SMARTer CARE Newsletters
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Non-stimulant Approaches to ADHD
There are situations that come up in a primary care setting when a pediatric patient presents with symptoms that are concerning for Attention Deficit Hyperactivity Disorder (ADHD) but where there are concerns about prescribing a stimulant medication. These are some of the situations when this can occur: The patient’s presentation meets the symptom checklist for […]
Choosing a Medication Treatment for ADHD
Once a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) has been made, a decision has to be made about treatment. Most children do well with a combination approach of medication and behavioral therapy. The most likely medication to start with is a stimulant medication. And then the provider has to make a decision from many, […]
Medication to Improve Outcomes in Alcohol Use Disorder
Medication to Improve Outcomes in Alcohol Use Disorder Some experts in the field of substance abuse are arguing for a change in the thinking of how to treat Alcohol Use Disorder (AUD). Most clinicians, with the focus being on sobriety, refer patients to detoxification and substance abuse programs, which is appropriate. Many clinicians do not […]
Link Between Lead Toxicity and ADHD
When a child first presents with symptoms of Attention Deficit Hyperactivity Disorder (ADHD), it is important to assess if there is an underlying medical cause for the symptoms. Lead is a neurotoxin that has been well studied to affect children’s cognition and behavior, and the behavioral profile seen with lead toxicity can mimic ADHD. Children […]
Patients with Elevated or Irritable Mood States: Mania & Hypomania
A unique element in behavioral health care — that of assessing a patient’s abnormal mood states — may on occasion be a special concern in the primary care setting. Comfort with assessing mood states and making appropriate psycho-social and medical interventions can be important skills. This eWeekly discusses the issues of mania and hypomania, as […]
Prescribing Psychotropic Medications for Women
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 […]
Treating Co-Morbid Depression and Coronary Artery Disease
Coronary Artery Disease is the leading cause of death in the United States and is one of the main contributors to the global burden of disease. One in four patients with coronary artery disease also suffer from depression, which adds to the risk of recurrent myocardial infarction and death. Guidelines exist to urge primary care […]
Premenstrual Dysphoric Disorder
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 far more substantial premenstrual mood symptoms known as premenstrual dysphoric disorder (PMDD). PMDD symptoms includes moderate to severe depressed mood, irritability, mood lability, anxiety, anger, […]
Is it Menopause or Depression?
Females in their 40s and 50s often present to their primary care providers with new-onset depressive symptoms. It can be difficult to assess if the symptoms are part of menopause/perimenopause or if they represent a new onset depressive disorder. One complicating factor is that menopause can independently increase the risk of onset of a depressive […]
Screening For Depression
Depression is the most common mood disorder in the general population. In 2014, an estimated 15.7 million adults aged 18 or older in the U.S. had at least one major depressive episode in the past year. This number represented 6.7% of all U.S. adults. In 2014, an estimated 11.4% of adolescents aged 12 to 17 […]