It used to be thought that obsessive-compulsive disorder (OCD) was rare, but it is more common than originally thought. The prevalence is between 2-3% worldwide and it affects males and females equally. Symptoms usually present between childhood and early adulthood, with 75% of patients having symptoms before the age of 18. OCD can be a […]

Treatment for Depression Related to Pregnancy

Last week’s e-Weekly discussed the different depressive syndromes as related to pregnancy. This e-Weekly will go into detail about treatment for depression for a patient who is in the antepartum or postpartum period. The first step is to determine the level of impairment of the symptoms. Baby blues resolves on its own with support and […]

Important Drug Interactions Between Psychotropic Medications and Contraceptives

Contraceptives are commonly used in women of childbearing age, many of who are also taking psychotropic medications for mental health concerns. It is important to be aware of the interactions between contraceptives and certain psychotropic medications as well as the psychiatric side effects of contraceptives themselves. Contraceptives have synthetic estrogen, progesterone or a combination of […]

Depression in Older Patients

Depression can occur in any patients as they age, even without a prior history of depression. Older individuals can present with mood symptoms that can seem to be part of the normal aging process, but it is important to assess for the possibility of a masked depression. Of note, there is an increased risk of […]

Important Drug Interactions with the SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used psychotropic medications to treat depression and anxiety. It is important to be aware of common drug interactions between them and other medications, especially because some SSRIs are competitive inhibitors of a variety of cytochrome P450 liver enzymes. Therefore, they can significantly increase the blood levels […]

Treating Anxiety in the Primary Care Setting: A Case Review

A recent case consultation highlighted medication treatment for an anxiety disorder in the primary care setting. This is a 33 year old male with Generalized Anxiety Disorder and Panic Disorder. He has some benefit from Celexa 40 mg qday, but continues to engage in avoidance behavior, which makes it difficult to sustain work and social […]

Guidelines for Tapering Benzodiazepines

Psychological and physiological dependence on benzodiazepines can occur in as little as two weeks of daily moderate use. It can occur in the most benign of clinical situations, and it is important for providers to be aware of the risk for dependence when prescribing this class of medications. If a patient has been on a […]

Appropriate Use of Benzodiazepines

Millions of prescriptions are written every year for benzodiazepines. In a large percentage of these cases, the provider is uncomfortable with the prescription. For this reason and many others, it is important to have a good understanding of when it might be appropriate to prescribe a benzodiazepine for a patient. This is also becoming particularly […]

Treatment for Anxiety in Children and Adolescents

The presenting symptoms of anxiety in children and adolescents were discussed in last week’s edition and today’s focuses on treatment in pediatric populations.  Primary care pediatric providers can play a major role in diagnosis, treatment planning, prescribing and, as needed, referring for consultation or specialty intervention. Treatment options include therapy or a combination of therapy […]

Depression related to pregnancy

Depression related to pregnancy is a common and potentially serious concern.  Therefore, it is important to understand the various conditions and when it is important to have a clinical intervention. Postpartum Blues: Symptoms of mood lability, irritability, interpersonal hypersensitivity and tearfulness are common in the postpartum period and are commonly known as the postpartum “blues”. […]