It’s easy to order labs—it’s the interpretation that’s difficult. In this article, we’ll review some of the more common labs you are likely to order as psychiatrists and give you some tips on interpreting them, as well as discussing what (if anything) you should do when a lab is abnormal.
Having a heart attack is depressing. Systematic reviews have found that depression increases the risk of future development of heart disease by 64% (Wulsin et al., Psychsom Med 2003;65: 201-210). But what do these facts mean in the terms of treatment?
Dr. Yohanan, as an internist specializing in geriatric medicine, you see many patients with “metabolic syndrome.” But there is a great deal of confusion out there as to what metabolic syndrome actually is, and whether that term remains useful.
Over the past several months, we have reviewed several articles that have endorsed cognitive behavioral therapy for the treatment of depression. In some cases, CBT has appeared even more effective than antidepressants, at least for the long-term prevention of relapse. But now, along comes a paper that appears to show that CBT isn’t particularly effective after all.
You may have already seen journal advertisements for Deplin (www.deplin.com), a formulation of L-methylfolate produced by a company called Pamlab LLC. Touted as an “antidepressant food,” Pamlab claims it is “a first choice in depression augmentation.”
Suddenly, psychopharmacology has apparently become “all Seroquel, all the time.” AstraZeneca’s atypical antipsychotic (generic name, extended release quetiapine), which already had FDA approval for schizophrenia and bipolar mania, recently won approval for bipolar depression, and is now pushing for indications in depression and generalized anxiety disorder (GAD).
Dr. Kesselheim, you and your colleagues just published an intriguing paper on generic medications (Kesselheim AS et al., JAMA 2008;300(21):2514-2526). I’d like to start by asking you to explain the generic approval process. What does the FDA do to give its seal of approval to generic medications?