Insomnia is so ubiquitous and misunderstood with respect to its health consequences and “treatability.” At the core of this is the widespread misconception that insomnia is primarily a symptom of other things. Insomnia is also identified in DSM-5 as an independent disorder (780.52) which, when occurring with other DSM-5 disorders, is considered a comorbid disorder rather than a symptom.

Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatment for depression; however, our confidence in their safety took a hit when the FDA issued a warning in 2011 about doses of citalopram above 40 mg causing QTc prolongation.

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After reading these articles, you should be able to…

Given how many essentially equivalent medications we have to choose from, how great would it be to have a test that tells us which drug to prescribe for which patient? Everybody wants personalized medicine, and in some other specialties, such as oncology, this is becoming a standard part of treatment. In this article, we’ll review some of the basics of pharmacogenetic testing and examine in more detail the commercial genetic tests that are currently available.

The basic goal of this kind of research is to try to find an association between a genetic variant and the clinical response to a particular medication. Given that there are dozens of medications to choose from for any given disorder, it would be very helpful if we could do a genetic test that would tell us which drug is the best for a particular patient.

Complementary and alternative medicine is gradually becoming more mainstream, and we covered some of these treatments in a recent issue of TCPR, but we didn’t cover yoga and meditation. Sudarshan Kriya yoga (SKY) is a meditation technique that combines yoga poses, sitting meditation, and breathing exercises.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

After reading these articles, you should be able to…

It’s important to realize that psychosis can result from many different non-psychiatric conditions—for example, substance use, electrolyte imbalances, thyroid abnormalities, systemic infections, nutritional deficiencies, brain tumors, and seizures, among others. By the time we see them, patients have usually already had a basic medical evaluation in an inpatient hospital or emergency room, and most non-psychiatric medical causes have been ruled out.