New CME Series
Explore the case of a 60-year-old white man with no prior psychiatric history who presented with newly developed aggression and legal trouble, following a head injury that failed to appear on a CT scan. The incidence of aggression in post–traumatic brain injury is high, but with few precursors, how are clinicians to treat this trauma?
Almost all clinicians will see a patient with symptoms of Alzheimer’s disease at some point in their careers. Do you dread giving a patient this diagnosis? Here, Dr Tariot tells you why your patients and their caregivers will be grateful when you directly and honestly explain what is happening and help them plan for the future.
Low-dose doxepin has produced favorable results in healthy adults and elderly persons with chronic or transient insomnia, while exhibiting an amenable adverse event profile. The aim of this article is to investigate the efficacy and safety of low-dose doxepin for insomnia in depressed patients.
This CME case study tells the story of Mr A, whose Alzheimer’s disease was preceded by 3 years’ worth of cognitive decline, as well as depression and visual complaints. Despite several visits to the opthamologist, Mr A showed no problems. Follow his case and the lessons it can teach about identifying Alzheimer’s disease in primary care patients.
Language impairment may cause more difficulty than memory impairment among caregivers and patients with Alzheimer's disease. Read this Neurology Report to discover ways to educate caregivers about communication problems, mistakes to avoid, and effective strategies to improve communication.
Tune in to this webcast and find out how to use evidence-based screening tools to identify early signs of cognitive impairment and learn about imaging and other biomarker measurement tools to help you recognize patients who are at increased risk for Alzheimer's disease.
Autistic disorder is characterized by qualitative impairments in reciprocal social interaction, verbal and nonverbal communication, among other characteristics.
Autism is a neurodevelopmental disorder with childhood onset characterized by atypical developments.
Capgras’ syndrome has a high incidence in patients with Alzheimer’s disease. It is a disorder in which a person holds a delusion that a close relative like a spouse or parent, a friend, or even an object has been replaced by an identical looking imposter or replica. Review the case of Mr A, an 80-year-old man who woke up one morning experiencing this and several visual hallucinations.
Posttraumatic stress disorder (PTSD) is often encountered in geriatric patients, and Alzheimer’s disease and other neurocognitive disorders are similarly common. Read these 2 case studies of patients whose PTSD occurred along with dementia, and learn more about the potential association between dementia and long-term PTSD.
Agitation, sexual disinhibition, and other behavioral and psychological symptoms create barriers to care for patients with dementia. In this case study, evaluate the use of nabilone to treat a 71-year-old man with dementia who showed agitation and sexual disinhibition as symptoms.
A vast array of idiopathic somatic complaints are common among depressed persons across the lifespan.
Headaches account for a high percentage of office visits to primary care physicians.
Comprehensive Behavior Intervention for Tics (CBIT) is a safer and effective alternative to antipsychotics for the treatment of Tourette’s disorder. This report describes the case of a 5-year-old child with Tourette’s disorder who benefited from the components of CBIT.
Tardive dyskinesia is a well-known side effect of conventional antipsychotics. Fluvoxamine may be an effective treatment for neuropsychiatric disorders via sigma-1 receptor agonism. Here, Albayrak and colleagues report 5 cases in which fluvoxamine was beneficial for both postpsychotic depressive disorder and tardive dyskinesia in patients with schizophrenia.
Read about the case of a 60-year-old woman who developed a disabling intention tremor in her hands, head, and jaw 2 months after aripiprazole was added to lamotrigine treatment.
Breakthrough disease is common, even in patients with good adherence to their medications. Review this Neurology Report to explore ways to assess and manage adherence, monitor disease course through clinical and MRI measures, and make timely treatment adjustments in your patients with multiple sclerosis.
Current disease-modifying treatments in multiple sclerosis (MS) are effective mainly in relapsing forms of MS and do not restore function. Discover unmet needs for treatments of progressive MS and MS symptoms, and get up-to-date on the development of neuroprotective agents.
Read this true patient case and commentary to reflect on the story of Mr A, a 35-year-old veteran with debilitating multiple sclerosis, who is facing the emotional consequences of his illness while residing at a nursing home unit.
