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Home » Topics » General Psychiatry

General Psychiatry
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Rosack’s FDA Watch: Atypical Antipsychotics and the Elderly

August 1, 2005
Jim Rosack
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Jim Rosack is a widely published healthcare journalist and is the new TCR Bureau Chief for FDA Affairs. His reports will appear periodically in the pages of The Carlat Report. Jim Rosack has disclosed that he has no significant relationship with or financial interests in any commercial companies pertaining to this educational activity. The author has disclosed that antipsychotics have not been approved by the U.S. Food and Drug Administration for use in the treatment of agitation. Please consult product labeling for the approved usage of these drugs.
The U.S. Food and Drug Administration (FDA) has ordered manufacturers of atypical – or secondgeneration- antipsychotic medications – to add a new black-box warning to the drugs’ labels telling prescribers and patients that the drugs are associated with an increased risk of death when used to treat psychosis and behavioral problems in elderly patients with dementia.
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Marc Agronin, M.D., on Treating Agitation in Dementia

August 1, 2005
Marc Agronin, M.D.
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Marc Agronin, M.D.Marc Agronin, M.D. Director of Mental Health Services Miami Jewish Home & Hospital for the Aged Assistant Professor of Psychiatry University of Miami School of Medicine Dr. Agronin has disclosed that he is the recipient of research grants from Forest Laboratories, Novartis, Ono Pharmaceuticals, Progenics, and Theravance, and is a member of the speakers bureaus for Forest Laboratories, Janssen Pharmaceutica, and Ortho-McNeil. Because of these industry relationships, the editors of The Carlat Report have scrutinized and edited the content of Dr. Agronin’s interview in order to identify and resolve any possible faculty conflicts of interest regarding this educational activity. The author has disclosed that antipsychotics, mood stabilizers, benzodiazepines, and trazodone have not been approved by the U.S. Food and Drug Administration for use in the treatment of agitation. Please consult product labeling for the approved usage of these drugs
TCR: Welcome back to The Carlat Report, Dr. Agronin. You were our expert in October of 2003 when we discussed the diagnosis of dementia, and I understand that since then you have been busy with a new textbook project.
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The Man Behind Alzheimer’s Disease

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.
As longtime TCR readers with good memories know, Alois Alzheimer (1864-1915) was a German neurohistologist who, in 1906, reported the phenomenon of plaques and tangles in the brain of a 51 year-old woman who had died after five years of progressive dementia (TCR October 2003).
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The Humble Progress Note

July 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.
By definition, a “progress note” should be a written record of the degree of our patients’ progress. We can all agree on this much, and this is pretty much where the agreement ends.
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Using Psychiatric Rating Scales in Clinical Practice

July 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.
Should we use rating scales in our clinical practices? And if so, which ones? Do the benefits of scales compensate for the extra time it takes to administer them?
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HIPAA Compliance for Psychiatrists: A One-Stop Shop

July 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 this month’s interview, Dr. Brendel does a wonderful job explaining what psychiatrists need to know in order to become HIPAA-compliant. In this article, TCR really gets down and dirty with HIPAA, taking you by the hand to tell you exactly what to do, what forms to use, and where to get them.
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Dr. Rebecca Brendel on HIPAA and Psychiatric Practice

July 1, 2005
Rebecca W. Brendel, M.D., J.D.  and HIPAA and Psychiatric Practice
From The Carlat Psychiatry Report
Issue Links: Editorial Information | PDF of Issue
Rebecca W. Brendel, M.D.Rebecca W. Brendel, M.D., J.D. HIPAA and Psychiatric Practice Clinical Fellow in Psychiatry, Harvard Medical School Fellow in Forensic Psychiatry, Massachusetts General Hospital Dr. Brendel has disclosed that she has no significant relationships with or financial interests in any commercial companies pertaining to this educational activity.

Dr. Brendel, thanks for agreeing to educate us about HIPAA, which remains a pretty mysterious and intimidating entity for most psychiatrists! How did you get to be such a HIPAA expert?
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Talking Back to Managed Care

July 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.
Oxford Health Plans (a subsidiary of UnitedHealthcare) recently shocked the psychiatric community by doing a retroactive audit of psychiatric services, and demanding repayment of up to tens of thousands of dollars of reimbursements from some physicians based on insufficient documentation.
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Equetro: New Name, Old Drug

June 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.
Okay, we’ll lay our cards on the table right away. Rarely has TCR been as annoyed by the launch of a new medication as we are by the launch of Equetro. The last time the pharmaceutical industry embarrassed itself this much was when Eli Lilly launched “Sarafem,” calling it a “new” medication for PMDD when it was simply Prozac with a new name and a new (pink) color (see TCR Vol. 2, No. 9).
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Antidepressants in Bipolar Disorder: The Controversy Continues

June 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.
There is a battle underway in the genteel circles of academic psychiatry. The disputed question is: Are antidepressants (ADs) good or bad for patients with bipolar disorder?
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