Harvard review of psychiatry
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Harv Rev Psychiatry · May 2006
Review Case ReportsCoalescence of psychiatry, neurology, and neuropsychology: from theory to practice.
In a climate of renewed interest in the synergy between neurology and psychiatry, practitioners are increasingly recognizing the importance of exchange and collaboration between these two disciplines. However, there are few working models of interdisciplinary teams that freely share expertise in real time, while providing clinical and academic training to future physicians who specialize in the central nervous system. ⋯ In addition to delivering enhanced patient care and promoting medical research, this clinical service has provided enriched cross-specialty training for fellows, residents, and medical students. The practical functioning of the team is described, and case vignettes are presented to illustrate the team's collaborative synergism in practice.
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Harv Rev Psychiatry · Nov 2005
ReviewAtypical antipsychotics in elderly patients with dementia or schizophrenia: review of recent literature.
Atypical antipsychotics have become a common pharmacologic option for the treatment of various psychiatric and behavioral symptoms in older adults, although these medications have been officially approved by the U. S. Food and Drug Administration for use only in schizophrenia and bipolar disorder. ⋯ In the trials involving elderly persons with schizophrenia, atypical antipsychotics were associated with significant improvements in psychopathology; differences in efficacy among atypical antipsychotics were unclear. A careful consideration of the risk-benefit ratio of atypical antipsychotics, as well as that of available alternative treatments, is needed for each individual elderly patient. Clinical judgment, caution, and consent should be the watchwords in this area of psychopharmacology.
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Harv Rev Psychiatry · Nov 2005
ReviewPharmacologic implications of neurobiological models of schizophrenia.
The dopamine model of schizophrenia has been supplanted by several additional models in order to account for genetic findings, risk factors, course of illness, and the diversity of symptom domains. The increasing number and complexity of potential models for this heterogeneous disorder offer new targets for pharmacologic treatment that differ in their appropriate time points for intervention and in their potential effects on the course of illness. This article reviews relevant neurodevelopmental, biochemical, and neurodegenerative models with respect to potential pharmacologic opportunities.
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Harv Rev Psychiatry · Nov 2004
ReviewOffice-based buprenorphine treatment for opioid-dependent patients.
Opioid dependence is epidemic in the United States, with increasing numbers addicted to heroin and burgeoning abuse of prescription opioid analgesics. Buprenorphine, the most recent addition to the pharmacotherapies available to treat opioid dependence, is novel among the opioid pharmacotherapies because of its partial agonist properties. It has been placed on Schedule III and is available by prescription from a physician's office-based practice. This review briefly summarizes the research supporting buprenorphine as a treatment for opioid dependence--including its clinical pharmacology, formulation with naloxone to prevent diversion, clinical use in treatment of opioid dependence, and issues regarding its use in special populations.