The need for viable augmentation strategies to assist in the pharmacological management of treatment-resistant depression has become so dire that clinicians seem to perk up to any option nowadays – regardless of how fly-by-night, “here today gone tomorrow” it may be. This is happening, at least in part, due to the ever-growing problem of suboptimum [...]
Antipsychotics developed after 1990 are referred to as second-generation agents because they act on different neuroreceptor sites compared to their first-generation (Thorazine, Haldol, Stelazine, Navane, Mellaril, etc.) counterparts. Specifically, the SGAs block both dopamine and serotonin receptors and are more different from each other than they are alike. SGAs have fewer movement-related side effects. They [...]
It’s no secret to those of us that work in the mental health arena that schizophrenics often relapse to the active, observable symptoms of schizophrenia (delusions, hallucinations, exaggeration, disorganization) due to medication non-compliance. The three primary reasons for this are as follows: In an active psychotic state, non-compliance is fueled by paranoia – which dictates [...]
Antidepressants: As a pharmacological class, the antidepressants work far too slowly to be an apt choice as a suicide deterrent. The older cyclic agents can actually be fatal in overdose, particularly if combined with alcohol. This is because many of them block the actions of histamine, thereby producing marked sedation. Serotonin antidepressants, particularly the SSRIs, [...]
It is estimated that10% of patients who are prescribed antidepressants never fill the prescription, 16% stop in the first week, 41% within 2 weeks, 59% in 3 weeks, and 68% in 4 weeks. The following instructions to patients may increase adherence:
Psychotic disorders can involve an extreme impairment in the ability to distinguish reality from fantasy, behave in an emotionally appropriate manner, and communicate effectively. The National Institutes of Health (NIH) indicates that schizophrenia is rare in children: Only about one in 1,000 have this disorder. Adolescent onset generally occurs between the ages of 11 and [...]
Many obese individuals participating in weight reduction programs which emphasize exercise and lifestyle modifications see an improvement in their depression, according to a new review published in February in the International Journal of Obesity. The weight loss programs varied, and included diet-only, exercise-only, and programs emphasizing counseling and behavioral change. Some participants also took medication [...]
In case you missed it, here are the highlights from my recent national webinar entitled: Antidepressants. What You Need to Know to Best Serve Your Clients. No one antidepressant or antidepressant class consistently outperforms another from an efficacy standpoint. There are no shining stars, just lights in the sky. With antidepressants treatment, there is no [...]
There’s nothing new to report about anxiety itself. That’s because it’s a normal human response; some of us experience it intermittently, other chronically. Most of the attention in this class of disorders is on PTSD and OCD. PTSD has aroused debate especially surrounding the definition of the traumatic event that anchors the symptoms. It is [...]
From a diagnostic perspective, bipolar disorder is complex, highly nuanced and does not lend itself to black-or-white judgments. As a profession, we are in transition to a different diagnostic system known as the “bipolarity index.” This index will focus on a series of manic and non-manic bipolar markers scored on a point system, eschewing the [...]