Black-and-white ideas don’t fit well in psychiatry, but they sometimes seep into my work nonetheless. There they nestle into some corner of uncertainty, making things a little more comfortable than they ought to be. In this issue, I expunge a few of them, with a little help from our friends.
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We unravel the myths that keep psychiatrists from using disulfiram (Antabuse) in alcohol use disorders. In the right patient, this medication is very effective and far less dangerous than the alternative: continued drinking.
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Antidepressants treat depression, but patients need something more to prevent future episodes. Giovanni Fava describes an evidence-based method that blends medication with psychotherapy in two phases: sequential treatment for prevention of depression.
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Medical notes may never be the same again. The Open Notes policy allows patients to read their record without delay, and nearly prevents doctors from withholding notes in the interest of safety. Here we share tips on how to use this policy to enhance the therapeutic relationship.
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Is genetic testing ready for clinical practice? It depends on which test we’re talking about. In this interview John Nurnberger details the tests to pay attention to on a genetic panel and describes how to use whole exome sequencing (WES) to identify genetic causes of autism and intellectual disability.
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Medications don’t have a good track record in PTSD, particularly in combat related trauma. Here we review two controlled trials where an old standby (mirtazapine) and a hopeful contender (riluzole) come up short.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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