Depression | Psychiatry | 02-2012
The use of omega-3 fatty acids for the treatment of depression is not a recommendation in depression treatment guidelines. A very thorough meta-analyses published last year, which excluded confounding factors ...
Mother’s little helper | Psychiatry | 04-2011
All psychotropic medications cross the placenta, are present in amniotic fluid and can enter human breast milk. Therefore the decision about the use of antidepressant medication during pregnancy or breastfeeding ...
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 ...
Drug holiday | Psychiatry | 02-2011
Research studies require a 6-week trial on a therapeutic dose of an antidepressant in order to determine whether the medication is efficacious. If you take this as your yardstick, a ...
Best antidepressant with drinks | Psychiatry | 05-2010
There are no anti-depressants which stand out from others in patients with alcohol abuse. As with anyone suffering from depression, you should start with an SSRI. Recent studies have shown ...
Anti-depressant bias | Psychiatry | 05-2010
Treatment refusal is a difficult problem that s somewhat different from simple non-compliance. The reasons may be numerous and they must be explored. Common reasons for not wanting to use ...
Antipsychotics for depression? | Psychiatry | 03-2010
More and more studies are being done on the use of antipsychotics in major depression. The vast majority of these are on the use of atypicals as an augmentation strategy ...
Turn off the tube | Psychiatry | 03-2010
This has been a matter of concern for some time. It s estimated that kids watch an average of 3 hours of TV a day and up to 6 hours ...
Eye movement therapy for traumatic stress | Psychiatry | 02-2010
EMDR, or eye movement desensitization and reprocessing therapy, was initially developed by Francine Shapiro to treat PTSD. The method uses bilateral stimulation visual tracking, auditory or tactile stimulation while the ...
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 ...
Quitting tobacco can be depressing | Psychiatry | 10-2009
Major depression and dysthymia are common illnesses. Incidence among the general population range from 10 15 , some say even higher. There does appear to be a link between smoking ...
Vitamin D for a sunny mood | Psychiatry | 09-2009
There are only a few studies that have looked at the relationship between vitamin D and depression, and very few trying to establish whether vitamin D supplementation is helpful. There ...
Stimulants for the overstimulated? | Psychiatry | 09-2009
ADHD is associated with an elevated risk for substance abuse disorders as well as an earlier onset. There s a higher incidence of substance use disorders SUDs in samples of ...
Demon weed? | Psychiatry | 08-2009
There is an increased association between regular cannabis use and psychosis. Whether this is a causal relationship, and if so what kind, is a question that has not been resolved. ...
How antidepressants can ‘flip’ unipolar patients | Psychiatry | 06-2009
It s long been assumed that antidepressants can flip patients into mania hypomania. I don t think this is disputed. There isn t uniform agreement, however, about whether this is ...
Serial sick note requests | Psychiatry | 05-2009
This is a particularly difficult question in a medical system where many particularly outside urban areas don t have a family doctor. A simple response would be to refer them ...
Long-term shock treatment | Psychiatry | 05-2009
Indications for maintenance ECT M-ECT as developed by the American Psychological Association Task Force Report on the Practice of Electroconvulsive Therapy are history of ECT-responsive illness either a patient preference ...
Sleepwalking not a disaster | Psychiatry | 04-2009
While sleepwalking episodes aren rsquo t rare 2-3 , nightly sleepwalking occurs in only 0.4 of the population. Sleepwalking or somnambulism is classified as a parasomnia occurring in non-REM sleep. ...
Unsafe at any speed? | Psychiatry | 04-2009
This is a complex problem and more difficult with psychiatric illness than some other medical illnesses such as seizure disorder. Most patients who are stable on maintenance therapy should be ...
Vitamin D for SAD? | Psychiatry | 01-2009
Generally, populations that live in northern climates suffer from vitamin D deficiency in winter. A study comparing vitamin D levels in those with seasonal affective disorder versus the general population ...
Bipolar disorder easier to treat | Psychiatry | 01-2009
A recent collaborative study with over 600 subjects on the relationship between bipolar disorder and borderline personality disorder BPD has established that although there appears to be a link between ...
Can psychiatry work by video link? | Psychiatry | 12-2008
There are case reports of telehealth psychotherapy, as well as a few review papers, that report on telepsychiatry in all of its uses. By far, the most common use is ...
Levodopa an option in myoclonic dystonia | Neurology | 12-2008
Myoclonus-dystonia syndrome MDS is a genetically heterogeneous condition characterized by a combination of lightning-like jerks and sustained muscular contractions that usually begin in childhood or adolescence. It most often localizes ...
