psychiatry
j7uy5 | February 28, 2007Note: this post involves a very small amount of self-disclosure.
That is a bit unusual.
My father is also a psychiatrist. He told me once about his
education in psychopharmacology. A guy got up to lecture,
identified himself as the "drug doctor," and gave a lecture on
psychopharmacology. In fact, he gave a series
of
lectures...about five, total.
That was in the early to mid 1950's. What did we have back
then? Basically two things: uppers and downers.
By the mid 1980's things had changed. We knew about
neurotransmitters and receptors. I distinctly recall a
lecture
in which the…
j7uy5 | February 26, 2007There is a whole field of
href="http://en.wikipedia.org/wiki/Evolutionary_psychology">evolutionary
psychology. Let me get this out of the way: I
remain
skeptical of the entire endeavor, even though there is now a
href="http://www.psych.ucsb.edu/research/cep/">Center for
Evolutionary
Psychology.
But when it makes it into the mass media, it deserves some
comment. The LA Times reported a few days ago on how the
formulation of psychiatric disorders is changing, in part because of
evolutionary theory.
href="http://www.latimes.com/features/health/la-he-evpsych12feb12,0,3649492.…
j7uy5 | February 19, 2007Joltvolta (great name, by the way), asked a good question after I
posted part 3.
When you say proceed methodically, employ good data
collection, etc. How does the individual do that for themselves? If
they don't have the availability to see a specialist multiple times a
week, or even in a month, what options do they have?
I will get to that, eventually, but there are a few more things I have
to cover first. After all, part of my agenda in writing this
series is to enable patients to do more for themselves. There is
a shortage of specialists, and so long as that is the case, it will be…
j7uy5 | February 14, 2007It occurs to me that in order to go any farther explaining how to
choose an antidepressant, I should take a moment to explain the concept
of an adequate trial. Earlier, I mentioned that the
patient's history of response to previous antidepressant trials is one
of the most important factors to consider. Having said that, it
is important to realize that there are problems with that, both
practical and theoretical.
In order to derive valid conclusions from the outcome of any prior
trial on an antidepressant, it is necessary to have the right
information.
Having the right information means…
j7uy5 | February 12, 2007(Part One is
href="http://scienceblogs.com/corpuscallosum/2007/02/basic_concepts_selection_of_an.php">here)
Now we get to the heart of the matter: how does one decide what
antidepressant to prescribe?
First, let's take a look at the factors that are considered relevant to
the choice. If you understand what factors are relevant, and why
they are relevant, then you will start to see how the decision is
made.
In the process of deciding which drug to prescribe, there
are two bodies of information. Well, actually there are more, but
to
keep things simple, I am going to artificially…
omnibrain | February 11, 2007As an academic your currency is your reputation, and how often your papers get cited (well assuming they aren't citing you for making up data). The inevitable result of this are battles of ideas being fought out at conferences, in special issues of journals and in review articles. If you discover something interesting and the mechanisms are not clearly visible (as they usually are not - especially in something like psychology!) other scientists begin to attack you - especially if your new idea challenges theirs!
In the science of the brain there are a few debates that immediately come to…
j7uy5 | February 9, 2007This is a nice little study that deserve a brief comment. It's
from Am J Psychiatry this month. What is shows is that
participation in psychotherapy can alter the rate of reported adverse
effects from medication, and decrease the rate at which patients stop
their medication because of adverse effects.
Note that this study was done with patients with panic disorder.
It may not be generalizable to other patient populations.
Usage note: I always use the term "adverse effects" rather than "side
effects," because it is more precise. Some side effects are good,
some bad, some neutral. So if…
omnibrain | February 6, 2007I'm proud to report that Ted Haggard is no longer gay since he underwent three whole weeks of very intensive counseling. He was so impressed with his counseling that him and his wife are going to attend university and get their masters degrees in psychology (I'm psyched he's joining me in my chosen profession!). It sounds like they'll be going to Phoenix Online University or somewhere similar and hopefully counseling people to ungay themselves just like he was so successful in doing! All praise Rev. Haggard!
The Rev. Ted Haggard emerged from three weeks of intensive counseling convinced…
omnibrain | February 2, 2007I'm really surprised when I run across something I've never ever heard about before. This is one of them.
BIID or body identity integrity disorder is when a person feels a compulsion to remove one or more body parts (arms, finger, legs, toes and I can't image what else). Below is a snippet from a very personal article from the Guardian about someone with this disorder.
I was six when I first became aware of my desire to lose my legs. I don't remember what started it - there was no specific trigger. Most people want to change something about themselves, and the image I have of myself has…
j7uy5 | February 2, 2007This morning, or noon, or whatever, I read Jonah's post at The
Frontal Cortex,
href="http://scienceblogs.com/cortex/2007/02/the_nfl_and_mental_illness.php">The
NFL and Mental Illness. It is a tragic story, but there is
one thing about it that I want to comment upon, regarding the reported
Adderall prescription.
But first, a digression. Reporters are expected to do at least a
little fact-checking. But in addition to checking facts,
sometimes it is appropriate to check for consistency.
href="http://www.nytimes.com/2007/02/02/sports/football/02concussions.html?ei=5090&en=…
omnibrain | January 30, 2007 GW Pharmaceuticals has developed a diet drug derived from Marijuana which suppresses the appetite. This is especially surprising for obvious reasons - perhaps a little ironic?!
