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Home » Topics » General Psychiatry

General Psychiatry
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Treating Postpartum Depression: A Look at the Evidence

October 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
What is postpartum depression (PPD), and why does it occur? PPD is generally defined as major depressive symptoms occurring within three months of childbirth. Don’t confuse PPD with the very common postpartum blues, a phenomenon that occurs in over half of women who give birth, peaks about four days after delivery, and fully remits by 10 days postpartum (N Engl J Med 2002; 347:194-199).
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Victoria Hendrick, M.D., on Drug Interactions and Drug Side Effects Specific to Women

October 1, 2005
Victoria Hendrick, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Victoria Hendrick, M.D.Victoria Hendrick, M.D. Associate Professor of Psychiatry UCLA School of Medicine and Olive View-UCLA Medical Center Dr. Hendrick has disclosed that she was/is a member of the speakers bureaus for GlaxoSmithKline and Pfizer Pharmaceuticals, and has given talks on the reproductive safety of Paxil (GlaxoSmithKline) and Zoloft (Pfizer). Because of these industry relationships, the editors of The Carlat Report have edited the interview in order to resolve any possible faculty conflicts of interest regarding this educational activity.
Dr. Hendrick, thanks for your return visit to the pages of TCR! I’m wondering whether, as a specialist in the psychiatric treatment of women, you can tell us about particular drug interactions that you feel we should be more aware of in treating women.
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Tom Cruise versus Brooke Shields: A Strange Chapter in Psychiatry

October 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
“You can use vitamins to help a woman through those things,” said Tom Cruise, denigrating Brooke Shields’s use of an SSRI to treat her postpartum depression, which she detailed in her recent book Down Came The Rain: My Journey Through Postpartum Depression.
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Lunesta, Rozerem, and More: Showtime for the New Hypnotics

September 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
Suddenly, putting patients to sleep is all the rage in psychiatry. Over the last year, two new hypnotics have been approved by the FDA – Lunesta (eszopiclone) in December 2004 and Rozerem (ramelteon) in July 2005. Indiplon (the generic name) is on the launching pad for approval in early 2006.
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Getting Patients off Benzos: Tips from Old Masters

September 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
Tapering patients off benzos (BZs) is certainly more art than science, but TCR has unearthed a surprising number of studies that help bring more science into the process. These studies are, by modern standards, ancient, because research follows the money, and there’s no longer much money to be made in benzodiazepines. So file these studies under “oldies but goodies”!
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Should we Prescribe Benzos to Alcohol Abusers?

September 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
Whether one should prescribe BZs to patients with a history of alcoholism is a controversial question, and one that tends to polarize psychiatrists into the “purists” versus the “realists.” Most alcoholics take BZs at some point in the course of their disorder, sometimes illegitimately, but often as part of a bona fide treatment program.
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John M. Talmadge, M.D., on Using Benzodiazepines in Substance Abusers

September 1, 2005
John M. Talmadge, M.D.
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
John M. Talmadge, M.D.John M. Talmadge, M.D. Director, Addiction Psychiatry Fellowship Training Program Associate Professor of Psychiatry University of Texas Southwestern Medical Center Dr. Talmadge has disclosed that, in the past 12 months, he has been a member of the speakers bureaus for Astra-Zeneca, Eli Lilly, Forest Pharmaceuticals, and Janssen. He has no current industry relationships to disclose. The editors of The Carlat Report have closely reviewed the content of Dr. Talmadge’s interview and have determined that there are no financial conflicts of interest regarding this educational activity.  
Dr. Talmadge, in your practice, do you ever prescribe benzodiazepines to people with substance abuse histories?
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A Constitutional Right to Benzos?

September 1, 2005
Stanley Cole, M.D.
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Stanley Cole, M.D., is a psychiatrist in private practice in Newton, Massachusetts. Dr. Cole has disclosed that he has no significant relationships with or financial interests in any commercial company pertaining to this educational activity.
My standard practice in treating patients with very frequent panic attacks had always been to start both a benzo and an antidepressant, with the expectation of eventually tapering the benzo. But I noticed, both with my patients and those I inherited from other psychopharmacologists, that hardly anyone ever seemed to get off benzos despite my preparing the patient for this plan.
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Cholinesterase Inhibitors: Under Siege

August 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
When Aricept (donepezil) was first approved by the FDA in 1996 for the treatment of Alzheimer’s Dementia (AD), there was an almost euphoric sense that we were finally beginning to make progress in treating a previously untreatable disease.
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Namenda: Pining for Another Indication

August 1, 2005
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Daniel Carlat, MD Dr. Carlat has disclosed that he has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.
In 2003, the FDA approved Namenda (memantine) as a treatment for moderate to severe Alzheimer’s Dementia (AD). Backed by the legendary marketing expertise of Forest Labs, the medication has become remarkably popular, gradually eating into the market share of the cholinesterase inhibitors (CIs). The question, as always, is whether this popularity is justified by the data.
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