The latest official statement on psychotherapies from the American Psychological Association more or less states that all techniques are equally effective, and it’s likely that the skills of individual therapists are as important as the specific technique they choose. This is all well and good, but meanwhile, in the real world, we need to make decisions about how to treat specific patients. If we wait for the definitive answers from research, we will be waiting for a very long time. This article details certain well-known techniques drawn from the broad umbrella of cognitive behavior therapy.
Insomnia is so ubiquitous and misunderstood with respect to its health consequences and “treatability.” At the core of this is the widespread misconception that insomnia is primarily a symptom of other things. Insomnia is also identified in DSM-5 as an independent disorder (780.52) which, when occurring with other DSM-5 disorders, is considered a comorbid disorder rather than a symptom.
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.
Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.