Blog | Pharmatherapist

Frequently Asked Questions

Q. When diagnosing depression in a client, how concerned should I be about identifying specific depression subtypes? Do specific subtypes suggest different treatment modalities? A. For years now, clinicians have attempted to categorize depressions into "subtypes." A few examples are: typical vs. atypical, reactive vs. biological and psychotic vs. non-psychotic. There are as many as 12 subtypes of Major Depressive Disorder, according to The Diagnostic and Statistical Manual, 4th Edition (DSM-IV). The important question though is whether labeling a depression [...]

joe2017-01-29T15:58:20+00:00

Fish Oil May Deter Schizophrenia

"Fat" is a bad word in our society, but omega-3 fatty acids are one of the superstars when it comes to improving nerve conduction. High levels of omega-3 fatty acids in the brain also reduce neuroinflammation, a factor commonly seen in people with depression. Cell membranes consist partly of omega-3s, which make it easier for the neurotransmitters norepinephrine, serotonin and dopamine to pass through cell membranes. This is an essential fatty acid, which means it is not produced by the [...]

joe2017-01-29T15:59:18+00:00

Antipsychotics and Kids: The Controversy Goes On and On

On December 4, 2009, the FDA approved the use of two more antipsychotic medications -- Zyprexa and Seroquel -- for treating schizophrenia and bipolar disorder in teens. Risperdal and Abilify are also specifically approved for the same use in this age group. In association with the approval of Zyprexa and Seroquel, the FDA also stated it wants to know more about the risk of weight gain and diabetes in youth taking these drugs and other antipsychotics as well. It has [...]

joe2020-04-16T20:14:27+00:00

Frequently Asked Questions

In my next few blogs, I will provide answers to the most frequently asked questions fielded from conferences, seminars, e-mail and telephone contact. So if you’ve wondered about the answers to these questions or have encountered them in your work with clients, please read on! I’m delighted to be of service in this capacity. Q. How long does it take for Zoloft, Paxil, Effexor and Wellbutrin to take effect? A. At least 50 percent of those who will eventually respond [...]

joe2017-01-29T15:58:19+00:00

Repetitive Transcranial Magnetic Stimulation (rTMS)

Repetitive Transcranial Magnetic Stimulation was approved by the FDA in October 2008 for patients with major depression who have failed one prior antidepressant trial. Stimulation of the brain is accomplished by a pulsed magnetic field that is passed through a coil of wire encased in plastic and held close to the head. This magnetic field penetrates the scalp and skull. The stimulation is made at regular intervals, thus the term “repetitive” TMS. In studies, rTMS appears to change brain activity [...]

joe2017-01-27T16:33:02+00:00

The Alcohol and Antidepressant Use Conundrum

There are two factors to consider when assessing the combined use of alcohol and antidepressants: first, the likelihood that an antidepressant’s effectiveness will be altered by alcohol (will consuming alcohol prevent or diminish the potential positive effects of the antidepressant?); and second, the chance that there will be some untoward and unintended consequences between alcohol and antidepressants. Given the complexity of individual biochemistry, the answer to the first question is difficult to nail down; but it more than likely depends [...]

joe2020-04-16T20:16:36+00:00

Saphris (asenapine): A New Entry Into the Ever-Growing Antipsychotic Mix

On August 14, 2009, the FDA approved Saphris (asenapine) as a new second-generation antipsychotic for the treatment of both schizophrenia and bipolar disorder. It is available only as a sublingual tablet, meaning that it is not effective if swallowed, and it must be left under the tongue to dissolve for it to be absorbed into the bloodstream. The available studies haven’t shown that Saphris (asenapine) provides any unique therapeutic advantage over other second-generation antipsychotics. The main contribution is that clinicians [...]

joe2017-01-29T15:57:16+00:00

Public Speaking: More Feared than Death?

I am often asked by new or aspiring speakers how to overcome the fear and sometimes downright paralysis associated with speaking in public. You may have read or heard about some people that fear public speaking more than death! Although this is utterly ridiculous, there are those that wouldn't stand before an audience and utter a single word, phrase, sentence or speech under any circumstances or for any price. Fear of speaking in public is considered a performance anxiety disorder. [...]

joe2020-04-16T20:21:54+00:00

Atypical Depression and Chromium Use

Atypical depressed individuals tend to sleep excessively, eat too much (particularly carbohydrates and lots of simple sugars), experience an often profound reactive dysphoria (melancholia) and tend to be very sensitive to interpersonal rejection. This depression is characterized by lethargy and often significant debilitation. Also, approximately 80 percent of atypical depressives meet diagnostic criteria for phobias and panic attacks. Chromium picolinate in some control studies helps decrease carbohydrate cravings by improving blood sugar regulation. That said, the other aforementioned profound symptoms [...]

joe2017-01-29T15:56:50+00:00

Helping Clients Overcome Resistance to Psychotropic Medication: Strategy #4

In this final installment of my blog series on helping clients overcome resistance to psychotropic medication I address how fear impacts decision making. Previous posts have examined The Shame Factor, Family Interference and Ambivalence. 4. Fear. Two often expressed issues that invoke clients' fear of psychotropic medication are: (a) medication will, in some way, "change who they are," or alter their personality, and (b) although their troublesome symptoms may improve, intolerable side effects will be possibly worse than the illness [...]

joe2017-01-29T15:56:37+00:00