We have medications that can affect serotonin, norepinephrine, and-to a lesser extent-dopamine. Many other neurotransmitters are involved with mood disorders, but we have no medications yet to target them. Neurostimulation offers a non-systemic somatic approach to depression, often with an improved side effect profile. More in this Q&A.
What is the future of psychiatric assessment and treatment of mood disorders? The articles in this Special Report explore some important aspects and issues.
Here: the history of psychotic depression for the Study of the Pharmacotherapy of Psychotic Depression (STOP-PD), a summary its epidemiology, significance, diagnostic complexity, and treatment, as well as case vignettes.
This article reviews the most recent (after 2010) published guidelines on bipolar depression.
Most, if not all, antidepressants can cause bothersome adverse effects. These are described here along with strategies to help patients cope.
Mood disorders in older adults are neither inevitable nor particularly resistant to treatment. With attention to the special needs of older patients during evaluation, treatment, and follow up, clinicians can help many patients derive greater enjoyment from their later years.
In this podcast, Dr Eric Plakun give an overview of key points and psychodynamic principles on treatment-resistent mood disorders, based on research and clinical experience.
Psychiatric comorbidity in epilepsy represents not only a matter of intellectual interest but also an important variable that affects prognosis in terms of morbidity and mortality.
Because half of pregnancies in this country are unplanned, it's crucial to counsel women of reproductive potential about their medications-regardless of their plans to conceive.
The 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.
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.
In a PsychCongress presentation on perinatal mood disorders, Marlene Freeman, MD, stressed that treatment is essential for women with mood disorders-but whether to treat becomes complicated during a women’s reproductive years.
Most 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.
Nonpharmacological interventions-such as mind-body interventions-can improve a partial response to antidepressants via stress reduction, improved physical functioning, increased socialization, and reduced risks of polypharmacy.
A 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.
Hypothyroidism 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.
With DSM-5, one more examination of bipolar diagnosis is warranted. After all, if a diagnosis is inaccurate, treatment efforts, however well-intentioned, may misfire.
Borderline Personality Disorder - Psychogenic Movement Disorders - Myalgic Encephalomyelitis - Migraine
According to the CDC's latest published report, there were 38,364 suicides in the US in 2010-an average of 105 each day. Globally, an estimated 1 million suicides occur annually.
These articles illustrate the variety and complexity of problems associated with comorbidity in psychiatric disorder.
Borderline personality disorder typically coexists with depression, anxiety, and substance abuse. Symptoms of these conditions may lead the clinician to miss the diagnosis of personality disorder entirely. Careful diagnosis of BPD and comorbid disorders is the first step.
Identification of atypical features is important in the treatment of depression for both treatment selection and prognosis, especially when initial measures prove ineffective. The concept of atypical depression has evolved over many years, and now it appears timely for a further revision.
A plethora of studies support the hypothesis that inflammation plays a role in the pathophysiology of major psychiatric disorders.
Given the likelihood that insufficient numbers of patients will be available for a randomized controlled trial of MAOIs in refractory depression or atypical depression, we must still rely on consensus guidelines and expert opinion.
DSM-5 presents psychiatry with a potential “reset button” for diagnostic reliability.
