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 […]

There has been a lot of discussion recently in the scientific world and lay press about the prevalence and consequences of vitamin D deficiency. As part of that discussion, there has been a suggestion that vitamin D deficiency could contribute to depression and that vitamin D supplementation could be a viable treatment option for depression. […]

Many children and adolescents present to their primary care provider’s office with concerns about inattention, poor focus or poor concentration. Since the primary care provider’s office is typically the first stop, it is important to be comfortable further evaluating the presenting problem, identifying associated symptoms, determining the diagnosis and implementing the best treatment plan. Many […]

The prevalence of Major Depression Disorder (MDD) in adolescents is 6%, with an additional 5-10% of teens presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio for MDD in adolescents. Teens frequently don’t necessarily present with the typical DSM criteria for MDD. Common depressive symptoms in adolescents include: irritability (as opposed to […]

The last e-weekly discussed the opioid epidemic. This article will discuss more about assessing for opioid use disorders and appropriate treatments. A person is diagnosed as having an opioid use disorder if he develops symptoms of tolerance and withdrawal to opioids as well as at least two other symptoms in the same year. Tolerance is […]