When The First Treatment Doesn’t Improve Your Depression
If your first treatment didn’t improve your depression, you’re not alone. About 40 to 50 percent of people don’t respond to the first antidepressant they take.
The reality is that medication is limited, and a person might need to try three different medications before they get better, according to Jonathan E. Alpert, M.D., Ph.D, the associate director of the Massachusetts General Hospital Depression Clinical and Research Program.
There are many reasons why the first treatment may not work. For instance, medications, such as steroids or hormones, can hinder the effectiveness of antidepressants. Even having a glass of ...
Source: World of Psychology - December 21, 2013 Category: Psychiatrists and Psychologists Authors: Margarita Tartakovsky, M.S. Tags: Depression Disorders General Mental Health and Wellness Psychotherapy Self-Help Treatment Antidepressants Bipolar Disorder Cognitive Behavioral Therapy Major Depressive Disorder Source Type: blogs
How Manipulated Clinical Evidence Could Distort Guidelines - the Case of Statins for Primary Prevention
This study excluded many patient for whom the statins were not contraindicated or warned against: uncontrolled hypertension; type 1 or type 2 diabetes mellitus on insulin or with a HgBA1C at least 10%; and body weight more than 50% "desirable limit for height." (Based on the official contraindications and warnings for commonly used statins, e.g., see contraindications for Lipitor here, active liver disease, pregnancy for likely to become pregnant, nursing mothers, hypersensitivity to the medicine; and warnings: use of cyclosprine or strong CYP3A4 inhibitors, uncontrolled hypothyroidism, renal impairment.) Thus ...
Source: Health Care Renewal - December 3, 2013 Category: Health Medicine and Bioethics Commentators Tags: American College of Cardiology American Heart Association clinical trials conflicts of interest evidence-based medicine guidelines manipulating clinical research review articles Source Type: blogs
Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!).
These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs
This ECG troubled us for a while !
In one of my classes , this ECG was presented . Controversy erupted.It was about the basics .
What is the QRS axis of this ECG ?
Not surprisingly there were handful of answers .
North west Axis
Indeterminate QRS
+150
+180
0 degrees
Extreme Right axis
Which is correct ? My guess is , it should be closer to + 180 . Lead 2 is equiphasic and perpendicular lead is negative limb of AVL ie + 150 .If you plot Lead 1 and AVF in graph and calculate we get + 135 . (In the strict sense , we are not supposed to take one standard lead and an augmented lead for plotting ). Finally, the strongest argumen...
Source: Dr.S.Venkatesan MD - October 20, 2013 Category: Cardiology Authors: dr s venkatesan Tags: cardiology -ECG Infrequently asked questions in cardiology (iFAQs) ecg in pulmoanry atresia extreme left and right axis indeterminate qrs axis north west axis what is north west qrs axis ? Source Type: blogs
Surviving wheat withdrawal
Wheat withdrawal can be unpleasant business. Read the many thousands of comments on this blog describing the physical and emotional turmoil that develops in the first few days of wheat avoidance and you will come to appreciate just how awful it can be.
It is important that wheat withdrawal is recognized for what it is, as some people say, “I feel awful. It must mean that I need wheat.” Nope. It is a withdrawal syndrome, a good thing, a transitional phase as your body tries to return to its normal state.
Wheat withdrawal has been labeled by different names over the years–”Atkin’s flu,”...
Source: Wheat Belly Blog - September 27, 2013 Category: Cardiology Authors: Dr. Davis Tags: Wheat withdrawal Source Type: blogs
Hypothyroidism: Am I Going to Die?
Here is an account of what I have learned since discovering my husband has a hypothyroid.Contributor: Sandra ParkerPublished: Sep 20, 2013 (Source: Most Recent Health Wellness - Associated Content)
Source: Most Recent Health Wellness - Associated Content - September 20, 2013 Category: Other Conditions Source Type: blogs
Guns, Again (--another broken record shrink rapper)
Apparently, if the shooter is dead, I can talk about it (a little). I don't know any facts except what I've seen in the paper, and I've interviewed absolutely no one, so I'm not going to say much, but I am going to use what I've read to write a post on the on-going issue of the role of mental illness and gun control.
