These are difficult times for everyone and this special edition of SmartCare E-Weekly is being sent out early to provide guidance on recommended practice with regard to renewing and as needed adjusting psychotropic medications for patients in the face of the constraints of the health emergency. SmartCare’s on demand provider line (858) 880-6405 is and […]

Managing Psychotropic Medications During the Coronavirus Emergency These are difficult times for everyone and this special edition of SmartCare E-Weekly is being sent out early to provide guidance on recommended practice with regard to renewing and as needed adjusting psychotropic medications for patients in the face of the constraints of the health emergency. SmartCare’s on […]

Although not a bread and butter primary care concern, Anti-NMDA Receptor Encephalitis is a recently recognized autoimmune process that can cause significant psychiatric, neurological and medical sequelae and it is an organic systemic disorder that may first present in the primary care setting. (NMDA = N-Methyl-D-Aspartate.) In the last decade, it has been more widely […]

There are non-pharmacological and pharmacological options to treat sleep disturbance in patients with dementia. Non-pharmacological approaches include: light therapy, regular exercise, and behavioral treatment/sleep hygiene. In general, evening bright light treatment is helpful for sleep maintenance problems and morning light exposure is helpful for patients whose sleep is phase-delayed or who are suffering from a […]

Sleep disturbance, including reduced sleep time, fragmented sleep, nighttime wandering, increased sleep latency, and daytime sleepiness and fatigue, are common concerns related to dementia. It is estimated that 1/3 of patients with Alzheimer’s dementia suffer from a sleep disturbance. The goal of this article is to review treatment options for sleep disturbance in patients with […]

When efforts to change sleep hygiene profiles prove unsuccessful and other contributing conditions have been examined and ruled out, use of a medication may be appropriate. Both prescribed and over-the-counter options are available and choice can be based on patient preference, clinical symptoms and need for short-term versus long-term treatment. Prescription Meds: In general the […]

Insomnia is a frequent complaint of patients in both the medical and psychiatric settings. Nearly 30% of adult will have issues with trouble falling or staying asleep at some point, however most of these issues are generally time limited and not impairing. For others, it is a very troubling issue. Insomnia Defined ―trouble with either […]

Women are almost twice as likely to be prescribed psychotropic medication as men. Because women are the primary consumers of psychotropic medications, it is important to pay attention to gender differences in the pharmacology of these medications. Other e-weekly topics have addressed issues related to pregnancy, menopause, and birth control with mental health, so this […]

CLINICAL SITUATION: Your patient is not tolerating or is not responding adequately to an SSRI or SNRI and the dose and duration have been adequate. Symptoms of anxiety or depression persist in spite of optimized psychosocial interventions and therapy and you believe that further psychopharmacologic intervention is required. What to do? There are four strategies […]

Grief as a response to significant loss is normal. However, the mourning that occurs during periods of grief has features that overlap with depression and anxiety. This makes it occasionally confusing to distinguish one from the other and to know how to help patients heal appropriately. In previous DSM versions, mental health professionals were to […]