They have been flooding into your office: grown-ups who believe that they have ADHD.

Dr. Prince, you have done innumerable evaluations of children and adults with ADHD. These days, psychiatrists in the community are besieged by patients wanting treatment for ADHD, and the pressure is on to come up with a diagnosis and treatment during a single 45 minute session. Is this possible?

David Sorenson, M.D., is medical director of the Anna Jaques Hospital Child Psychiatry Inpatient Unit in Amesbury, Massachusetts. His experiences with patients misusing ADHD medications should give us pause.

The discovery that stimulants are helpful for behavioral problems in children was another of the serendipitous discoveries so common in psychiatry. Dr. Charles Bradley, in the 1930’s, was medical director of a small child psychiatric hospital.

Panic disorder is a much harder nut to crack than we give it credit for. We tend to get complacent about treating it, because so many patient appear to do well on the standard starting regimen of an SSRI with or without a benzodiazepine.

When it comes to cognitive behavior therapy (CBT) and most psychiatrists, a little knowledge is a troubling thing. We know that CBT is effective, but we don’t know how to practice it. We know that a lot of patients ask us about it, but we don’t know enough to confidently describe to them what it entails.

Neurontin (gabapentin) spends plenty of time in our patient’s medicine cabinets, but lately it has spent nearly as much time splashed across news sections of daily papers. Parke-Davis, the company that used to market Neurontin before it merged with Pfizer, has been accused of improperly promoting its use for a variety of off-label indications (1).

Dr. Pollack, as the head of the Anxiety Disorders Program at Mass General, you’ve had the opportunity to evaluate thousands of patients with panic disorder. Do have any practical tips for those of us with less experience?

Laura Duffy, M.D. is an Attending Psychiatrist at California Pacific Medical Center in San Francisco who was recently referred a patient with panic disorder whose anxiety was triggered in an unusual way.

Zyprexa (olanzapine) became rapidly popular after its introduction in the United States in 1996. Its structural similarity to Clozaril (clozapine) led to hopes that it would be as effective for treatment-resistant cases as Clozaril but without the risk of agranulocytosis.