Tag Archives: TCAs

Suicidality: Management in Medical Inpatient Settings

For a patient who survives a recent suicide attempt, the emergency department usually is the first stop for assessment and triage. If the patient is medically cleared, ideally a psychiatrist, but sometimes another mental health professional, evaluates the patient and decides whether psychiatric inpatient or outpatient management is the appropriate disposition. It is important for… Read More »

Alzheimer’s Therapy: Antidepressants

Overview. Major depression affects approximately 15% of Alzheimer’s disease patients. By comparison, 5-12% of the general population aged 15 years or older in the major pharmaceutical markets experience at least one episode of major depression per year. Because depression itself may lead to declines in cognition and function, treatment of depression in Alzheimer’s disease patients… Read More »

Pharmacotherapy of Adult ADHD

Originally conceptualized as a disorder of childhood (), attention deficit hyperactivity disorder (ADHD) is increasingly recognized in adults. attention deficit hyperactivity disorder is estimated to affect 2-9% of school-age children and up to 5% of adults (). Although some investigators question the persistence of attention deficit hyperactivity disorder in adulthood (), long-term controlled follow-up studies… Read More »

Stimulants in the treatment of adults with ADHD

Stimulant treatment of adults with attention deficit hyperactivity disorder can be characterized as follows. Stimulants represent the first-line pharamcotherapy for attention deficit hyperactivity disorder in adults. The two main types of stimulants, methylphenidate and amphetamine compounds, have different effects and are metabolized differently. Methylphenidate does not show up on urine drug screens. Stimulants are not… Read More »

Nonstimulant medications in the treatment of adults with ADHD

Here are some important points regarding nonstimulants in the treatment of adults with ADHD. Tricyclic antidepressants and bupropion are second-line therapies. Antidepressant dosing of the agents appears necessary for attention deficit hyperactivity disorder efficacy. Serotonergic medications do not appear effective in the treatment of core attention deficit hyperactivity disorder symptoms but may be useful for… Read More »

Information about Anxiety Disorders for Patients and Families

Anxiety disorders are a group of disorders that have different causes but share many symptoms. Anxiety disorders are the most common of the psychiatric illnesses. The core symptoms of anxiety disorders are nervousness, worry, and fear. The patient’s symptoms may cause distress and result in some functional impairment. In the spectrum of anxiety disorders, anxieties… Read More »

Pharmacologic Treatment in Children and Adolescents for OCD

Clomipramine (Anafranil) Clomipramine (Anafranil), a tricyclic antidepressant (TCA) and potent serotonin re-uptake inhibitor, was used in the first controlled pharmacologic treatment trial in children and adolescents for OCD. Nineteen pediatric patients (mean age, 14.5 ± 2.3 years) were studied in a 12-week double-blind placebo-controlled crossover study (5 weeks of active medication) (). Doses of clomipramine… Read More »

Pharmacological Treatment of Pain

While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »

Selected Chronic Pain Conditions

Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »

Dissociative [Conversion] Disorders

Description of Medical Condition A sudden change in state of consciousness, identity, motor behavior, thoughts, feelings and perception of external reality to such an extent that these functions do not operate congruently. Many pathologic symptoms can be found, but the patient experiences dysphoria, suffering, and maladaptive functioning. Disorders include: • Dissociative amnesia • Dissociative fugue… Read More »