Tapering patients off benzos (BZs) is certainly more art than science, but TCR has unearthed a surprising number of studies that help bring more science into the process. These studies are, by modern standards, ancient, because research follows the money, and there’s no longer much money to be made in benzodiazepines. So file these studies under “oldies but goodies”!

Whether one should prescribe BZs to patients with a history of alcoholism is a controversial question, and one that tends to polarize psychiatrists into the “purists” versus the “realists.” Most alcoholics take BZs at some point in the course of their disorder, sometimes illegitimately, but often as part of a bona fide treatment program.

When Aricept (donepezil) was first approved by the FDA in 1996 for the treatment of Alzheimer’s Dementia (AD), there was an almost euphoric sense that we were finally beginning to make progress in treating a previously untreatable disease.

In 2003, the FDA approved Namenda (memantine) as a treatment for moderate to severe Alzheimer’s Dementia (AD). Backed by the legendary marketing expertise of Forest Labs, the medication has become remarkably popular, gradually eating into the market share of the cholinesterase inhibitors (CIs). The question, as always, is whether this popularity is justified by the data.

As longtime TCR readers with good memories know, Alois Alzheimer (1864-1915) was a German neurohistologist who, in 1906, reported the phenomenon of plaques and tangles in the brain of a 51 year-old woman who had died after five years of progressive dementia (TCR October 2003).

By definition, a “progress note” should be a written record of the degree of our patients’ progress. We can all agree on this much, and this is pretty much where the agreement ends.

Should we use rating scales in our clinical practices? And if so, which ones? Do the benefits of scales compensate for the extra time it takes to administer them?

In this month’s interview, Dr. Brendel does a wonderful job explaining what psychiatrists need to know in order to become HIPAA-compliant. In this article, TCR really gets down and dirty with HIPAA, taking you by the hand to tell you exactly what to do, what forms to use, and where to get them.

Oxford Health Plans (a subsidiary of UnitedHealthcare) recently shocked the psychiatric community by doing a retroactive audit of psychiatric services, and demanding repayment of up to tens of thousands of dollars of reimbursements from some physicians based on insufficient documentation.

Okay, we’ll lay our cards on the table right away. Rarely has TCR been as annoyed by the launch of a new medication as we are by the launch of Equetro. The last time the pharmaceutical industry embarrassed itself this much was when Eli Lilly launched “Sarafem,” calling it a “new” medication for PMDD when it was simply Prozac with a new name and a new (pink) color (see TCR Vol. 2, No. 9).