Bipolar Disorder in Primary Care Part 2: Treatment 7/20/2017

It is important that primary care providers have a basic level of understanding of the medications used to treat bipolar disorder as they may be called upon to help maintain and monitor ongoing medication treatment or they may be the first person to identify the condition in a patient. Regardless of the context, the primary […]

Is This Bipolar Disorder? 7/27/2017

Case Presentation: A 24 year old female who meets criteria for a major depressive episode was started on fluoxetine (Prozac) and titrated up to 20mg per day. Her presenting depressive symptoms included: sad mood, hypersomnia, fatigue, poor concentration, and crying spells for 1 month. Her symptoms were and still are impacting her functioning at work. […]

Tic Disorders 8/3/2017

A tic is defined as a sudden, rapid, non-rhythmic, repetitive movement. There are motor tics and vocal tics. Examples of motor tics include: eye blinking, grimacing, nose wrinkling, tongue protruding, shoulder shrugging, head rolling and body writhing. Examples of vocal tics include: throat clearing, sighing, smacking sounds, sucking sounds, coughing and hiccupping. Sometimes it can […]

Understanding Different Mental Health Therapies 8/10/2017

Psychotherapy is a mainstay treatment for many mental health conditions. In the primary care setting, it is helpful to have a basic understanding of the common therapies that might be recommended to help guide patients as they are accessing treatment. Cognitive Behavioral Therapy (CBT): This is one of the most common types of psychotherapy and […]

Motivational Interviewing 8/17/2017

Motivational interviewing (MI) is a technique that can be applicable to all clinical settings including primary care. MI is defined as “a person-centered, goal-oriented approach for facilitating change by exploring and resolving ambivalence” (Miller 2006). It can be useful in situations when a patient’s behavioral choices negatively impact his/her health condition – examples include smoking, […]

Cannabis-Induced Psychosis 8/24/2017

As cannabis use increases, with easier access and recent legislation, there has been significant emerging evidence for cannabis-related risks. It is important for primary care providers to be aware of these, because a primary care office may be the place where patients present with these negative effects and educating patients about the potential risks is […]

CBT for Insomnia 8/31/2017

Insomnia is one of the primary presenting complaints in the primary care setting. It can be the only symptom the patient is reporting or it can be part of a constellation of symptoms related to a medical cause or mood or anxiety disorder. That, of course, has to be investigated first. Once that has been […]

Interactions: BCP’s and Psychotropic Meds 9/7/2017

Contraceptives are commonly used in women of childbearing age, many of who are also taking psychotropic medications for mental health concerns. It is important to be aware of the interactions between contraceptives and certain psychotropic medications as well as the psychiatric side effects of contraceptives themselves. Contraceptives have synthetic estrogen, progesterone or a combination of […]

Pharmacogenetic Testing in Psychiatry 9/14/2017

There has been increasing interest in the use of pharmacogenomic testing to help with medication choice when treating psychiatric conditions. Advocates are claiming they can be helpful for personalizing prescribing, improving outcomes, and reducing costs. Some of these commercial tests are now covered by some insurance companies. While clinicians would love to have a way […]

Premenstrual Dysphoric Disorder (PMDD) 9/21/2017

Approximately 75% of women experience premenstrual changes – increased irritability, tension, depressed mood, breast tenderness and bloating – commonly referred to as premenstrual syndrome (PMS). About 5-10% of women experience moderate to severe premenstrual mood symptoms known as premenstrual dysphoric disorder (PMDD). PMDD includes depressed mood, irritability, mood lability, anxiety, anger, difficulty concentrating, and insomnia […]