Per today's New York Times:
But several senators, like Senator Richard Blumenthal, Democrat of
Connecticut, who has pushed for tougher gun laws since last year’s
elementary school massacre in Newtown, Conn., see mental health policy
as a way forward.
“Mental health
is really ...
Source: Shrink Rap - September 19, 2013 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Alzheimer's Test, Alzheimer's Questionnaire
Conclusions
Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.
Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment. Michael Malek-Ahmadi, Kathryn Davis, Christine Belden, Sandra Jacobson and Marwan N Sabbagh. BMC Geriatrics
Why Do Alzheimer's Caregivers Torture Themselves?
Dementia and the Eight Types of Dementia
Alzheimer'...
Source: Alzheimer's Reading Room, The - September 14, 2013 Category: Dementia Authors: Bob DeMarco Source Type: blogs
Hypothyroidism treatment: controversies, FAQs and tricks of the trade
(Source: Notes from Dr. RW)
Source: Notes from Dr. RW - September 9, 2013 Category: Internists and Doctors of Medicine Tags: endocrinology Source Type: blogs
A Lot to Deal With, But I Should Probably Count My Blessings
One of my weird symptoms is back, although people can be complete klutz's sometimes; however, everyone knows what is "normal" for them. I fell again, in the same weird way. My feet just came up from under me and I landed on my elbow I think (because it really hurts) on the hard wood floor and started yelling in pain. I chalked it up to the maids just coming that day so maybe the floors were slippery, no clue. But the next day I stubbed my pinkie toe so bad that it was bleeding from the toenail and still really hurts. Great, my race is Sunday with a painful pinkie toe.On their own, big deal, so ...
Source: bipolar.and.me - August 31, 2013 Category: Mental Illness Source Type: blogs
Biomarkers in acute coronary syndrome
Creatine (CK) and Isoenzymes
Three CK isoenzymes described are the MM, MB and BB fractions. In 1970’s, MB fraction was shown to be elevated in and highly specific for acute myocardial infarction. Later it was shown that CK-MB can be released from skeletal muscles as well, especially regenerating skeletal muscles. This lead to a search for better more specific markers of acute myocardial necrosis. CK-MB level begins to rise 4-6 hours after myocardial infarction and it takes up to 12 hours for it to be elevated in all patients with myocardial infarction. CK-MB levels return to baseline within 36-48 hours. Hence it is the m...
Source: Cardiophile MD - August 17, 2013 Category: Cardiology Authors: Prof. Dr. Johnson Francis MD, DM, FACC, FRCP Edin, FRCP London Tags: General Source Type: blogs
Positive Strategies for Coping with Levoxyl Shortage
From young adult thyroid cancer patients, to those suffering from Graves’ Disease, Hasimoto’s, and other hyperthyroid and hypothyroid conditions, I have been receiving many emails from distressed patients coping with the recent shortage of levoxyl. Pfizer says it will resume production of levoxyl in 2014, and until then many of us are coping as we try to adjust to new medications like synthroid or generic levothyroxine.
As with any medical issue it is often the challenging and horrific stories that we hear about the most. So I wanted to take the time to present some positive experiences I have encounte...
Source: Everything Changes - July 1, 2013 Category: Cancer Authors: Kairol Rosenthal Tags: Uncategorized Source Type: blogs
D-Blog Week, Day 5: Freaky Friday
Friday: Just like in the movie, today we’re doing a swap. If you could switch chronic diseases, which one would you choose to deal with instead of diabetes? And while we’re considering other chronic conditions, do you think your participation in the DOC has affected how you treat friends and acquaintances with other medical conditions?When we talk about Freaky Friday, are we discussing the Jodie Foster version or the Lindsey Lohan version? Because in the end I'd rather be Jodie Foster. Or Jamie Lee Curtis. Can I just switch with one of them in real life? I know there are quite a few j...
Source: Dorkabetic - May 17, 2013 Category: Diabetes Authors: Hannah McDonald Source Type: blogs
