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Medicating Pediatric Bipolar Disorder: Challenges and Concerns

There's little doubt that the diagnosis of childhood-onset bipolar disorder is on the rise. Office visits by children diagnosed with bipolar disorder multiplied 40-fold from 1994-2003. Disagreements abound as to what this means. Some researchers view the trend as a sign of progress: A disorder that has long gone undiagnosed in children is now being better screened and treated. Others, however, are more skeptical; they perceive the trend to be an example of gross over-diagnosis. In truth, bipolar disorder is [...]

joe2012-11-12T14:07:28+00:00

Over Procrastination

We all procrastinate, and if you claim you don't, there's something other than blood running through your veins, as this phenomenon is simply part of the human condition. But that said, ask yourself if this sounds like you: After exhaustive research you’re still waiting on that one final scintilla of information permitting you to finally spring into action to buy a new house, a new car or accept that job you’ve recently been offered. So what's the problem here, after [...]

joe2009-07-27T05:46:22+00:00

Observations from my Recent Trip to Boise and Salt Lake City: Southwest Airlines

Thanks to everyone that attended my mid-June psychopharmacology seminars in Boise, Idaho and Salt Lake City, Utah. I sincerely hope that all attendees enjoyed and benefited from the trainings. More importantly, I strived to better your condition with regard to this subject matter, as all of you are entitled to a lasting return on your investment of time and money. I rarely fly Southwest Airlines. I have no bias against this airline, I just tend to choose the other major [...]

joe2012-11-12T14:07:22+00:00

Bipolar Disorder vs. ADHD: The Quick and Dirty

Irritability, frustration intolerance, aggression and inattentiveness are present in both disorders. Did I miss anything? What are your experiences when it comes to differentiating Bipolar disorder and ADHD?

joe2012-11-12T14:07:04+00:00

Do Antidepressants Really Deliver?

I suppose the answer to this question hinges on the definition of deliver. Let’s start up top with the bottom line: Treating depression pharmacologically is not easy! A major study, the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) is the largest independently funded clinical trial for depression. The study’s primary objective was to develop a series of evidence-based steps for guiding prescribers in making sequenced treatment choices to enhance the odds of response rates and subsequent remission. The six-year study [...]

joe2009-07-17T10:59:26+00:00

In Relationships, We Either Trade Up or We Trade Down

Here's a question I hear often when doing counseling and the issue turns to relationships: How do I continue to pursue a relationship with my significant other while at the same time retain my independence? My answer is always the same: You're asking the wrong question! Why? In relationships, we either trade up or we trade down. A better question to ask would be: What criteria should I establish for choosing my partner? Those that choose partners consistent with the [...]

joe2009-06-26T16:12:53+00:00

Augmenting Antidepressants with Deplin (l-methylfolate)

Vitamin B folate or folic acid -- active in citrus fruits, legumes, green, leafy vegetables -- is yet another arrow in the psychiatrist’s quiver for managing treatment – resistant depression (TRD). Deplin (l-methylfolate) is a folic acid type of derivative. Deplin helps normalize amounts of the neurotransmitters norepinephrine, serotonin and dopamine when used in conjunction with antidepressants. Folate is also crucial to the production of S-Adenosyl-Methionine, or SAM-e, which aids in the synthesis of nerve cell membranes and activates norepinephrine, serotonin and [...]

joe2009-06-18T14:18:45+00:00

Escitalopram (Lexapro) Approved for Treatment of Major Depression in Adolescents

Escitalopram (Lexapro), has gained FDA approval for the acute and maintenance treatment of major depressive disorder (MDD) in adolescents ages 12 to 17 years. "Adolescent depression can often be challenging to treat because there are limited treatment options that are proven to be effective and well tolerated in this patient population," noted Graham Emslie, MD, professor of psychiatry at the University of Texas Southwestern Medical Center in Dallas, in an FDA news release. Escitalopram (Lexapro) is the second antidepressant to [...]

joe2009-06-09T10:20:03+00:00

Metabolic Monitoring in Patients Utilizing Antipsychotics Considerably Lacking

Among insured patients initially prescribed second generation antipsychotics, monitoring of blood sugar and lipid levels falls very short of the 2004 American Diabetes Association (ADA) guidelines, researchers report. The guidelines are based on the considerable evidence that these medications can increase risk for cardiovascular disease by adversely affecting lipid and glucose metabolism as well as body weight. By 2006, the study showed just over 10% of patients that were newly prescribed second generation antipsychotics received lipid profile monitoring and just [...]

joe2009-06-05T10:15:48+00:00

FDA Approves “deep brain stimulation” for OCD

The Food and Drug Administration has approved "deep brain stimulation" for treatment resistant obsessive-compulsive disorder, or OCD. This is the first instance that this procedure, which involves the surgical implantation of electrodes deep within the brain to trigger electrical activity, has been approved for use in a psychiatric syndrome. The implants have previously been used to treat movement disorders, mostly notably Parkinson’s disease. Once the electrodes are surgically in place, clinicians control how the electrical impulses are delivered to the [...]

joe2015-03-30T15:51:54+00:00