Restrictive eating disorders are defined by calorie restriction and resulting malnutrition. People with AN intentionally restrict energy intake and have an intense fear of weight gain, body dysmorphia and/or a lack of recognition of the severity of malnutrition.
How do you care for patients with restrictive eating disorders in primary care? Read More »
If we prescribe an antidepressant, what dose do we start and how do we increase it? A slower antidepressant up-titration may reduce side effects and improve initial adherence, but it may also delay clinical response
How do you individualize antidepressant prescribing? (Part 2) Read More »
Understanding the patient’s prior experiences with psychotropic medications allows you to individualize your prescribing – pick the right medication, the right starting dose, and the right titration for this person.
How do you individualize antidepressant prescribing? (Part 1) Read More »
Patients may be reluctant to bring up restrictive eating or excessive exercise habits; it is up to the clinician to begin this conversation and share concerns. Use the ask, offer, ask framework to guide the conversation.
How do you talk with patients about restrictive eating? Read More »
SSRIs are the first line treatment for patients with PMDD, with a response rate of 60-70%. PMDD symptoms respond quickly to SSRIs, allowing SSRIs to be dosed continuously, intermittently during the luteal phase, or intermittently when symptomatic.
How do you treat premenstrual dysphoric disorder (PMDD)? Read More »
Symptoms of PMDD are of comparable severity to those of other mental health disorders, including MDD and GAD. Confirming a provisional PMDD diagnosis requires daily prospective symptom ratings for at least 2 menstrual cycles. Symptoms of PMDD fluctuate consistently and predictably with menstrual cycles.
How do you diagnose premenstrual dysphoric disorder (PMDD)? Read More »
Diagnosing ADHD in an adult involves both ruling-in ADHD by developmental history, current symptoms and functional impairment in multiple contexts and ruling-out other common causes of inattention.
How do you diagnose ADHD in an adult? Read More »
Do not mix an MAOi, including methylene blue, with other strongly serotonergic medications like SSRI/SNRIs, tramadol, meperidine, or dextromethorphan due to the risk of serotonin toxicity.
Which drug combinations are high-risk for serotonin syndrome/toxicity? Read More »
While there are no FDA approved medications for cocaine use disorder and contingency management has the best evidence as behavioral treatment, there is a signal for topiramate (up to doses of 300mg/day) for promoting cocaine nonuse days.
Snow and Sauce: What medications can help patients reduce cocaine (and alcohol) use? Read More »
Serotonin syndrome is a toxidrome caused by a recent increase in serotonergic drug exposure. It is defined by the clinical triad of neuromuscular excitation, altered mental status, and autonomic excitation.
How do you recognize the spectrum of serotonin syndrome/toxicity? Read More »
