perimenopause exacerbates heart disease, diabetes, and osteoporosis. Details about management options here.
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Olanzapine/Fluoxetine Combination Affirmed for Bipolar Depression
July 17th 2013A recent meta-analysis supports evidence of the effectiveness of the fixed olanzapine/fluoxetine combination (Symbyax) in treating the depressive phase of bipolar disorder. Response was ranked higher, but with no more adverse effects, than with treatment with olanzapine alone.
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Hypothyroidism: An Important Diagnostic Consideration for the Psychiatrist
July 11th 2013Hypothyroidism is a common clinical disorder that psychiatrists frequently encounter. However, symptoms of thyroid dysfunction are often vague and nonspecific, which can lead to delayed or missed diagnosis.
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Integrative Treatment of Bipolar Disorder: A Review of the Evidence and Recommendations
July 3rd 2013Before recommending any natural product to a patient with bipolar disorder, the clinician should be familiar with important safety considerations. This article summarizes provisional guidelines for the use of CAM and integrative therapies in patients with bipolar disorder.
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Psychiatric Epigenetics: A Key to the Molecular Basis of and Therapy for Psychiatric Disorders
June 11th 2013The major challenges for epigenetic therapies are target specificity of the drugs-an issue that is also true for most of the currently used drugs in medicine, especially in psychiatry.
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Impulse Control Disorders: Clinical Characteristics and Pharmacological Management
June 2nd 2013Impulse control disorders are common psychiatric conditions in which affected individuals typically report significant impairment in social and occupational functioning, and may incur legal and financial difficulties as well.
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The Role of Biological Tests in Psychiatric Diagnosis
May 23rd 2013"Psychiatric diagnosis is certainly imperfect -- but so is much of diagnosis throughout medicine. And whatever the current limitations, psychiatric diagnosis is useful and essential. There are no 'paradigm shifts possible til we learn a lot more. To imply otherwise is misleading and confusing to patients."
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Diagnosis and its Discontents: The DSM Debate Continues
March 29th 2013When critics of psychiatric diagnosis insist that terms like “schizophrenia” or “bipolar disorder” are inherently stigmatizing, they are unwittingly perpetuating the very prejudice they wish to end. It is time to shine a bright light on this self-fulfilling prophecy.
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For Persons With Serious Mental Illness, Weight Loss Is Possible
March 26th 2013Medication side effects of weight gain and increased appetite, together with non-adherence often found in persons with schizophrenia, bipolar disorder, and other serious mental illnesses, have challenged clinicians in the past.
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