Laboratory_testing_in_psychiatry - Articles

Thyroid Augmentation in Bipolar Disorder

April 5, 2022

Tammas Kelly, MD. Clinical Assistant Professor of Psychiatry at the Jacobs School of Medicine and Clinical Associate Professor of Psychiatry at the George Washington University School of Medicine. Author of The Art and Science of Thyroid Supplementation for the Treatment of Bipolar Depression. Dr. Kelly has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

A primer on the role of thyroid augmentation in bipolar depression, including dosing tips, side effects, interactions, and when and if to perform labs. With Tammas Kelly, MD.

Alcohol-Induced Liver Disease

March 1, 2022

Ramon Bataller, MD

Ramon Bataller, MD

Chief of Hepatology, University of Pittsburgh Medical Center, Pittsburgh, PA.

Dr. Bataller has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Bataller reviews the progression of alcohol related liver disease and the clinical signs associated with each from steatosis to steatohepatitis, fibrosis, and cirrhosis. He also walks us through the elements of liver function tests, differentiates markers of inflammation from those of synthetic function, and discusses their clinical utility.

Genetic Testing: What You Need to Know in 2021

June 29, 2021

John Nurnberger, MD, PhD

John Nurnberger, MD, PhD

Vice Chair for Preclinical Research, Department of Psychiatry, Indiana University, Indianapolis, IN. Dr. Nurnberger has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Is genetic testing ready for clinical practice? It depends on which test we’re talking about. In this interview John Nurnberger details the tests to pay attention to on a genetic panel and describes how to use whole exome sequencing (WES) to identify genetic causes of autism and intellectual disability.

EXPERT Q&A

Inflammatory Biomarkers in Depression

February 10, 2020

Andrew H. Miller, MD

Andrew H. Miller, MD

William P. Timmie Professor of Psychiatry and Behavioral Sciences, Emory University, GA Dr. Miller has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Andrew Miller, Vice Chair of Psychiatry Research at Emory University, translates two decades research on inflammation and depression into practical terms, including a low-cost biomarker that may guide antidepressant selection.

Biomarkers of Alcohol Use

October 2, 2019

The newer biomarkers of alcohol use include carbohydrate-deficient transferrin; ethyl glucuronide and ethyl sulfate; and phosphatidylethanol.

Determining Dementia

May 1, 2017

Andrew E. Budson, MD

Andrew E. Budson, MD Professor of neurology and associate director of the Boston University Alzheimer’s Disease Center. Author, Seven Steps to Managing Your Memory: What’s Normal, What’s Not, and What to Do About It, and Memory Loss, Alzheimer’s Disease, and Dementia: A Practical Guide for Clinicians, 2nd Ed Dr. Budson has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

There used to be this rule of thumb that you don’t need to worry about people who are worried about their memory; you need to worry about people who aren’t worried. And that might be true for people with dementia, where there is often a loss of insight. But if you want to pick up memory problems at the earlier, mild cognitive impairment stage, do an evaluation when someone is worried about memory loss.

Pharmacogenetic Testing: An Update

March 1, 2017

Daniel Carlat, MD

Daniel Carlat, MD Publisher The Carlat Psychiatry Report Dr. Carlat has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Given how many essentially equivalent medications we have to choose from, how great would it be to have a test that tells us which drug to prescribe for which patient? Everybody wants personalized medicine, and in some other specialties, such as oncology, this is becoming a standard part of treatment. In this article, we’ll review some of the basics of pharmacogenetic testing and examine in more detail the commercial genetic tests that are currently available.

Understanding Pharmacogenetics Research

March 1, 2017

Rudolf Uher, MD

Rudolf Uher, MD Professor, Department of Psychiatry, Dalhousie University School of Medicine, Halifax, Nova Scotia Dr. Uher has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The basic goal of this kind of research is to try to find an association between a genetic variant and the clinical response to a particular medication. Given that there are dozens of medications to choose from for any given disorder, it would be very helpful if we could do a genetic test that would tell us which drug is the best for a particular patient.

Before You Write That Prescription: Guidelines for Ordering Lab Tests

November 1, 2015

Rajnish Mago, MD

Rajnish Mago, MD Director, Mood Disorders Program, Associate Professor of Psychiatry, Thomas Jefferson University Dr. Mago discloses that he has received research grants from Alkermes, Allergan (formerly Forest Laboratories), Genomind, and Takeda, and that he has been a paid consultant to Genomind, Guidepoint Global, Otsuka, and Lundbeck. Dr. Carlat has reviewed this article and found no evidence of bias in this educational activity.

Mental health clinicians often ask for a single, black-and-white answer to the question: Which lab tests should I order before starting this particular medication? Inevitably, the answer is that it depends. Here are some guidelines that are useful.

Distinguishing Between Medical and Psychiatric Conditions

November 1, 2015

Barbara Schildkrout, MD

Barbara Schildkrout, MD

Assistant Professor of Psychiatry, Part-Time Harvard Medical School, in the Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, Massachusetts. Author of “Unmasking Psychological Symptoms” and “Masquerading Symptoms,” both published by John Wiley and Sons, Inc.

Dr. Schildkrout has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Schildkrout discusses strategies for differentiating medical and psychiatric disorders. The interview covers how mental health professionals can catch red flags for medical conditions such as dimentia and seizures.