The Carlat Psychiatry Report

Insomnia is one of the most common comorbidities you’ll see in your depressed and anxious patients. But it is often misunderstood. While the common view is that insomnia is caused by a primary psychiatric or medical condition, it is more accurate to simply say that patients have insomnia and depression at the same time. Insomnia is almost never an isolated problem.

Research has generally found that both antidepressants and psychotherapy offer similar efficacy in the short-term, but that after treatment discontinuation, results are better with psychotherapy.

Sometime in 2013, we’ll presumably be forced to shell out a hundred bucks or so for the fifth edition of DSM. While we do not have the space to review every potential change here, we will cover those of most clinical importance. Free Article!

We know that for many conditions, both medications and psychotherapy work about equally well. Common sense would dictate that there is some final common pathway of neuropsychiatric change underlying the symptomatic improvements we see. But identifying what is happening in a living human brain is extremely tricky.

While psychotherapy remains the gold standard for treatment of post traumatic stress disorder, medications are often used to alleviate the symptoms of the illness.

Currently, lithium is FDA approved for both acute mania and for maintenance bipolar treatment, but not for bipolar depression. Lithium is dirt-cheap and the size of its database for efficacy in bipolar disorder is unmatched by any other medication, although many of these studies are old.