On November 20, 2007, the FDA issued an “early communication” warning about possible dangerous side effects of Chantix (varenicline), a new smoking cessation agent that affects brain nicotine receptors. Several cases of new-onset depression, suicidal ideation, and aggressive or erratic behavior have been reported via the Medwatch program.

Dr. Fink, recently you and your colleague, Michael Taylor, reviewed the latest studies of electroconvulsive therapy in patients with major depression in JAMA (Fink M and Taylor MA, JAMA 2007;298(3):330-332). I thought we might start by talking about ECT efficacy. How effective is it?

After reading these articles, you should be able to…

Clearly, sleeping pills work; the more relevant issue is whether there are any significant differences among them, and whether we should pony up 3 dollars per pill for the Maserati medications or just 3 cents per pill for perfectly adequate Civics.

Four questions for a quick initial evaluation of insomnia.

On February 8, 2007 the model and actress Anna Nicole Smith was found dead in her hotel room at the Seminole Hard Rock Hotel in Florida.

You wrote an excellent book on non-pharmacological approaches to insomnia, and I’d like to go over some of the techniques you suggested. What are some practical techniques that psychiatrists can use in the context of short visits with patients?

After reading these articles, you should be able to…

When it comes to legal issues, prevention is by far the best medicine. In this article, we will talk about good forensic habits that will protect you from certified letters signed by attorneys. Much of this advice is gleaned from that classic textbook, Clinical Handbook of Psychiatry and the Law (Gutheil and Appelbaum, Lippincott Williams and Wilkins, 3rd ed., 2000).

When HIPAA first came out, the big concern was that it would limit the release of psychiatric information and would place barriers to being able to talk to other members of a patient’s treatment team. But it turns out that HIPAA actually had the opposite effect in many ways.