General Psychiatry
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CLINICAL Q&A

The Modafinils in Bipolar Depression

June 10, 2020
Chris Aiken, MD.
Chris Aiken, MD. Editor-in-Chief of TCPR. 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.
Provigil and Nuvigil, the modafinils, may not work for full depressive episodes, but they do something else in bipolar disorder that’s important to patients. This article explores their cognitive effects, as well as their potential to cause addiction and mania.
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When Further Medication Trials Seem Futile

June 10, 2020
Joseph Goldberg, MD
Joseph Goldberg, MDJoseph Goldberg, MD

Dr. Goldberg is a clinical professor of psychiatry at the Mount Sinai School of Medicine and maintains a private practice focused on mood disorders. He has published three psychiatric textbooks and is completing a fourth on psychopharmacology. Dr. Goldberg has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Joe Goldberg believes we do a disservice by shuffling patients through medication trials that have little chance of working. He shares techniques to engage patients, motivate change, combat demoralization, as well as his top pharmacologic strategies for highly resistant depression.
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Autism: The Goal Posts Have Moved

June 10, 2020
Peter Smith, PsyD.
Peter Smith, PsyD. Dr. Smith has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
The mysterious rise in autism diagnoses has invited every type of conjecture, from vaccines to aging parents. By comparing it to the rate of schizophrenia, this study arrived at an answer that’s a little more mundane, but a lot less speculative.
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Locked-In Syndrome and Quality of Life

June 10, 2020
Eugene Rubin, MD.
Eugene Rubin, MD. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
People can still find meaningful lives even in with the most debilitating medical disorders, including locked in syndrome. In this neurologic disorder, patients maintain full awareness but are unable to speak or move due to complete paralysis of nearly all voluntary muscles in the body.
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Trazodone: The Forgotten Antidepressant

May 7, 2020
Eugene Rubin, MD
Eugene Rubin, MD Private practice, Bingham Farms, MI. Dr. Rubin has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
Trazodone is rarely used as an antidepressant, and that’s a missed opportunity. It lacks the weight gain, sleep disruption, and sexual side effects that so many antidepressants cause. In this article are two important dosing tips that can make it work better.
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EXPERT Q&A

Telepsychiatry: From Crisis to Opportunity

May 7, 2020
Peter Yellowlees, MD
Peter Yellowlees, M. Professor of psychiatry and Chief Wellness Officer at University of California-Davis Health. Past President of the American Telemedicine Association. Dr. Yellowlees has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.
“Don’t think of it as telepsychiatry, think of it as a home visit,” says Peter Yellowlees as he teaches us how to create more meaningful interactions through the digital screen. Dr. Yellowlees covers many of the dicey details of this medium: Involuntary hospitalization, interstate regulations, medical notes, billing, and how to set up the equipment on a budget are all inside.
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A Potentially Lethal Side Effect You Probably Never Heard Of

May 7, 2020
Chris Aiken, MD.
Chris Aiken, MD. Editor-in-Chief of TCPR. 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.
The FDA recently raised alerts about a potentially fatal side effect on clozapine that’s causing more fatalities than neutropenia. It’s constipation, and the problem extends to a few other psychotropics as well. In this article, a three step, evidence-based algorithm for managing it.
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