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Home » Topics » General Psychiatry

General Psychiatry
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DEA changes rules to allow post-dating of schedule II substances

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Max Fink, MD
In a ruling certain to make psychiatrists and their patients happy, the DEA has finally said that doctors may give patients 90 days worth of prescriptions for schedule II controlled substances, which includes stimulants and narcotics.
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Placebo more effective than antipsychotics for aggression in mental retardation

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Max Fink, MD
In a multi-center study conducted in Great Britain and Australia, 86 adults with mental retardation (IQ < 75) and aggressive behavior were randomized to double-blind treatment with Risperdal (mean dose, 1.8 mg/day), Haldol (mean dose, 2.9 mg/day), or placebo. The primary outcome was score on the modified overt aggression scale (MOAS) at 4 weeks.
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Criteria proposed to predict which prodromal patients will become psychotic

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Max Fink, MD
The North American Prodrome Longitudinal Study is a consortium of 8 academic centers (all but one in the U.S.) seeking to develop predictors of the development of psychosis in young patients who present with prodromal symptoms.
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New lab test recommended before prescribing Tegretol or Lamictal to Asians

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Max Fink, MD
The FDA has issued a warning that Asian patients with a specific human leukocyte antigen (HLA) are at increased risk of developing life-threatening Stevens Johnson syndrome rash, and should be tested for this antigen before initiating treatment.
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The Use of Lamictal in Psychiatry

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Dr. Ghaemi, Lamictal (lamotrigine) has become a very popular medication in psychiatry, but there remains some confusion about when to use it. What is its official FDA-approved indication?
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Learning Objectives, Anticonvulsants in Psychiatry, TCPR, February 2008

February 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
After reading these articles, you should be able to…
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Transcranial Magnetic Stimulation: The Saga Continues

January 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD
The last time we took a close look at transcranial magnetic stimulation (TMS) was three years ago (TCPR, Jan 2005), and we concluded that it had promise as a treatment for major depression. In that article, we reported that the company making the device, Neuronetics, would apply for FDA approval as early as Fall of 2005, and that we could be passing magnetic coils over our patients’ heads as early as 2006.
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Using EEG to Predict Medication Response

January 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD
Many psychiatrists are already hearing from patients about “this new technique” of using EEG to predict whether a given antidepressant will work. How good is this technology? Is it even remotely ready for prime time?
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Vagus Nerve Stimulation: A Brief Update

January 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD
VNS (vagus nerve stimulation) was initially developed and approved for treatment-refractory epilepsy. Cyberonics conducted one sham-controlled study for treatment-resistant depression, and while this double-blind study showed no statistical benefit over placebo, an open-label extension showed enough benefit to impress someone at the FDA.
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Discontinuing mood stabilizers often leads to relapse during pregnancy

January 1, 2008
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
John O’Reardon, MD
Although we tend to feel comfortable counseling patients to continue antidepressants during pregnancy, because most of them do not appear to cause congenital abnormalities, mood stabilizers are trickier.
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