Opioid drugs represent one of the great triumphs of medicine, because they are extremely effective at relieving pain. Since the 1960s, multiple forms of synthetic opioids have been introduced, including such wellknown drugs as hydrocodone (Vicodin) and oxycodone (Percocet, Oxycontin).
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If you are a typical psychiatrist practicing in a setting other than a substance abuse clinic, chances are good that you rarely order drug testing on most of your patients. But should you be doing this more?
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Motivational interviewing is really a way of talking to people that calls forth their own motivations for change. Instead of telling them that they need to change, it’s a way of encouraging them to want to change.
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In 2005 and 2006, two trials showed a substantial advantage for quetiapine (Seroquel) over placebo for bipolar depression. Based on these trials, which were known by the acronym BOLDER I and II, quetiapine received an FDA indication for the condition.
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The early detection of schizophrenia is a hot topic in psychiatry. If we could detect schizophrenia during the “prodromal” phase, before overtly psychotic symptoms became problematic, perhaps early intervention could prevent or delay the onset of full-blown schizophrenia.
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SSRIs are the mainstay of medication treatment for social anxiety disorder (SAD), while cognitive behavior therapy (CBT) is at least as effective. Oddly, combined SSRI and CBT treatment has not clearly outperformed each treatment alone in controlled trials. But a new study implies that MAOIs combined with CBT may be particularly effective.
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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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