In a study only partially funded by the manufacturer of Provigil (modafinil), 85 patients with bipolar depression, already taking mood stabilizers, were randomly assigned to augmentation with Provigil (N=41) or placebo (N=44).
It was a sorely needed study: compare sibutramine (Meridia) with topiramate (Topamax) in patients with psychotropicassociated weight gain. Sibutramine is generally considered one of the most effective weight loss agents.
In psychiatry, we typically order screening labs on new patients for a variety of purposes, including to rule out medical causes of psychiatric symptoms, to record baseline data before prescribing medications that may lead to lab abnormalities, and to screen for general medical problems. What labs should we order for new patients?
When you are planning to start a patient on medications, what labs should you order at baseline, and what should you order over time? This is quite a different question from whether to do a set of labs at the start of treatment to screen for disease etiology, and it’s an area where I believe we should be much more proactive.
Fibromyalgia is a condition characterized by at least 3 months of widespread pain (both above and below the waist and on both sides of the body) and by the presence of at least 11 tender points (these are the official American College of Rheumatology criteria).
Clinical lore has it that SSRIs are preferable to bupropion for depressed patients who present with anxiety and insomnia. Papakostas and colleagues tested this assumption by obtaining patient data from 10 studies funded by GlaxoSmithKline (makers of brand name Wellbutrin) over the years.