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    Management of Alcohol Withdrawal in the Outpatient Setting

    Approximately 2% to 9% of patients seen in a family physician’s office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome (AWS) if they abruptly abstain from alcohol use.  Treatment goals for patients with AWS are to reduce withdrawal symptoms; prevent seizures, delirium tremens, and death; and prepare the patient for […]

    Treatment Approaches for GAD

    The main treatment approaches for GAD comprise psychotherapy, pharmacotherapy or a combination of both. The often chronic and disabling nature of GAD means that some individuals may fail to respond fully to first-line treatment.  Your patients may require a sequential trial of treatments or possibly the use of combination therapy. Given the chronic nature of […]

    Generalized Anxiety Disorder (GAD)

    Anxiety disorders are the most prevalent of all psychiatric disorders, with generalized anxiety disorder (GAD) being the most common seen in primary care. Nearly 8% of patients consulting a primary care provider have GAD according to the World Health Organization (WHO). Despite this, it is a diagnosis that can easily be missed. The good news […]

    Treating ADHD in Young Children

    The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is becoming increasingly prevalent, in part because of better assessments, but also in part because of misdiagnosis and jumping too early to diagnose. The effect is that the diagnosis of ADHD is being given at younger and younger ages. This leads to the question of the best […]

    An Important Community Resource: 2-1-1 San Diego

    For those of us working in health care, we are increasingly aware that many of the health challenges our patients face are rooted in the social, economic and environmental context in which they live.  Access to healthcare services is only one piece of the puzzle for our patients to achieve better health. There are numerous […]

    Is There a Link Between Vitamin D Deficiency and Depression?

    There has been a lot of discussion recently in the scientific world and the lay press about the prevalence and consequences of vitamin D deficiency. As part of that discussion, there has been a suggestion that vitamin D deficiency could contribute to depression and that vitamin D supplementation could be a viable treatment option for […]

    Screening for Suicide Risk Among Teens

    Suicide is now the second leading cause of death in adolescents, in the United States, surpassing homicide and second only behind unintentional injuries (motor vehicle accidents, accidental overdose). This switch occurred because of both a reduction in deaths from homicide and a modest increase in deaths from suicide. Deaths from suicide had been decreasing from […]

    Light Therapy

    Light therapy is a non-pharmacological treatment that is best studied for seasonal affective disorder (SAD) but has also been found to be useful in other depressive disorders. It can be tried as the primary treatment for mild depression or for antepartum or postpartum depression and as an adjunctive treatment for moderate-severe depression. It has been […]

    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 […]