In psychiatry, we typically order screening labs on new patients for a variety of purposes, including to rule out medical causes of psychiatric symptoms, to record baseline data before prescribing medications that may lead to lab abnormalities, and to screen for general medical problems. What labs should we order for new patients?

When you are planning to start a patient on medications, what labs should you order at baseline, and what should you order over time? This is quite a different question from whether to do a set of labs at the start of treatment to screen for disease etiology, and it’s an area where I believe we should be much more proactive.

Dr. Perlis, can you help us understand the role of pharmacogenetics in psychiatric practice?

A recent issue of Archives of Internal Medicine contained two articles suggesting that SSRIs may result in loss of bone density in the elderly.

Fibromyalgia is a condition characterized by at least 3 months of widespread pain (both above and below the waist and on both sides of the body) and by the presence of at least 11 tender points (these are the official American College of Rheumatology criteria).

Clinical lore has it that SSRIs are preferable to bupropion for depressed patients who present with anxiety and insomnia. Papakostas and colleagues tested this assumption by obtaining patient data from 10 studies funded by GlaxoSmithKline (makers of brand name Wellbutrin) over the years.

After reading these articles, you should be able to…

Here’s an outrageous question for you: Does psychotherapy work? Of course it does, you say, particularly cognitive behavior therapy (CBT). CBT has become so mainstream that Forbes magazine devoted its April 2007 cover article to it.

Over 30 years of practicing and teaching psychotherapy with a range of patients, Dr. Arnold Robbins has developed an integrated approach that can be individualized and is useful for his patients.

How do you combine CBT and psychopharm? What techniques are helpful for reducing hallucinations? Do you use CBT specifically to improve adherence to medications? These questions and more are addressed.