Avoid the temptation to over-prescribe ADHD meds | Psychiatry | 11-2008
If the teacher is pushing you to prescribe more stimulants for a child, he or she obviously feels that the treatment isn t working. The best thing to do in ...
What to monitor when prescribing antipsychotics | Psychiatry | 08-2008
Each of the various atypical antipsychotics has a somewhat different side effect profile, so the type of tests to do, lab or otherwise, will vary. For example, olanzapine and clozapine ...
Rural docs blur personal boundaries | Psychiatry | 06-2008
The only way to ideally maintain boundaries in a rural community is to either have no patients or have no friends. Since neither of these options is possible, the rural ...
Prescribe exercise to lift depression | Psychiatry | 05-2008
In many cases, the results are quite impressive, i.e. the antidepressant effects are as good as medication. I'd suggest continued use of both.Although there haven't been very many rigorous studies ...
Saving sexual function while on SSRIs | Psychiatry | 02-2008
Atomoxetine is a selective norepinephrine reuptake inhibitor SNRI , initially marketed as an antidepressant, but now used for patients with ADHD. There are no reports in the literature about the ...
What gifts is it OK to accept? | Law | 12-2007
Your question asks when does a gift of appreciation for services rendered become payment or a bribe in order to receive future preferential treatment This is considered an especially serious ...
Withdrawing meds in advancing dementia | Neurology | 11-2007
Cholinesterase inhibitors -- donepezil, galantamine and rivastigmine -- can be modestly effective in ameliorating cognitive and behavioural manifestations of dementia. It may be difficult to decide when the drug is ...
Do lamotrigine or pregabalin prevent migraine? | Neurology | 09-2007
Neither of these drugs carries an official indication for migraine prophylaxis. Even off-label, neither is anywhere close to a first-line treatment for migraine. Since you're asking, though, let's take a ...
La lamotrigine ou la prégabaline préviennent-elles la migraine ? | Neurology | 09-2007
Ni la lamotrigine ni la pr amp eacute gabaline n'ont d'indication officielle pour la prophylaxie de la migraine. M amp ecirc me hors indication, ces agents ne conviennent pas au ...
Don't forget about transient global amnesia | Neurology | 06-2007
TGA is a fascinating condition. Once seen, it's never forgotten by the examining physician and never remembered by the patient. A previously well person, usually over 50, suddenly develops a ...
Can cataracts act as SAD in the elderly? | Geriatrics | 05-2007
Data on the prevalence of SAD is limited. The average age of onset seems to be in the third decade and the risk decreases with age. After the age of ...
Premature ejaculation in teenagers | Urology | 04-2007
In the absence of any other complaint, for instance, urinary symptoms suggesting prostatitis elaborate workup is unnecessary. Varying degrees of premature ejaculation are universal in youths. If normal life is ...
Does zolpidem induce sleepwalking? | Clinical Pharmacology | 10-2006
Undesired behaviours are a potentially serious side effect of many psychoactive medications. While they're generally uncommon on the whole, and in particular in most sedative hypnotics, they're very troubling when ...
What to do about severe belching | Gastroenterology | 10-2006
Severe belching in the absence of other symptoms such as acid regurgitation or heartburn is most likely functional. Occasionally, gastroesophageal reflux disease may be responsible, but in your patient, lack ...
Wernicke's disease: the bane of alcoholics | Neurology | 09-2006
Wernicke-Korsakoff syndrome WKS can be a devastating consequence of thiamine deficiency. The acute presentation of Wernicke's is typically a triad of ataxia, abnormal extraocular movements and disturbed mentation or consciousness. ...
Schizophrenia: are two meds better than one? | Psychiatry | 04-2006
The new guidelines for the treatment of schizophrenia put out by the amp lt i amp gt Canadian Journal of Psychiatry amp lt i amp gt in November 2005 clearly ...
Shedding light on winter blues | Psychiatry | 03-2006
There's a review of research on light therapy in a recent journal of psychiatry Golden RN et al. amp lt i amp gt Am J Psychiatry amp lt i amp ...
Probing into the sigh | Respirology | 02-2006
A sigh is defined as a breath with a larger tidal volume than the surrounding breaths. Occasional sighs are common and are felt to occur to prevent normal atelectasis. There's ...
Is low magnesium a cause for concern? | Rheumatology | 02-2006
In the absence of significant malabsorption or clinically relevant gastrointestinal, liver or renal disease, the likelihood that such minor abnormalities on laboratory testing are of any clinical significance is practically ...
Divalproex: is rising serum ammonia a concern? | Nephrology | 12-2005
Elevated serum ammonia levels may occur in patients taking the valproate family of therapy, which includes divalproex, despite normal liver function tests. In addition, the reaction may indicate an underlying ...