Neuroscience research isn’t solely devoted to finding medications to treat neurologic and psychiatric illnesses. It’s also helped us understand the eduring effects of stress and potential psychosocial remedies. For example, psychoanalytic therapy may offer some level of permanent relief to patients who’ve had early traumatic experiences.
What’s your perception of borderline personality disorder? In this article, examine 2 symptom manifestations among patients with borderline personality in primary care and general medical settings—namely pain sensitivity and multiple somatic complaints. In addition to reviewing the research of others, the authors highlight their own investigations into these 2 areas.
At his initial assessment, Mr A claimed that his relatives had been replaced by actors. He also told his clinicians that his body vanished and that the devil replaced it with a younger one. In his case, both delusions were caused by similar activity in the brain. This letter to the editor asks how this activity relates to his depression.
Fibromyalgia is a painful disorder with no curative treatments, and available medications typically only provide partial relief. This Brief Report investigates effective use of serial intravenous lidocaine infusions for management of 3 patients with fibromyalgia. The authors describe the details of the procedure and review the relevant literature.
It’s rare to see a patient present with a single illness in family practice. More often than not, clinicians are asked to diagnose and treat multiple illnesses, such as chronic pain, depression, and sleep disorders. So, what are the keys to good therapy? Find out what Dr. Jackson has to say.
Patients with fibromyalgia have reported experiencing discouragement, rejection, suspicion, and stigma during their encounters with health care professionals. How do these experiences impact health outcomes? Review results from a study that assessed fibromyalgia patients’ self-reported quality of life and pain based on perceptions of physician attitudes, trust in physicians, perceptions of medical professionals, type of treatment, and various demographic variables.
Dementia may arise in patients with Alzheimer’s or Parkinson’s disease. This review of the literature discusses the pharmacology, mechanism of action, and chemical properties of rivastigmine to provide practical guidance on rivastigmine patch use in Alzheimer’s disease and Parkinson’s disease dementia.
Mr A was diagnosed with Parkinson’s disease in 1996, and more than 20 years later, began to experience severe personality and behavioral changes, including depression and hypersexuality. Read this case series to learn about these changes in patients with Parkinson’s disease and how to approach these changes in a clinical context.
Explore the case of a 41-year-old patient with Parkinson’s disease who presented in a mental health clinic after experiencing new-onset compulsive behavior with the dopamine agonist ropinirole. For the past few months, he was having intense sexual desires, an increase in appetite, and had started gambling.
Physicians who are not sleep specialists often feel they lack knowledge about sleep disorders. Complete this CME activity to familiarize yourself with disorders associated with excessive daytime sleepiness and the assessment methods used to diagnose these disorders.
With the increasing number of available insomnia medications, how do you choose the best treatment for your patients? Gain a better understanding of how various medications affect sleep processes and which agents enhance sleep-promoting systems or block wake-promoting systems.
There is an increasing need for sleep medicine in returning veterans, but primary care providers are often unfamiliar with diagnosing and treating sleep disorders. Read about this pilot project to evaluate sleep medicine services to patients in a primary care setting established at the Minneapolis VA Medical Center.
Have you ever wondered how people cope with the devastating sequelae of strokes?
We read with interest the recenetly published discussion concerning the use of atypical antipsychotic medications in the primary care setting.
Is it reasonable to assume that just about everyone becomes depressed following a stroke?
Posttraumatic stress disorder and alcohol use disorder often co-occur, with many veterans and trauma victims self-medicating in an effort to reduce their symptoms. Discover a case in which accurate diagnosis and combination treatment with naltrexone and prazosin was effective for both disorders.
Prescription monitoring programs have been implemented in response to a rise in prescription medication misuse, but they only record drugs obtained through legal means. This study investigates prescription drug use and the utility of these monitoring programs in identifying misuse in an outpatient clinic.
This article describes the case of Mr A, a 51-year-old former musician with chronic alcoholism and multiple inpatient rehabilitation stays for addiction counseling and detoxification. The authors discuss interventions for alcohol use disorders and provide guidelines for physicians when treating these patients.