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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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.

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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.

Open Dialogue, developed in the 1990s in Tornio, Finland, is both a way of communicating (while paying attention to one’s vocabulary) and a system of care. All communication about patients occurs in their presence and is based on respectful language that is often derived from the patient’s own words. Learn more about this technique as it applies to treating psychosis in this article.