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 […]

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 […]

Important Drug Interactions with SSRI’s 9/28/2017

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 […]

Complementary and/or Alternative Medicine Concerns 10/5/2017

Many people are interested in using complementary and/or alternative medicine (CAM) when they are dealing with physical or mental health concerns. This is sometimes because they are worried about side effects from traditional medical treatments. Sometimes it is because they are not seeing the relief they expected from the traditional treatment prescribed by their medical […]

Supported vs. Unsupported Off Label Prescribing 10/12/2017

Off-label prescribing is a central and common source of treatment throughout medicine, particularly psychiatry. Lack of FDA indication does not equate to lack of evidence. It is therefore important to distinguish between supported and unsupported off-label prescribing practices. Supported off-label prescribing is the use of medications for a non-FDA-approved indication with clinical literature to support […]

Positive Mental Health: A Better Outcome Measure for Remission? 10/26/2017

Symptom remission has been traditionally used as the outcome measure for remission in mental health disorders. This is how remission is defined in clinical trials. But is that what patients actually perceive as remission or what they want from treatment? When this has been assessed further, patients indicate what they are looking for with remission […]

Prazosin: Effective or Not? 2/22/2018

Prazosin (brand name = Minipress) is an alpha agonist medication that has long been used for hypertension and benign prostatic hyperplasia (BPH). It has anecdotally been found to be helpful for nightmares and sleep disturbance in patients with Post Traumatic Stress Disorder (PTSD) and has become increasingly used in veterans with PTSD. The starting dose […]