mirtazapine

What treatments help patients stop using methamphetamine?

Carter is a 41 year old man who comes to see you for a routine follow-up visit. He previously used cocaine on nights out with friends. Today, Carter tells you that he stopped using cocaine entirely because he found something better: crystal (methamphetamine). For the last year, he has used a little bit of crystal […]

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When should you stop an SSRI trial for depression due to lack of efficacy?

30 yo woman with generalized anxiety disorder presents in her first major depressive episode. She is depressed, hopeless, sleeping poorly, exhausted, and losing weight (6 pounds in the last month). She has never taken psychiatric medications before. She would like to try a medication to treat both depression and anxiety (so bupropion is out).  You prescribe

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Which antidepressants are least likely to cause weight gain?

After almost 2 years of discussing pharmacotherapy, a 48 year old woman with severe generalized anxiety disorder (GAD) agrees to take medication. She starts taking escitalopram and increases the dosage. After 8 weeks on a daily dose of escitalopram 20mg, her anxiety symptoms are in remission. She has no side effects. However, when you see her 6 months

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How long should a patient with recurrent major depressive disorder continue their antidepressant?

Your patient is a 40 year old woman with a history of recurrent major depressive disorder. When she presented initially, she was feeling low, with decreased motivation, poor concentration, low energy, trouble sleeping, and thoughts of death. She had no plans to hurt herself. You referred her to therapy and started escitalopram, titrated to 10mg daily. At

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What change could reduce anxiety in a patient with partial benefit from an SNRI?

A 62 yo woman has a history of chronic pain from osteoarthritis, severe sciatica, recurrent major depression, generalized anxiety, and insomnia. She takes chronic low-dose opioids for pain and an SNRI (duloxetine, titrated to 60mg BID) for pain, depression, and anxiety, with moderate improvement in pain and depression and mild improvement in anxiety.   She currently

What change could reduce anxiety in a patient with partial benefit from an SNRI? Read More »