Evidence for St. John's wort | Psychiatry | 12-2005
Until recently, the evidence in favour of St. John's wort hypericum extract in the treatment of depression suggested that it was effective in mild to moderate depression, but not in ...
Do childhood fears reflect anxiety disorder? | Pediatics | 09-2005
Phobias are very common in childhood amp amp 151 fear of storms, going to bed in the dark, etc. They're not usually part of a generalized anxiety disorder and can ...
How ADHD meds match up | Psychiatry | 08-2005
The combination drug amphetamine dextroamphetamine has been taken off the market in Canada, but not the U.S. The Canadian Psychiatric Association's guidelines committee for ADD ADHD has done a thorough ...
The skinny on caffeine | Endocrinology | 06-2005
I refer you to the paper in the amp lt i amp gt Annals of Internal Medicine amp lt i amp gt that indicates that coffee and caffeine intake lowered ...
Dreamy interpretations | Psychiatry | 06-2005
Dreams occur during rapid eye movement REM sleep. While traditional analysts see them as resulting from the mind's attempt to resolve inner conflicts and deal with emotions, others view them ...
Fetal alcohol syndrome: short diagnosis | Psychiatry | 05-2005
Alcohol ingested during pregnancy may be the most prevalent cause of cognitive impairment in newborns. The severity of the problems appears to be dose related. Fetal alcohol syndrome includes growth ...
Which anticonvulsants best stabilize mood? | Psychiatry | 05-2005
A number of second- and third-generation anticonvulsants are currently used in psychiatry. Carbamazepine and valproate appear to be effective in the treatment of acute mania while carbamazepine and lamotrigine are ...
Clozapine: at the heart of side effects | Cardiology | 01-2005
According to the CPS, tachycardia may be observed in 25 of patients on clozapine and may be sustained. The average increase in pulse rate is 10-15 beats per minute. This ...
Update on atypical facial neuralgia | Neurology | 12-2004
Patients presenting with facial pain may be displaying one of several conditions including atypical facial pain, atypical odontalgia, trigeminal neuralgia, trigeminal neuropathy, glossopharyngeal neuralgia, geniculate neuralgia, burning mouth syndrome, temporomandibular ...
Are benzodiazepines safe with CPAP? | Respirology | 12-2004
The best treatment for sleep apnea -- a disorder that can lead to an increased incidence of sudden death, arrhythmias, hypertension, etc. -- is the CPAP mask. It often takes ...
Fibromyalgia and 5-HTP | Rheumatology | 10-2004
Presently, we don't consider 5-HTP useful in treating fibromyalgia. LR see our psychiatrist's response to this question in the psychiatry category
Psychotherapy effect seen on PET scans | Psychiatry | 05-2004
Cognitive behaviour therapy CBT relieves depression by improving positive thinking and questioning and altering negative cognitions. It seems to raise the levels of neurotransmitters that are deficient in this condition ...
HRT for psychosis worsening after menopause | Obstetrics Gynecology | 09-2003
There's actually been a lot of research lately into psychiatric relapses during times of hormonal changes puberty, postpartum, premenstrual and peri postmenopause . It appears that, in some women, HRT ...
Tests for early diagnosis of Alzheimer’s | Neurology | 05-2003
Early diagnosis of Alzheimer s disease or any dementia begins with a high index of suspicion. A general clinical evaluation, looking for evidence of underlying metabolic disturbance, as well as ...
Do antidepressants affect cortisol in depression? | Endocrinology | 12-2002
Our endocrinologist responds I'm not aware of a specific effect of antidepressants on morning cortisol levels. Depression, however, can lead to a biochemical pseudo-Cushing's syndrome with elevation of serum cortisol ...
Can triptans and SSRIs be combined? | Neurology | 11-2002
Serotonin syndrome can present with a myriad of symptoms, including mental status and behavioural changes, tremor, weakness, hyperreflexia, myoclonus and autonomic symptoms such as fever chills and diarrhea. The combination ...
FIBROMYALGIA; IS IT PHYSICAL OR EMOTIONAL? | Rheumatology | 10-2001
Fibromyalgia is considered to be a pain amplification disorder. There's continued interest in determining whether this has a true organic basis, and we don't want to dismiss this possibility. But ...
DEMENTIA: WHICH IS WHICH? | Geriatrics | 12-2000
Lewy body-related dementia is increasingly recognized as an important cause of dementia -- the second most frequent cause after Alzheimer's disease. Differentiating the two is important since early studies suggest ...
