Sleeping Pills: Which Ones for Which Patients?

Topics: Antidepressants | Antipsychotics | Benzodiazepines | Hypnotics | Mood Stabilizers

Insomnia is one of the most common comorbidities you’ll see in your depressed and anxious patients (Becker PM and Sattar M, Curr Treat Options Neurol 2009;11(5):349–357). But it is often misunderstood. Over the last several years there has been a shift in how we conceptualize insomnia co-occurring with psychiatric disorders. While the common view is

The Carlat Guide to Medications Used for Insomnia

Topics: Antidepressants | Antipsychotics | Benzodiazepines | Hypnotics | Mood Stabilizers | Natural Medications

This handy table lists the medications most often used to treat insomnia. Click here to see table

FDA Warning: High Doses of Citalopram May Be Dangerous for the Heart

Topics: Antidepressants

St. John’s Wort or Celexa for Minor Depression?

Topics: Antidepressants | Depressive Disorder | Natural Medications

Combined Antidepressants No More Effective than Monotherapy

Topics: Antidepressants | Depressive Disorder

Side Effect Management

Topics: Antidepressants | Free Articles

Let’s face it, dealing with side effects is not high on the list of “things we like most about psychiatry.” In this issue’s interview, Mark Zimmerman describes a study showing just how unenthusiastic we tend to be in ferreting out our patients’ side effects. The bottom line of his study was that patients on antidepressants reported 20 times mo

Serotonergic Antidepressants and Abnormal Bleeding

Topics: Antidepressants

Do SSRIs and SNRIs cause bleeding? Several review articles have been published about it, and patients are beginning to ask us about it. What’s the scoop? First, let’s talk mechanisms. Only a minority of serotonin receptors live in the brain, and in fact platelets contain more than 90% of circulating serotonin. Serotonin promotes platelet aggregation

Four “New” Antidepressants. Or Are They?

Topics: Antidepressants | Free Articles

What’s new in antidepressant treatment? Not much. Some existing antidepressants have received new FDA indications. For example, duloxetine (Cymbalta) was approved for generalized anxiety disorder in 2009 and for chronic musculoskeletal pain in 2010. Also in 2009, quetiapine extended release (Seroquel XR) was approved as an adjunctive treatment for maj

Working With Primary Care Physicians in Treating Depression

Topics: Antidepressants

Black Box Redux: SSRIs and Risk of Suicide

Topics: Antidepressants | Child Psychiatry

It has been eight years since child psychiatry first began to deal with controversy about SSRIs and their potential to prompt suicidal behavior in youth. The controversy was prevalent in the popular press from the time of the introduction of SSRIs, leading the FDA to state in 1991 that “there is no credible evidence of a causal link between the use of

Long-Term Exercise May Extend Remission in Depression

Topics: Antidepressants | Depressive Disorder

SNRIs Likely No Better than SSRIs for Depression

Topics: Antidepressants | Dementia

Antidepressant Treatment in Pregnancy: An Update

Topics: Antidepressants | Women's Issues in Psychiatry

The last time TCPR covered the topic of psychotropics in pregnancy was less than two years ago, in February of 2009. Since then, however, some new treatment guidelines have been published, and they appear to be useful to clinicians—a nice change from most guidelines that are so all-inclusive that they might as well be called textbooks. These new gu

Current APA/ACOG Recommendations for Managing Depression during Pregnancy in Three Scenarios

Topics: Antidepressants | Depressive Disorder | Women's Issues in Psychiatry

Considering pregnancy, taking ADs If moderate to severe depressive symptoms, delay conceiving, continue and optimize meds until stable If in early remission (started AD less than 6 months ago), delay conceiving, continue meds until stable If in full remission, but history of both recurrence and non-response to psychotherapy, continue meds

The Motherisk Program

Topics: Antidepressants | Women's Issues in Psychiatry

Antidepressant Response Not Linked to Serotonin Transporter Gene

Topics: Antidepressants | Depressive Disorder | Research Updates

Zoloft Ineffective for Depression in Heart Failure

Topics: Antidepressants | Depressive Disorder

SAMe May be Effective Augmentation for Antidepressants

Topics: Antidepressants | Depressive Disorder | Natural Medications

Treating Depressed Adolescents Who Have Attempted Suicide: Results of the TASA Trial

Topics: Antidepressants | Child Psychiatry | Depressive Disorder

Historically, research into the effectiveness of antidepressants for depressed youths has been unimpressive. In the 1980s, Joaquim Puig-Antich studied the then-popular tricyclic antidepressants and found no evidence to support their effectiveness (Puig-Antich J, Arch Gen Psych 1987;44(1):81–89). To make matters worse for tricyclics, in the 1990s sever

Editor’s Perspective: Do Antidepressants Work in Kids?

Topics: Antidepressants | Child Psychiatry | Depressive Disorder

The extent to which antidepressants are effective for pediatric depression continues to stir controversy, as discussed in this issue of CCPR. Parents, the media, and even our young patients themselves sometimes tell us that our medications don’t work and may well be dangerous. And yet, as clinicians, we know of many children who have apparently benefi