Patients With Depression Exhibit High Serotonin Turnover Rates
May 2nd 2008Discovering the biological basis of major depressive disorder (MDD) could lead to improved medication and therapeutic treatment for patients with this condition. To date, the cause of MDD is not well understood, but researchers believe that elevated levels of the brain serotonin, 5-hydroxytryptamine (5-HT), may play a role.
Study Homes In on Patients' Beliefs Affecting Antidepressant Adherence
May 1st 2008Patients' beliefs about antidepressant drugs are a key factor driving adherence to therapy. According to a recent study, beliefs about efficacy and adverse effects, along with demographic attributes, are among the factors affecting antidepressant adherence.
The Muscarinic Hypothesis of Schizophrenia
April 16th 2008Since the discovery of dopamine as a neurotransmitter in the late 1950s, schizophrenia has been associated with changes in the dopaminergic system. However, the dopamine hypothesis of schizophrenia cannot explain all the symptoms associated with this disorder. Therefore, research has also focused on the role of other neurotransmitter systems, including glutamate, g-aminobutyric acid, serotonin, and acetylcholine (ACh) in schizophrenia.
The Vesicular Monoamine Transporter
April 16th 2008The vesicular monoamine transporter (VMAT) is a membrane-embedded protein that transports monoamine neurotransmitter molecules into intraneuronal storage vesicles to allow subsequent release into the synapse.1,2 By accumulating both newly synthesized neurotransmitter molecules and freshly returned neurotransmitter molecules from the synapse, VMAT function plays a critical role in the signaling process between monoamine neurons. The VMAT exists in 2 distinct forms: VMAT1 and VMAT2.3
A New Tool for Teaching Psychopharmacology
April 16th 2008Everyone would probably agree that the practice of clinical psychiatry has changed profoundly over the second half of the past century. One of the most remarkable changes has been the rapid development and expansion of clinical psychopharmacology, which has become, like it or not, a dominant part of the clinical practice of most psychiatrists. Available treatments for mental disorders changed and our armamentarium broadened. We have numerous medications for psychiatric disorders. We even use medications for disorders traditionally considered only amenable to and suitable for psychotherapy.
The Development and Use of Modern Psychotherapeutic Medications
April 16th 2008The modern era of psychopharmacology is only 60 years old, having begun with the discovery of the psychotherapeutic benefits of reserpine, lithium, monoamine oxidase inhibitors, and chlorpromazine in the late 1940s and early 1950s, which was followed a few years later by the synthesis and testing of the tricyclic antidepressants and benzodiazepines.
The Death of My Therapist: A Patient's Story
April 16th 2008If you had asked me a year ago if I could have faced what I am about to describe and come out on the other side I would have said "Hell, no!" It has been a year of pain and struggle, and although certain parts cannot be changed, I still think that if things had been handled a little differently I might not have gone through some of what I did. Here is my story.
Common Issues in Female Sexual Dysfunction
April 16th 2008"I've lost my interest in sex." As psychiatrists, we hear this concern (if we ask) from women in a variety of situations: those who are depressed, postpartum, menopausal, traumatized, and those who have been treated with psychotropic medications. Thankfully, we have many interventions, both behavioral and pharmacological, to use in addressing sexual issues.
Medications and Quality of Life With Schizophrenia
April 16th 2008The expression "quality of life" is an intuitively familiar and popular concept, and it epitomizes the public's hopes and expectations. In clinical settings, it demands the inclusion of patients' feelings, attitudes, and opinions in medical decision making.
Vietnamese Amerasians and Former Political Prisoners
April 16th 2008Vietnamese Amerasians and the former political prisoners of South Vietnam are living legacies of the Vietnam War. Now that many live in the United States, it is important for psychiatrists to have an understanding of their life experiences and be able to recognize psychiatric disorders that are common among them.
The Complex Interrelationships of Menstrual Cyclicity and Anxiety Disorders
April 15th 2008The ocurrence and severity of anxiety disorders have been correlated with fluctuations in female sex steroid levels in both epidemiological and experimental studies.1-5 Female reproductive hormones play a role not only in the development and course of anxiety disorders but also in treatment response.
Can Atypical Antipsychotics Reduce Suicide Risk in Patients With Schizophrenia?
April 15th 2008Suicide is a devastating, tragically frequent outcome for persons with varying psychiatric conditions, including schizophrenia. An estimated 5% to 10% of persons with schizophrenia commit suicide and 20% to 50% attempt suicide during their lifetime.1,2 Patients with schizophrenia have more than an 8-fold increased risk of completing suicide (based on the standardized mortality ratio) than the general population.3
Intimate Partner Violence Among Women With Severe Mental Illness
April 2nd 2008The 1994 death of Nicole Brown Simpson and the subsequent highly publicized murder trial of her ex-husband, O.J. Simpson, brought increasing national attention to the problems of domestic violence and intimate partner murder. In 2000, there were 1247 female victims of intimate partner murder in the United States.1 Fully one third of female murder victims were killed by an intimate partner.1 On the positive side, rates of female victimization by intimate partner violence and murder appear to have decreased in the recent past.
Accountable but Not Responsible
April 2nd 2008"Jack" has been in our emergency department at least 100 times in the 4 years I have worked at the Veterans Affairs Hospital. I first encountered him in the medical ICU, where he was hospitalized multiple times with chest pain and ECG changes after cocaine binges.
Study Faults Selective Publication of Antidepressant Trials
April 2nd 2008Medical journals have a unique image in the US health care system. Because most of them adhere to a strict system of critical peer review, they are often seen as unimpeachable sources of accurate information about the safety and efficacy of new medications.
Mental Health Services for Survivors of Mass Violence
April 2nd 2008Nearly one sixth of the world's population has experienced mass violence, be it abducted Ugandan children who are forced to commit atrocities against their families and serve as child soldiers or Iraqi civilians who daily live with bomb blasts, killings, and sectarian violence.