SMARTer CARE Newsletters
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ADHD And Co-Morbid Tic Disorder
A call recently came into the SmartCare PC2 line that highlights an important clinical situation. Case Presentation: 10 yo boy with history of motor tic disorder (eye blinking, shoulder shrugging) who was then diagnosed with ADHD combined type. He was started on Concerta and titrated to 36 mg qAM, which has been helpful for his […]
Treatment of Alcohol Abuse
While behavioral treatments and support groups are the mainstay of treatment for alcohol abuse problems, there are medications that can be helpful as well. Naltrexone is an opiate antagonist that is used for the treatment of alcohol dependence. Research shows that it is particularly useful in decreasing heavy drinking. It is found to be more […]
Management of Alcohol Withdrawal in the Outpatient Setting
Approximately 2% to 9% of patients seen in a family physician’s office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome (AWS) if they abruptly abstain from alcohol use. Treatment goals for patients with AWS are to reduce withdrawal symptoms; prevent seizures, delirium tremens, and death; and prepare the patient for […]
Treatment Approaches for GAD
The main treatment approaches for GAD comprise psychotherapy, pharmacotherapy or a combination of both. The often chronic and disabling nature of GAD means that some individuals may fail to respond fully to first-line treatment. Your patients may require a sequential trial of treatments or possibly the use of combination therapy. Given the chronic nature of […]
Generalized Anxiety Disorder (GAD)
Anxiety disorders are the most prevalent of all psychiatric disorders, with generalized anxiety disorder (GAD) being the most common seen in primary care. Nearly 8% of patients consulting a primary care provider have GAD according to the World Health Organization (WHO). Despite this, it is a diagnosis that can easily be missed. The good news […]
Treating ADHD in Young Children
The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) is becoming increasingly prevalent, in part because of better assessments, but also in part because of misdiagnosis and jumping too early to diagnose. The effect is that the diagnosis of ADHD is being given at younger and younger ages. This leads to the question of the best […]
An Important Community Resource: 2-1-1 San Diego
For those of us working in health care, we are increasingly aware that many of the health challenges our patients face are rooted in the social, economic and environmental context in which they live. Access to healthcare services is only one piece of the puzzle for our patients to achieve better health. There are numerous […]
Is There a Link Between Vitamin D Deficiency and Depression?
There has been a lot of discussion recently in the scientific world and the 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 […]
Screening for Suicide Risk Among Teens
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 […]
Light Therapy
Light therapy is a non-pharmacological treatment that is best studied for seasonal affective disorder (SAD) but has also been found to be useful in other depressive disorders. It can be tried as the primary treatment for mild depression or for antepartum or postpartum depression and as an adjunctive treatment for moderate-severe depression. It has been […]