Clearly the marijuana plant contains many many different compounds - but who would have thought that one of them suppressed the urge to gorge yourself on cheeze doodles and icy pops. The drug will soon be entering into human trials to combat obesity.
Don't get too exited about getting high on the drug though since that doesn't happen to be one of the side effects. Well...that is unless you want to find the secret…
omnibrain | January 28, 2007 Check out the brains of mice on drugs. This site is a very strange one to say the least- it starts with a bunch of high mice in a club of sorts just struggling to stand up. Then the interactive flash demo starts in which you have to drag a mouse into a comfy chair which transports it into a weird device that shows what's happening to the mouse's brain depending on what it snorted, smoked, or injected earlier.
Freakin' weird - a wee bit trippy ;). Especially from an academic institution.
Check out the Mouse Party.
omnibrain | January 25, 2007Answer... They both have tasteless protests when someone dies from something they attribute to the wrong thing.
A Scientology group targeting "toxic" medications plans to protest in Sudbury today for a public airing of any drugs given to the teen accused of murdering another boy at Lincoln-Sudbury Regional High School last week.
The group's gripe hits as the Sudbury community struggles to cope with Friday's stabbing death of straight-A student James Alenson, 15.
Scientologists are demanding at the demonstration that:
the types of drugs given to accused killer John Odgren, 16, and the…
omnibrain | January 17, 2007It looks like there are a couple of interesting articles/TV shows out there in the last couple days highlighting some Omni Brain topics of the last few weeks.
You know how I love the mind control people, It looks like the Washington Post has a great article on it...
Mind Games
New on the Internet: a community of people who believe the government is beaming voices into their minds. They may be crazy, but the Pentagon has pursued a weapon that can do just that.
And of course you all remember the severed dogs head! National Geographic is producing a show about the Russian research that came up…
omnibrain | January 9, 2007We're always happy to link to (good) sites mentioning Omni Brain - but this one is better than usual :) Check out this interesting podcast from the blog Shrink Rap called My Three Shrinks. This
week covers topics like neuroeconomics, fMRI lie detection, and of course omnibrain ;) If you haven't been to Shrink Rap before...
Dinah, ClinkShrink, & Roy introduce Shrink Rap: a blog by psychiatrists for psychiatrists. A place to talk; no one has to listen. All patient vignettes are confabulated; the psychiatrists, however, are mostly real.
omnibrain | January 9, 2007Ohh boy...here we go. From the New Scientist Blog:
An ongoing US experiment to turn "homosexual" rams straight by altering their hormone levels has sparked the ire of both gay activists and animal rights groups. The work is reportedly being carried out at Oregon State University in the city of Corvallis and at the Oregon Health and Science University in Portland.
I can imagine what groups like Love in action are going to do when they get their hands on this. From wikipedia (this article also highlights other groups like this):
Love in Action, or LIA, was founded in 1973 by John Evans and the…
j7uy5 | January 2, 2007There have been stories and novels about the end of privacy.
1984, by George Orwell, comes to mind. I also
remember reading a science fiction short story once, about how
technology had made privacy so difficult to maintain, and so accepted
by society, that it was considered rude to want privacy. I
can't remember who wrote that one.
This post was inspired by an article in the Wall Street Journal, that
points out how little privacy there is when it comes to medical
records. More below the fold...
Time Magazine just published 25 "top-10" lists for 2006. One
of the lists is for
href="…
j7uy5 | December 28, 2006CNN has a
href="http://www.cnn.com/2006/WORLD/americas/12/27/brazil.anorexia.ap/index.html">report
about a cluster of deaths from Anorexia, in Brazil.
The subject has become a morbid fascination for
Brazilians, and is even the theme of a popular TV soap opera. It has
also touched off a debate within Brazil's fashion industry that has
long presented the rail-thin model as the paragon of female beauty.
The objection I have is that the article provides the heights and
weights of the women at their time of death. I don't think
there is any way that the journalists or editors would know…
j7uy5 | December 26, 2006Several bloggers have already commented on Johnson &
Johnson's new schizophrenia drug,
rel="tag">Invega®. The official
FDA announcement is
href="http://www.fda.gov/bbs/topics/NEWS/2006/NEW01534.html">here.
The first blog post I saw was at
href="http://garrettsparks.blogspot.com/2006/12/medicine-jj-wins-fda-approval-for.html">Sparkgrass:
I'd hate for somebody to have to come up with, ya
know, a new drug. Not to say that a longer acting atypical isn't a nice
addition to the palette, but the fact that J&J's stock is
suddenly worth more because their chemists did some…
j7uy5 | December 23, 2006I've been following the fish oil story for a while, ever since a
href="http://archpsyc.ama-assn.org/cgi/content/abstract/56/5/407">small
study in 1999 showed potential benefit in patients with
bipolar disorder. The theoretical basis for the study was
that omega-3 fatty acids alter neurotransmission in a way that is
similar to lithium and valproic acid. A
href="http://ajp.psychiatryonline.org/cgi/content/abstract/163/6/969">recent
review in Am J Psych. Says the same thing that most other
articles have said over the past seven years:
CONCLUSIONS: Deficits in omega-3 fatty acids…