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The Aging Brain: Preventing Cognitive Decline

April 10, 2019
We’ve all been there. A 63-year-old patient comes to you with a chief complaint of memory loss. She tells you that she has a hard time remembering people’s names and forgets where she puts her keys. She lives and drives on her own without a problem, but asks, “Isn’t there some memory pill I can take?” What advice can we give her?
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Screening Tests for Cognitive Decline

April 10, 2019
Screening tests can also help distinguish normal aging from a Neurocognitive Disorder. The popular Mini Mental Status Exam is being replaced by more sensitive tests like the Montreal Cognitive Assessment (MOCA) and the Saint Louis University Mental Status Examination (SLUMS). Both of these can be completed in 10 minutes and are normed for Mild and Major Neurocognitive Disorders. An abbreviated form of the SLUMS, the Rapid Cognitive Screen, can be administered in 5 minutes.
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Sleep and PTSD

April 10, 2019
Michael McCarthy, MD
Michael McCarthy, MD Michael McCarthy, MD

Associate Adjunct Professor, Department of Psychiatry, University of California at San Diego. Dr. McCarthy has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Insomnia is different in PTSD. Some of that is explained by the symptoms of PTSD, such as nightmares, hyperarousal, anxiety, and physical restlessness. But there’s another thing we’re seeing that isn’t as obvious: sleep apnea.
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Ask the Editor - Jet Lag and Psychiatric Disorders: Plan for Prevention

April 10, 2019
Chris Aiken, MD.
Chris Aiken, MDChris Aiken, MD.
Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Jet lag happens when people fly across multiple time zones. The body’s internal clock gets out of sync with the outside signals of sunrise and sunset. The result is insomnia, poor concentration, fatigue, and gastrointestinal symptoms.
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Insomnia and Substance Use Disorders

April 10, 2019
Nicholas Rosenlicht, MD
Nicholas Rosenlicht, MD Nicholas Rosenlicht, MD

Clinical Professor of Psychiatry, University of California, San Francisco, School of Medicine. Founder and served for 15 years as the director of the UCSF-VAMC Mood Disorders Clinic. Dr. Rosenlicht has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Sleep problems are common in recovery, and they have many causes such as withdrawal states, circadian rhythm disruptions, and a host of psychiatric and medical comorbidities. It’s a two-way street: Insomnia raises the risk of substance misuse, and addiction can cause or worsen sleep problems.
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Moderate Alcohol Use Associated With Reduced Risk of Dementia

April 10, 2019
Michael Posternak, MD

Michael Posternak, MD. Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients.
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A Second Look at Genetic Testing

March 29, 2019
Chris Aiken, MD.
Chris Aiken, MDChris Aiken, MD.
Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Genetic tests are marketed with a bold claim: that a handful of genes can predict medication response. AssureRx’s GeneSight is the most popular of these tests, and in 2015 we reviewed the evidence behind its panel. In short, it was lacking, but the company has just released new data that may move it a little closer to the mainstream.
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