February 2010  << Back  

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Help improve your patients’ physical as well as mental health

Donald W. Black, MD


I want to alert readers to the upcoming annual meeting of the American Academy of Clinical Psychiatrists, hosted in collaboration with Current Psychiatry, to be held April 8 to 10, 2010, at the Sheraton Hotel and Towers in Chicago. The meeting, “Mood and anxiety disorders: Solving clinical challenges, improving patient care,” offers an opportunity for peer-to-peer learning and networking. The lineup of topics is impressive: mood and anxiety disorders across the life span; best practices for treating social anxiety disorder, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder; maximizing antidepressant therapy while managing side effects, drug interactions, and suicide risk; and diagnostic challenges regarding the distinctions between unipolar and bipolar depression, atypical depression, and borderline personality disorder. Attendees will receive up to 18 AMA PRA Category 1 Credits™. Richard Balon, MD, is the meeting chair, and I serve as co-chair. The outstanding faculty includes Kiki D. Chang, MD, Marlene P. Freeman, MD, Frederick K. Goodwin, MD, George T. Grossberg, MD, James W. Jefferson, MD, Andrew Nierenberg, MD, Natalie Rasgon, MD, PhD, and Murray B. Stein, MD, MPH. I feel that this will be one of our best meetings yet and I hope to see all of you there.

This issue of Annals of Clinical Psychiatry presents articles that can help improve your patients’ physical as well as mental health. Mitchell Barnett, PharmD, MS, and colleagues analyze Medi-Cal data showing that patients taking second-generation antipsychotics (SGAs) are not being appropriately monitored for metabolic parameters. This has become a significant issue for psychiatrists and their patients after discoveries about SGAs’ association with glucose and lipid abnormalities. The authors suggest that pharmacists trained in medication therapy management become more involved in monitoring patients, an idea worth considering.

It is worth remembering that medication alone is not fully responsible for a patient’s metabolic problems. As David C. Henderson, MD, and colleagues show, dietary fat intake in patients taking clozapine or risperidone routinely exceeds fat intake by other patients. Clearly, some patients preferentially consume excess dietary fat, magnifying the influence of SGAs on metabolic parameters. One conclusion we could draw is that patients have a responsibility to monitor their food intake and should not be passive participants in this process.

Other contributions to this issue include new research by Ella J. Daly, MB, MRCPsych, and colleagues on health-related quality of life in depressed patients enrolled in the STAR*D trial; from Dan J. Stein, MD, PhD, and colleagues on the influence of early childhood adversity on the development of hypertension; and from Nancy C. Raymond, MD, and colleagues showing that naltrexone may help reduce compulsive sexual behaviors. Suhayl Nasr, MD, and colleagues report a near 10% prevalence of sleep apnea among psychiatric patients, an alarming figure that may be related to rising obesity rates among our patients. Lastly, Rif S. El-Mallakh, MD, and colleagues compare intermediate-release and extended-release carbamazepine, and show that both are effective treatments in manic and depressed patients with bipolar disorder.