I examined results of multiple meta-analyses published in top tier, peer reviewed journals. The findings were clear and consistent: effect sizes for psychodynamic psychotherapy are at least as large as those reported for other therapies that are promoted as “empirically supported” or “evidence based.” Also, the benefits of psychodynamic therapy are lasting. Patients not only improve, but continue to improve even after therapy ends.
Using combination antipsychotic treatment has become more common over the years, presumably reflecting a common sense theory that in refractory patients, two medications might be more effective than one. But studies thus far of the practice have been small and inconclusive.
Addiction, not surprisingly, behaves like other mental disorders. No one is too shocked when a patient with a history of major depression develops a new episode. The same is true of alcoholism: it often follows a relapsing-remitting course characterized by partial remission.
Alcoholism and anxiety go hand in hand. The extent of this comorbidity is clear from the numbers: as many as 45% of patients with alcohol disorders meet diagnostic criteria for a co-occurring anxiety disorder.
Over 20 years ago, at the time of planning for DSM-IV, alcohol abuse was thought to be a milder form of alcohol dependence, or perhaps even something separate involving more episodic, as opposed to daily or near daily, drinking. However, new research has proven this is not so.
Most of us who prescribe benzodiazepines (BZs) have a love-hate relationship with them. On the one hand, they work quickly and effectively for anxiety and agitation, but on the other hand, we worry about sedative side effects and the fact that they can be difficult to taper because of withdrawal symptoms.