Carly Simon swears by it. The daytime show “The Doctors” gave it a glowing review. Ads for it seem to be invading psychiatrists’ Google search results. We’re talking, of course, about the Fisher Wallace Stimulator and the similarly touted Alpha-Stim device. How do these devices work? Are they actually effective? And where do they fit into the rapidly expanding array of neuromodulators?
Assurex Health recently sent me an email inviting me to dine at Legal Seafood to learn about “Clinical Applications of Psychiatric Pharmacogenetics.” I didn’t go, but increasingly I am hearing from colleagues about their experiences at these dinner programs: “What do you think about this GeneSight test? The data looked pretty impressive at this dinner.”
Opioid drugs represent one of the great triumphs of medicine, because they are extremely effective at relieving pain. Since the 1960s, multiple forms of synthetic opioids have been introduced, including such wellknown drugs as hydrocodone (Vicodin) and oxycodone (Percocet, Oxycontin).
In bipolar disorder, depression is often the neglected stepchild. Mania gets more attention, perhaps because it presents so dramatically. Imagine two bipolar patients in an emergency room: one withdrawn and depressed, sitting quietly, and another ranting and pacing the room. Which one would be seen first?
In the wake (pun intended) of last year’s FDA warnings of next-morning impairment and the lower dosing recommendations for “Z drugs,” wouldn’t now be the perfect time for a new hypnotic to enter the marketplace?
Of all the factors that contribute to mood, hormonal variations, such as those found in premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) can have a particularly strong effect. I’ve heard some people, for instance, describe PMS as a “powerful spell” that women are put under once every month.
More than 38% of Americans use complementary and alternative medicine (CAM) yearly, with 12.7% using so-called “natural products." More than a third of people over age 50 report use of supplements, yet only about half have discussed this with their doctors.
At the crossroads of these experiences lies the concept of the psychosis prodrome and early intervention/prevention efforts. But without evidence of a florid psychotic episode, when should one intervene?
Marsha Linehan developed DBT to help patients with BPD (Linehan MM, Cognitive Behavioral Treatment of Borderline Personality Disorder. New York, NY: The Guilford Press;1993), and over the past two decades it has received strong empirical support.
Lurasidone (Latuda) was approved by the FDA for schizophrenia in October 2010 and is the 10th atypical antipsychotic in our toolbox. The key question is: does lurasidone have any advantages over existing agents, or is it just another “me-too” drug?
Deputy Editor: Talia Puzantian, PharmD, BCPP, clinical psychopharmacology consultant in private practice in Los Angeles, CA
Executive Editor:Matt Phillion
Ronald C. Albucher, MD, is the director of counseling and psychological services and clinical assistant professor of psychiatry, Stanford University in Palo Alto, CA.
Steve Balt, MD is a psychiatrist in private practice in the San Francisco Bay area.
Richard Gardiner, MD, is a psychiatrist in private practice in Potter Valley, CA.
Alan D. Lyman, MD, is a child and adolescent psychiatrist in private practice in New York City, NY.
James Megna, MD, PhD, is the director of inpatient psychiatry and an associate professor of psychiatry and medicine at SUNY Upstate Medical University in Syracuse, NY.
Robert L. Mick, MD, is a contract physician in addiction medicine and military psychiatry in Bloomfield, NY.
Michael Posternak, MD, is a psychiatrist in private practice in Boston, MA.
Glen Spielmans, PhD, is an assistant professor of psychology at Metropolitan State University in St. Paul, MN.
Marcia L. Zuckerman, MD is director of Psychiatric Services at Walden Behavioral Care in Waltham, MA.
All editorial content is peer reviewed by the editorial board. Dr. Albucher, Dr. Balt, Dr. Gardiner, Dr. Goldberg, Dr. Lyman, Dr. Megna, Dr. Mick, Dr. Posternak, Dr. Spielmans, and Dr. Zuckerman have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity. Dr. Balt discloses that his spouse is employed as a sales representative for Otsuka America, Inc.