In July of 2013, the FDA approved a new serotonin norepinephrine reuptake inhibitor (SNRI) Fetzima (levomilnacipran) for major depressive disorder in adults only. The efficacy of Fetzima at once-daily doses of 40-120mg was established in three randomized, placebo-controlled studies in adults with MDD. […]
Ordinarily, I am not a fan of unsolicited feedback. But if you’re soliciting it, or for that matter seeking coaching or counsel, defending your current position or even worse, assuming a defensive posture isn’t going to help you. Defending your ideas or ways of doing something will preclude you from listening intently for the messages put forth by those you’ve chosen to help you change your current situation. And being defensive means that you not only won’t listen to the [...]
The benzodiazepines have been the mainstay of anxiety management for several decades now. In the past decade or two, the antidepressants, particularly the serotonin agents, have entered the picture when it comes to managing anxiety pharmacologically. Both benzodiazepines and contemporary antidepressants are FDA-approved for anxiety treatment and are most often employed in the “worried-well” with often vague symptoms of anxiety that fall into the generalized type. […]
Anyone who has either recently started or is contemplating the use of antidepressants or benzodiazepine anti-anxiety agents should ask themselves: what is it I am asking of the drug and for how long do I envision availing myself of its services. […]
If we’ve got passion for doing or accomplishing something, then the motivation to follow through on the project naturally accompanies the passion right? Not so fast. Once we embark upon a venture that fires us up and we’ve figured out a platform for launching it and a productive way to make some waves, why do we then sometimes find ourselves increasingly more uninterested and unmotivated? And why does energy turn into drudgery the closer we get to the reality of [...]
Interesting to know what’s on neuroscientific radar screens, but impractical in the treatment room because we treat in the here and now. Moves at a “laboratory” pace – very slow. Subject to the vagaries of funding. Disappoints often – the complexity of brain functioning has defeated the DSMs and even the best NIMH efforts in search of valid and reliable biomarkers. Progress in understanding mental disorders is painstaking – they’ll be no holes-in-one, no all-encompassing explanations, nothing “Einsteinish.” There will [...]
Although considered highly prevalent, bipolar disorder is routinely misdiagnosed. Psychiatric literature is replete with data about over-diagnosis – particularly in pediatric populations – but this disorder is frequently under-recognized also. Here are the major headwinds combating effective identification and treatment: […]
Worry is what people do when they won’t, or don’t know how to be productive. Worry saps energy and provides a way to spend time. It goes hand-in-hand with procrastination and time wasters like continuously checking e-mail, social media or mindless web surfing – all of which keeps them from getting down to business. […]
It’s a lot easier to dabble with success than really go for it. This is because if we haven’t yet achieved it, it’s hard for us to get our heads around what success will be like. The alternative is much easier – getting our heads around failure. Thinking about all the reasons a new venture will fail takes the pressure off having to confront the fact that our current plan – as we’ve developed it – really stinks, and is [...]
One day last week, all five clients I worked with were taking antidepressants. I asked all five if they believed they were benefiting from them; four of the five told me they couldn’t tell. […]
