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Medicating Bipolar Disorder: Recent Advances

Although this comes as no surprise to me, there is now clear evidence that lithium is the most efficacious single agent for managing bipolar mania and bipolar depression. If, for whatever reason, lithium is not effective as monotherapy, combining Depakote with it does increase efficacy – although not markedly. The lithium/Depakote combination therefore is optimal in the treatment of bipolar mania. It is becoming increasingly more evident that traditional antidepressants (cyclics, SSRIs, SNRIs, Atypicals) have little, if any advantage, in [...]

joe2017-01-29T15:32:22+00:00

A Gaze into the Future of Psychopharmacology

I got to wondering one day last week about the future of psychopharmacology in the 21st century. Here's what I envision unfolding: Psychopharmacology will be directed toward the observable and measurable characteristics that define mental illnesses by gene expression, RNA fingerprint, brain mapping, brain imaging and DSM categories with a track record of medication responsiveness. I can imagine a day when a clinician, faced with a client who has major depression, will be able to order a gene scan that [...]

joe2017-01-29T15:27:17+00:00

Frequently Asked Questions

Q. Why do so many antidepressants seem to cause sexual dysfunction? A. In addition to its antidepressant effects, serotonin is a rather powerful vasoconstrictor. It can restrict blood flow to sexual organs and negatively impact sexual performance, libido and the ability to reach orgasm. Q. Is Prozac’s long half-life a drawback to its action? A. Yes and no. Prozac’s long half-life can be an advantage to the individual prone to forget doses, but a disadvantage to those taking additional medications [...]

joe2017-01-29T15:26:11+00:00

For Your Consideration: Tips for Assessing and Treating Clinical Depression

Think of depression not as a diagnosis, but instead as a cluster of symptoms with many possible causes. Possible causes of clinical depression: Psychosocial stressors. Often referred to as reactive depression, individuals have difficulty adjusting to troublesome environmental stimuli such as a recent divorce, job loss or the death of a family member or close friend. Biological. These depressions typically emerge in the absence of precipitating psychosocial events. They are considered endogenous in nature and are associated with physiological changes [...]

joe2017-01-29T16:01:08+00:00

Aging and Mental Health

Except for dementia, the incidence of mental illness does not increase with age. Alzheimer’s disease is a common, but not inevitable consequence of aging – about 50 percent of people over the age of 95 suffer from it. The majority of mental deterioration before age 80 is a result of the disease process, not aging. Although we all experience word finding difficulty as we age, there is no corresponding decline in IQ scores. Successful vs. unsuccessful aging can be predicted [...]

joe2017-01-29T16:00:26+00:00

Seven Cardinal Symptoms of Mania and Hypomania

The seven classic symptoms of mania and hypomania are probably best summed up through the use of the acronym D I G F A S T Distractibility: Inability to maintain focus on tasks Insomnia: Reduced need for sleep accompanied by increased energy in spite of little sleep Grandiosity: Inflated self-esteem Flight of ideas: Racing thoughts Activities: Increase in goal-directed activity – work, social, school Speech: Excessive, circumstantial, tangential chatter, pressure to keep talking or more talkative than usual Thoughtlessness: Risky [...]

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

Good Stress vs. Bad Stress
Good Stress vs. Bad Stress

Good Stress vs. Bad Stress

It's logical and natural for us to think of stress as something that problematic in our lives. The truth is not all forms of stress are bad for us. In fact, short-term periods of acute, slight-to-moderate, predictable stress poses no health problems, and is a normal and healthy part of daily living. The short-term release of the neurotransmitter norepinephrine can be beneficial since this neurochemical helps create memories and has been shown to improve mood. Short-term stress also helps us [...]

joe2020-04-16T20:07:32+00:00

Psychotropic Medication Use During Pregnancy: The Very Latest

Antidepressants: According to recent data, none of the antidepressants that have been studied in pregnancy have been found to increase the baseline rate of 1 percent to 3 percent for major fetal malformations. Some studies, however, report an increased rate of spontaneous abortions. The SSRIs are not associated with malformation of the fetus or fetal organs. Recently however, the FDA issued a public health advisory regarding first trimester exposure to Paxil (paroxetine) and cardiac malformations (1.5-2 percent vs. non-exposed 1 [...]

joe2014-01-29T18:55:43+00:00

Ways to Save on Prescription Drugs

The cost of prescription drugs will not stop rising anytime soon, but there are a number of ways to save. Here are some suggestions: The place to start is with your choice of insurance company or plan. Find out about the range of prescription benefits and whether or not the medications you’re taking are covered under your plan. Clarify co-pay information and whether or not brand name drugs are covered. This is particularly important if you take several medications. Medicare [...]

joe2020-04-16T20:10:53+00:00

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