Psychiatric Times Vol 18 No 5

It was supposed to only take 100 days, but that was eight years ago. When President Bill Clinton took office in January 1993, an air of expectancy permeated Washington, D.C.'s stuffy corridors, and for a moment it seemed as if the world's most developed nation would finally have a national health care policy.

Dr. Usdin steps down from his role of Psychiatric Times' book review editor after 11 years of service.

There are two goals in the acute treatment setting (e.g., emergency department): initiation of treatment and reducing the symptoms of agitation and aggression that frequently accompany an acute psychotic breakdown. Treatment options and considerations are reviewed.

The FDA approved two new intramuscular, immediate-release formulations of atypical antipsychotics. Both olanzapine (Zyprexa IM) and ziprasidone (Geodon IM) were recommended as safe and effective for the treatment of agitation in patients with schizophrenia.

The SSRIs have become the most widely prescribed antidepressants in the United States. With this increased use has come more information on adverse events associated with their use, such as sexual dysfunction. However, movement disturbances associated with SSRI use can adversely impact treatment. This article explains the pathology of movement disorders and describes confounding variables such as other medications, pre-existing neurological insults and the nature of case reviews. Those at risk include the elderly, patients taking neuroleptics and those exposed to high levels of SSRIs.

A groundbreaking program at UCLA goes into inner-city schools to help students work through trauma. By learning how to deal with the trauma itself and reminders of the trauma, students are able to improve their academic and social performance.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, and it may manifest as mood disturbances in those affected. How can this medical condition be treated in women who have bipolar disorder?

In examining the demographics of a state Medicaid population, we found that members of ethnic minorities, rural residents, women, and patients aged 45 years and older were more likely to receive first-generation antipsychotic medications than the newer, second-generation agents, which have a more favorable side-effect profile.

Patients with schizophrenia have a high risk of committing suicide. Between 25% and 50% attempt suicide at least once, resulting in approximately 3,600 successful attempts each year in the United States. What are the risk factors for suicide one should look for in treating patients with schizophrenia? Herbert Y. Meltzer, M.D., discusses the issue and offers warning signs.

In spite of the enormous success of antidepressants, there are surprisingly few that are available in other than oral form. There is now substantial evidence that intravenous administration is well tolerated and may accelerate onset of therapeutic effect. With the possibility of transdermal delivery3/4a noninvasive and painless route of administration requiring no technical support3/4parenteral antidepressants may become more acceptable in this country and warrant further clinical investigation.

Dietary supplementation of SAM-e--naturally produced and physiologically necessary compound for living cells--is being investigated for its use as a viable treatment for depression.