Selective serotonin reuptake inhibitors (SSRIs) are commonly used psychotropic medications to treat depression and anxiety. It is important to be aware of common drug interactions between them and other medications, especially because some SSRIs are competitive inhibitors of a variety of cytochrome P450 liver enzymes. Therefore, they can dramatically increase the blood levels of medications […]

Suicide is now the second leading cause of death in adolescents, in the United States, surpassing homicide and second only behind unintentional injuries (motor vehicle accidents, accidental overdose). This switch occurred because of both a reduction in deaths from homicide and a modest increase in deaths from suicide. Deaths from suicide had been decreasing from […]

With improved and consistent early screening, increasing awareness and broader definitions of Autism Spectrum Disorders (ASD), it is becoming increasingly common for the question of ASD to come up in the primary care setting. Sometimes parents present with their own concerns or concerns brought up by school or daycare providers about their children. Other times, […]

Post Traumatic Stress Disorder (PTSD) is a mental disorder than can occur after a person is exposed to a traumatic event. It is classified as a “trauma and stress-related disorder” in the DSM-5. It used to be thought that PTSD only occurred in combat situations but it is now known that it can occur as […]

Independently, Major Depressive Disorder (MDD) and Attention-Deficit Hyperactivity Disorder (ADHD) are two of the most commonly diagnosed psychiatric conditions. Additionally, many people who have concerns about depression and/or ADHD present first in the primary care setting. It is not uncommon for these disorders to present together, which can have implications for assessment, treatment and outcomes. […]

Perimenopause is defined as the early and late menopause transition stages as well as early menopause. This typically lasts 4-8 years. It has been identified as a vulnerable time for development of depressive symptoms and major depressive episodes. It is therefore important for providers in primary care to be aware of the risk of depressive […]

Antidepressant medications, most commonly the selective serotonin reuptake inhibitors (SSRIs), are frequently prescribed by primary care providers for depression, anxiety, and impulse control disorders. There are some important guiding principles to keep in mind when prescribing these medications, which can dramatically improve a patient’s response to treatment and ensure ongoing safety. Here is a review […]

Insomnia is a common symptom in anxiety disorders, in fact it is a criteria for several DSM 5 Anxiety Disorders. It is important to inquire about sleep disturbance as part of the assessment for anxiety disorders, especially because there is clear evidence that the presence of insomnia in anxiety disorders is associated with increased morbidity. […]

It is not uncommon to see patients who are taking a long list of medications, some for which there isn’t a clear indication for ongoing use. This occurs for medications for physical health as well as mental health. It is important for a prescriber of any medication to assess in a thoughtful manner if it […]

Attention-deficit/hyperactivity disorder (ADHD) affects about one-third of adults who had ADHD in childhood. It can be difficult to diagnose because of the overlap in symptoms of adult ADHD with depression, anxiety and substance abuse, and reliance of the patient’s self report of symptoms. Studies of self-referral suggest that only 1/3 – ½ of adults who […]