Tag Archives: Thyroxine

Anxiety Secondary to General Medical Conditions

Many medical problems have been reported to cause anxiety, but their significance is in some cases uncertain due to reporting bias and lack of controlled studies. Nonetheless, it is important for the psychosomatic medicine physician to consider medical causes of anxiety when evaluating an anxious patient. It is particularly important to evaluate medical causes when… Read More »

Theories of drug action in medicine

Historians Edmund Pellegrino and Charles Rosenberg have described the history of the modern idea of a disease and of specific treatments. In contrast to the older ‘humeral’ notion of disease as a general state of bodily imbalance, the modern scientific view emerged during the late 19th and early 20th century. According to this latter view… Read More »

Which drugs is most likely to lead to overt hypothyroidism?

Which medication, when given to patients with preexisting treated hypo-thyroidism, is most likely to lead to overt hypothyroidism? A. Lamotrigine (Lamictal) B. Carbamazepine (Tegretol) C. Phenytoin (Dilantin) D. Divalproex sodium (Depakote) E. Gabapentin (Neurontin) The answer is B. Enzyme-inducing antiepilepsy medications, including carbamazepine (Tegretol) and oxcarbazepine (Trileptal), can reduce serum thyroid hormone concentrations through increased… Read More »

General Guidelines for Treatment for Mood Disorders in Children and Adolescents

How long to treat? Clinically a positive response from medication is frequently reported during the first 2 weeks, especially if the child or adolescent is going to benefit positively from the medication. An initial report of a slight lifting of mood is encouraging. In those who respond (typically 60-70 per cent of youngsters) medication should… Read More »

Side Effects Of Lithium

Lithium continues to serve as the gold-standard mood stabilizer and a model for other agents being explored for their possible mood-stabilizing properties. Despite its narrow therapeutic index, lithium remains an important treatment for bipolar disorder. Adverse reactions to lithium that occur in >10% of patients include polydipsia, nausea, diarrhea, abnormal taste, and tremor. Less common… Read More »

Rapid Cycling

Bipolar disorders are characterized by elevated morbidity and mortality. Although pharmacotherapy can positively influence the course of the disease, recurrence has been estimated in a range between 10% and 30% in the case of perfect compliance to prophylactic therapy. In some patients, the course of the disease assumes characteristics of elevated cyclicity with a —… Read More »

Pharmacological Treatment Of Rapid Cycling

The first treatment intervention for rapid cycling should always be the assessment (and treatment) of possibly underlying medical conditions such as hypothyroidism or alcohol and drug abuse. Furthermore, a careful evaluation of medication history can yield important information on a possible correlation between drug treatment and consecutive rapid cycling. Lithium Salts Rapid cycling seems to… Read More »

Mood Stabilizing Medications in the Treatment of Psychotic Disorders

Mood Stabilizing Medications in the Treatment of Psychotic Disorders of Children and Adolescents, Other Treatments, and Alternative Treatments For a variety of reasons, other medications are added frequently to the psychopharmacological treatment of chronic psychotic conditions in children and adolescents. Among these, mood stabilizers (valproate, lithium, lamotrigene, and others) play a significant role in the… Read More »

Hyperprolactinemia

Predictable, Rather Common, Potentially Serious Prolactin is secreted episodically (with peak levels at night and through levels at noon). Prolactin release is inhibited by dopamine released from the hypothalamus. Stress, exercise, and hypoglycemia may increase the prolactin levels. Estrogens decrease prolactin response to dopamine and increase the response to TSH. Insulin induces prolactin secretion. Prolactin… Read More »