General Psychiatry - Articles - Page 128

Transcranial Magnetic Stimulation is Approved. Now What?

January 1, 2009

Daniel Carlat, MD

One year ago we reviewed the status of transcranial magnetic stimulation for depression, and concluded with the following TCPR Verdict: “TMS for depression: Approval is highly unlikely.” We were wrong.

The New Brain Devices in Psychiatry: A Brief Review

January 1, 2009

Dhwani Shah, MD

In this issue of TCPR, we focus on TMS (Transcranial Magnetic Stimulation), which has just been approved for treatment resistant depression. There are also other brain devices in various stages of research and development. Here is a quick run-down of four of them.

SSRI Discontinuation Linked to Poor Outcomes

January 1, 2009

Dhwani Shah, MD

Section editor, Glen Spielmans, PhD

Dhwani Shah, MD. Associate Clinical Professor University of Pennsylvania Department of Psychiatry.
Dr. Shah reports no financial relationships with any commercial companies related to this article.

In a naturalistic study, researchers identified 87 patients in an outpatient clinic who had taken SSRIs for depression and who were clinically stable for at least five years. After five years, 27 patients elected to discontinue SSRIs, and 60 elected to continue.

The Role of Etiquette-Based Medicine

January 1, 2009

Glen Spielmans, PhD

Section editor, Glen Spielmans, PhD

Dr. Spielmans has disclosed that he has no relevant financial or other interests in any commercial companies ertaining to this educational activity.

We’ve all been told from time to time that we should mind our manners. A Boston psychiatrist, Michael Kahn, suggests that manners are not limited to dinner parties; rather, he calls for “etiquette based medicine.”

EXPERT Q&A

Practical Issues in Using Transcranial Magnetic Stimulation

January 1, 2009

John O'Reardon, MD

TCPR-January-2009-TMS_JohnO'ReadonMD_Headshot.png

John O'Reardon, MD. Associate Professor of Psychiatry, University of Pennsylvania Health System.

Dr. O’Reardon has disclosed that he has received research grants from Neuronetics, Cyberonics, Cerex Biopharma, and Pfizer, and is on the speaker's bureaus of Eli Lilly and Bristol-Myers Squibb. Dr. Carlat has found that there is no evidence of commercial bias in this educational activity.

Dr. O’Reardon, the FDA recently approved TMS for depression. Can you clarify exactly what this approval was for?

Learning Objectives, Transcranial Magnetic Stimulation, TCPR, January 2009

January 1, 2009

After reading these articles, you should be able to…

Medications for Fibromyalgia

December 1, 2008

Daniel Carlat, MD

Recently, the FDA gave its first two approvals for medications to treat fibromyalgia (FM): first Lyrica (pregabalin) and then Cymbalta (duloxetine). While it is nice that FM is receiving some attention from big pharma, the badge of FDA approval should be taken with a grain of salt.

Cymbalta For Physical Pain in Depression: Fact or Fiction?

December 1, 2008

Glen Spielmans, PhD

It has become increasingly clear that depressed patients quite often suffer from some degree of physical pain, which may adversely impact treatment outcome. Indeed, research suggests that as the pain severity of patients increases, the odds of achieving a successful antidepressant response decreases (Bair MJ et al., Psychosom Med 2004;66:17-22).

Diagnosis and Non-Drug Management of Fibromyalgia

December 1, 2008

Dr. Clauw, you’ve devoted your career to the research and clinical care of patients with fibromyalgia. How do you approach the diagnosis of this illness?