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Latest Posts

Antidepressants To Treat Dementia: How Can They Help?

“Wow, Celexa?”

“Yeah, who knew?”

I overheard this conversation in the ladies’ room immediately after a session speaker advised treating agitation and aggression in dementia with citalopram. Indeed, there was a bit of a murmur in the audience when Dr. Aleta Borrud made the suggestion during her talk at the Mayo Update in Hospital Medicine 2011 course.

Part of the reason for the reaction may be– as a physician I spoke with noted– that Read more »

*This blog post was originally published at ACP Hospitalist*

Patients Need Encouragement To Talk About Depression

More than two in five patients hesitate to discuss depression in the primary care setting, leading researchers to offer practical tips on how to encourage people to broach the subject.

The big reasons for not talking to doctors included fears about patient confidentiality and fear of losing emotional control in front of the doctor, among those with a history of depression. Among those with no prior history, a fear of antidepressants/psychiatry and the perception that primary care isn’t the right setting are two big reasons.

To learn why patients choose not to talk about their depression, researchers Read more »

*This blog post was originally published at ACP Internist*

Psychiatrist Suggests More Active Treatment For Major Depression

Most patients with major depression require a second medication. A psychiatrist suggests that exercise could fulfill that need, too.

Because most patients with major depression don’t fully respond to just one drug, it’s common to try a second drug or cognitive behavioral therapy. But the rate of non-response in this group is prompting researchers to look for an intervention that most patients could do and that would add to current therapies.

Moderate and intense levels of daily exercise can work as well as administering a second antidepressant drug, as long as Read more »

*This blog post was originally published at ACP Internist*

Increased Number Of Antidepressants Prescribed To Patients Without A Psychiatric Diagnosis

Prescriptions for antidepressants given by nonpsychiatrists to patients without a specific psychiatric disorder increased more than 12% in 12 years, leading to the drug class becoming the third most commonly prescribed, a study found.

A study in the August issue of Health Affairs reported that antidepressant prescriptions by doctors who didn’t record a specific psychiatric disorder increased from 59.5% of all prescriptions by nonpsychiatrists in 1996 to 72.7% in 2007.

Researchers reviewed data on patients age eighteen or older from the 1996-2007 Centers for Disease Control and Prevention’s National Ambulatory Medical Care Surveys, a national sample of more than 233,000 office-based visits. The proportion of antidepressants prescribed for patients without a psychiatric diagnosis increased from 2.5% of all visits to nonpsychiatrist providers to 6.4% between 1996 and 2007. For visits to primary care providers, antidepressant prescribing grew from 3.1% to 7.1%. For other nonpsychiatric providers, visits without a psychiatric diagnosis grew from 1.9% to 5.8%. In contrast, antidepressants prescribed with a psychiatric diagnosis increased from 1.7% to 2.4%.

Patients who received antidepressants without a psychiatric diagnosis by nonpsychiatrist providers were more likely to be Read more »

*This blog post was originally published at ACP Internist*

How Effective Are Antidepressants?

Antidepressant drugs have been getting a bad rap in the media. I’ll just give 3 examples:

  • On the Today show, prominent medical expert :-) Tom Cruise told us Brooke Shields shouldn’t have taken these drugs for her postpartum depression.
  • In Natural News, “Health Ranger” Mike Adams accused pharmaceutical companies and the FDA of covering up negative information about antidepressants, saying it would be considered criminal activity in any other industry.
  • And an article in Newsweek said  “Studies suggest that the popular drugs are no more effective than a placebo. In fact, they may be worse.”

Yet psychiatrists are convinced that antidepressants work and are still routinely prescribing them for their patients. Is it all a Big Pharma plot? Who ya gonna believe? Inquiring minds want to know:

  • Are antidepressants more effective than placebo?
  • Has the efficacy of antidepressants been exaggerated?
  • Is psychotherapy a better treatment choice?

The science-based answers to the first two questions are Read more »

*This blog post was originally published at Science-Based Medicine*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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