Shop till you drop | Psychiatry, Clinical Pharmacology | 03-2011
Given the recent holiday season, this is indeed a timely question. While some may question the degree to which this is a medical problem, there does appear to be a ...
NRT is never a bad idea | Cardiology | 10-2010
No, a cigarette is the last thing one would want to give to such a patient. Simply stated, smoking provides the body with over 5,000 chemicals, while NRT nicotine replacement ...
Best antidepressant in cocaine addiction | Psychiatry | 01-2010
No studies have been done on the differential efficacy of antidepressants in cocaine-induced depression or comorbid depression in cocaine abusers. Studies have been done on the use of antidepressants for ...
Truck drivers on opioids | Clinical Pharmacology | 05-2009
This is an excellent question, and the easy answer is that it s largely dependent on the patient. While it might seem self-evident that patients taking oxycodone or other potent ...
Avoiding opiate addiction | Clinical Pharmacology | 12-2008
The main strategy to prevent addiction is to be clear as to the indication for the opiate, i.e. that the physician and patient are clear on the reason that the ...
Which opiate causes the least dependence? | Clinical Pharmacology | 05-2008
Finding the least addictive opioid has been a clinical problem almost since these substances -- described by Osler as God's own medicine -- entered clinical practice. Very old studies done ...
Treating pain in alcohol/drug abusers | Rheumatology | 01-2008
I suggest an active range of motion physiotherapy program, psychologic counselling and other modalities for pain relief. These could include central antagonists, e.g. tricyclic antidepressants. In experienced hands -- for ...
Dealing with activity addictions | Psychiatry | 05-2007
Addictions involve an overstimulation of brain pleasure reward circuits, down-regulation of dopamine receptors, escalated use due to tolerance, depression, anxiety and novelty-seeking in the absence of the addictive activity, and ...
Best treatments for essential tremor | Neurology, Geriatrics | 03-2007
Essential hand tremor ET is sometimes referred to as senile tremor when the onset is late in life. It's extremely common. Beta-blockers are usually the first line of drug treatment, ...
Gambling on dopamine | Psychiatry | 11-2006
There are numerous biologic hypotheses regarding pathologic gambling PG . They're driven by classification quandaries -- i.e., as a problem of impulse control, of the obsessive-compulsive disorder spectrum, as disinhibition ...
Should schizophrenics smoke? | Psychiatry | 09-2006
Studies have shown that schizophrenic patients have a 3-4-fold increase in addiction to cigarettes as compared to the general population, and that approximately 80-90 of them smoke. In addition, they're ...
What's a safe level of nicotine? | Psychiatry | 04-2006
There's no safe level of nicotine absorbed through cigarette smoking, though smoking a cigarette every few days is unlikely to be problematic. Common sense should guide you in counselling patients. ...
Can nursing home residents sleep better? | Geriatrics | 01-2006
In the community, the estimated prevalence of chronic insomnia is in the range of 17-42 of the elderly. It's even higher in the nursing home population. Non-pharmacologic treatment and proper ...
No gambling with naltrexone | Psychiatry | 11-2005
Naltrexone inhibits dopamine neurons in the ventral tegmental area of the brain and decreases dopamine function in the nucleus accumbens. Dopamine's role in these parts of the brain is to ...
Prescription addiction | Psychiatry | 04-2004
I'm sure that you've spoken to your patient about the dangers of this addiction and tried to get him to consider a substance abuse program. Perhaps by talking to him ...
Legality of secretly giving a placebo | Legal | 04-2003
This is a difficult situation. Let's look at the legal consequences first. The Supreme Court of Canada says that a physician is in a position of trust and confidence, so ...
Nocturnal leg cramps: what are the options? | Neurology | 12-2002
We've traditionally treated nocturnal leg cramps using quinine, though there have been reports of benefit from other agents, such as magnesium and B-complex vitamins. These pharmacologic interventions aren't that effective, ...
anxiety relief with lorazepam | Psychiatry | 10-2001
Lorazepam can be useful for treating anxiety disorders in several ways. First, sublingual lorazepam may provide quick relief for panic attacks. Second, lorazepam taken t.i.d. may curb anticipatory anxiety, allowing ...
DRYING OUT A NASAL SPRAY ADDICT | ENT | 06-2001
This scenario is so common that it's been given the name amp quot rhinitis medicamentosa. amp quot It's a drug-induced rhinitis secondary to rebound nasal congestion associated with frequent and ...
