Current Psychiatry

Articles from Vol. 7, No. 10, October

Adverse Drug Effects: An Upside to the Downside?
Medication side effects are generally regarded as the Achilles' heel of pharmacologic treatment. And who can argue with that? Adverse effects are the downside of drug treatment of psychiatric disorders and are blamed for tolerability and adherence...
Going outside Your Area of Expertise: How Far Is Too Far?
Dear Dr. Mossman: I am an adult psychiatrist practicing in a geographically isolated area. I am working with the family of 10-year-old "Bobby" who is struggling with attention problems. Top notch neuropsychologic testing recommends a stimulant trial,...
How to Reduce Overdose Risk with 'Super Benzodiazepine' Atypicals: Monitor for Adverse Respiratory Events When Prescribing Atypicals Alone or with Any Traditional CNS Depressants
A new pattern of morbidity and mortality in suicidal patients who overdose has emerged with the broader use of atypical antipsychotics. (1) Although it is not known how often antipsychotics and benzodiazepines are combined in suicide attempts, clinicians...
Mnemonics in a Mnutshell: 32 Aids to Psychiatric Diagnosis; Clever, Irreverent, or Amusing, a Mnemonic You Remember Is a Lifelong Learning Tool
From SIG: E CAPS to CAGE and WWHHHHIMPS, mnemonics help practitioners and trainees recall important lists (such as criteria for depression, screening questions for alcoholism, or life-threatening causes of delirium, respectively). Mnemonics' efficacy...
Perimenopausal Depression: Covering Mood and Vasomotor Symptoms; Hormones, Antidepressants, or Psychotherapy-What Would You Recommend?
Symptoms of perimenopausal depression are not inherently different from those of depression diagnosed at any other time in life, but they present in a unique context: [ILLUSTRATION OMITTED] [ILLUSTRATION OMITTED] * Hormonal fluctations may...
Put Your Patients to Sleep: Useful Nondrug Strategies for Chronic Insomnia; Sleep Diaries and Dispelling Dysfunctional Beliefs May Be as Effective as Hypnotics
Ms. H, age 53, has a 20-year history of recurrent major depressive disorder. She seeks treatment for insomnia; her primary complaint is that "no medicine has really ever helped me to sleep for very long." She reports that every night she experiences...
The Sailor Who Won't Follow Orders: Mr. L Is Rehospitalized 9 Times in 3 Months but Repeatedly Fails to Adhere to Outpatient Treatment. What Is the Cause of His Exasperating Behavior?
CASE An unlikable patient Mr. L, age 56, is admitted to the psychiatric unit at our Veterans Affairs Medical Center for active suicidal ideation; he has a history of self-injurious behaviors that include mutilation and overdose. He also has a history...
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