The Journal of clinical psychiatry
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To assess the incidence of symptoms (palpitations, syncope) and electrocardiographic signs (increased QT duration and dispersion) of an increased risk of torsades de pointes in youth treated with ziprasidone. ⋯ Ziprasidone was associated with a dose- and level-independent, significant prolongation of QTc duration in one-quarter of youth. However, prolongation of QTc dispersion was nonsignificant, and no patient experienced concomitant abnormal prolongation of both QTc duration and QTc dispersion. The dissociation between prolonged QTc duration and dispersion suggests low arrhythmogenic potential in youth with normal baseline ECGs.
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Both the usage of prescription drugs such as opioid analgesics and benzodiazepines and overdoses involving them have increased dramatically in the United States since the 1990s. Patients using these drugs often have a combination of painful conditions, substance abuse, and other forms of mental illness. Psychiatrists and many primary care physicians might not be familiar with existing evidence-based guidelines for opioid prescribing or with programs designed to reduce the abuse of prescription drugs such as state prescription drug monitoring programs. Psychiatrists need to be informed regarding this problem to partner effectively with both pain specialists and primary care providers in their community.
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Bipolar disorder is a complex condition that is difficult to diagnose and treat, and many patients with this illness are not receiving adequate care, particularly in the early stages of the disorder when effective treatment is most critical. Self-Assessment CME is an educational activity in which clinicians answer a series of multiple-choice questions to ascertain their current knowledge and practice in treating CNS disorders. After completing the self-assessment, clinicians have the opportunity to review correct answers, see how their colleagues responded, and receive recommendations for further reading. This Self-Assessment CME activity focuses on recognizing and bridging gaps in knowledge pertaining to bipolar disorder recognition and treatment.
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Review Meta Analysis
The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials.
To assess the effectiveness of exercise in adults with clinical depression. ⋯ Our results suggest a short-term effect of exercise on depression: on average, depression scores 0.4 of a standard deviation lower in clinically depressed patients randomly assigned to an exercise intervention at the end of that intervention compared to those randomly assigned to a none exercise group. There is little evidence of a long-term beneficial effect of exercise in patients with clinical depression.