Tatiana Tarasoff was a student at the University of California at Berkely in the late 1960s, and she met Prosenjit Poddar, a graduate student from India, at a folk dancing class.
While few psychiatrists specialize in eating disorders, most of us see patients with anorexia or bulimia from time to time. It’s hard to keep up on the latest literature when we see such patients rarely. As you’ll read in this article, eating disorders are still among the most challenging treatment issues in psychiatry.
Dr. Bulik, I first learned about your work when I reviewed your book, Runaway Eating, which I rated as the best book for patients on eating disorders. I know that one of the reasons that you gave the book that title is that many patients don’t quite fit the conventional diagnostic categories of anorexia nervosa and bulimia nervosa.
Recall that in October of 2003, the FDA issued a public health advisory about the possibility that antidepressants cause suicidal ideation in children and adolescents.
Most psychiatrists have at least heard of pramipexole (Mirapex) by now, and many of us have actually prescribed it. The Journal of Clinical Psychiatry recently published a short and sweet review of its potential uses in psychiatry.
Researchers randomly assigned 202 depressed older adults (average age, 53 years old, 75% women) to four conditions: supervised group exercise 3 times a week, at-home aerobic exercise (unsupervised), sertraline, 50-200 mg/day, or placebo.
In surveys, it’s clear that most psychiatrists practice as unimaginatively as I typically do, meaning that their drug of first choice for most depressed patients is an SSRI (Petersen T, et al., Prog Neuropsychopharmacol Biol Psychiatry 2002; 26:177-187).
How high can we safely dose common psychotropics? Given the poor performance of medication combinations in recent studies, it’s time for a close look at the safety and efficacy of raising doses, sometimes known as “dose optimization.”