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Treatment of Depression in Children and Adolescents - Implementing AHRQ Effective ... Restricted content. Login required.

Nov 1, 2020 - What are the benefits and harms of nonpharmacologic and pharmacologic treatments for depressive disorders in children and adolescents?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/1101/p558.html

Appropriate Use of Opioids for Chronic Pain - Lown Right Care: Reducing Overuse and ... Restricted content. Login required.

Sep 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2020/0915/p335.html

Smoking Cessation with Text Messaging and App-Based Interventions - Cochrane for ... Restricted content. Login required.

Aug 1, 2020 - Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p148.html

Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder ...

Jul 1, 2020 - Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2020/0701/p10.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.html

Antidepressants Plus Benzodiazepines for Adults with Major Depression - Cochrane for ... Restricted content. Login required.

May 1, 2020 - A combination of tricyclic antidepressants and benzodiazepines is more effective for major depression in adults than tricyclic antidepressants alone in the first four weeks of treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p527.html

Lithium for Acute Mania - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

May 1, 2020 - Lithium is more effective at inducing a reduction of at least 50% on the validated Young Mania Rating Scale compared with placebo (number needed to treat [NNT] = 6; 95% CI, 5 to 8; six studies; n = 1,707).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p528.html

Prescribing Opioids for Chronic Pain: Unintended Consequences of the 2016 CDC Guideline...

Apr 15, 2020 - Since the 2016 CDC guideline for the use of opioid pain relievers was released, there has been a significant reduction in opioid prescribing, and the guideline has been adopted by state Medicaid agencies, insurers, and others. Widespread implementation of the guideline has had ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0415/p458.html

Benzodiazepines for Panic Disorder in Adults - Medicine by the Numbers - American ... Restricted content. Login required.

Apr 1, 2020 - Should benzodiazepeines continue to be prescribed during the initiation phase of selective serotonin reuptake inhibitors for acute relief of panic attacks? Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0401/od1.html

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ... Restricted content. Login required.

Mar 15, 2020 - Esketamine is an in-office treatment for patients with a severe major depressive disorder to be used in addition to oral antidepressant therapy.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0315/p339.html

Music Therapy for Depression - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

Mar 1, 2020 - Moderate-quality evidence shows that music therapy added to standard care is more effective in the first three months than standard care alone for depressive symptoms based on clinician-rated outcomes and patient-reported outcomes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p273.html

Do Not Change Antidepressant Treatment Early Based on a Lack of Response - POEMs - ... Restricted content. Login required.

Feb 15, 2020 - Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p250.html

Adverse Events of Pharmacologic Treatments of Major Depression in Older Adults - ... Restricted content. Login required.

Feb 1, 2020 - What are the adverse events of antidepressants prescribed to treat major depressive disorder in adults 65 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0201/p179.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician Restricted content. Login required.

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Augmentation of Antidepressant Treatment Offers Little Benefit - POEMs - American ... Restricted content. Login required.

Dec 15, 2019 - The available evidence that treatment-resistant depression (depression that is unresponsive to two different treatments of adequate dose and length) responds well to augmentation treatment (i.e., adding psychotherapy, lithium, or aripiprazole [Abilify] to current treatment) is weak.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od3.html

Stuttering: Understanding and Treating a Common Disability - American Family Physician

Nov 1, 2019 - Childhood-onset fluency disorder, the most common form of stuttering, is a neurologic disability resulting from an underlying brain abnormality that causes disfluent speech. Stuttering can lead to significant secondary effects, including negative self-perception and negative perception ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p556.html

Opioid Use Disorder: Medical Treatment Options - American Family Physician

Oct 1, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p416.html

Common Misperceptions About Buprenorphine Prescribing for Opioid Use Disorder - ...

Oct 1, 2019 - The antidote to the opioid use disorder epidemic is the thoughtful use of evidence-based medicine and an honest understanding of what we know—and what we don't know—about caring for people with substance use disorders.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1001/p396.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Weak Evidence Supports Augmentation Therapy for Treatment-Resistant Depression - POEMs ...

Sep 15, 2019 - There is weak research to guide treatment decisions for patients who have not responded to two adequate courses of antidepressant treatment. One study of cognitive behavior therapy showed benefit over placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p376.html

Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults - Cochrane ...

Sep 1, 2019 - Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p278.html

Identification of and Treatment for Unhealthy Alcohol Use in Primary Care Settings - ...

Jun 15, 2019 - We have identified the ways in which family physicians can implement the USPSTF screening recommendation for unhealthy alcohol use and then intervene when a patient has a positive screen.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0615/p733.html

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Psychological and Pharmacologic Treatments for Adults with PTSD - Implementing AHRQ ...

May 1, 2019 - What are the benefits and harms of psychotherapies and pharmacologic agents for the treatment of adults with posttraumatic stress disorder (PTSD)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0501/p577.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.html

Pharmacologic Treatment of Borderline Personality Disorder - FPIN's Help Desk Answers -...

Mar 1, 2019 - There is no pharmacotherapy regimen that improves the overall symptoms of borderline personality disorder. When used for six months or less, antipsychotics can improve paranoia, dissociation, mood lability, anger, and global functioning.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0301/od2.html

Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults - Practice ...

Jan 1, 2019 - A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of helping ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0101/p57.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Counseling Patients in Primary Care: Evidence-Based Strategies - American Family Physician

Dec 15, 2018 - Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling strategies developed ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p719.html

Therapist-Guided, Internet-Delivered Cognitive Behavior Therapy for Anxiety - FPIN's ...

Oct 1, 2018 - Therapist-guided, Internet-delivered CBT can be used as an effective treatment for anxiety in adults and is similar in effectiveness to face-to-face CBT.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1001/p459.html

Deprescribing Antipsychotics for Behavioral and Psychological Symptoms of Dementia and ...

Sep 15, 2018 - As part of the Deprescribing Guidelines in the Elderly Project, a Canadian team consisting of two family physicians, one geriatric psychiatrist, two geriatricians, and four pharmacists has provided recommendations to guide physicians in deprescribing antipsychotics for behavioral and ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0915/p394.html

Management of Insomnia Disorder in Adults - Implementing AHRQ Effective Health Care ...

Sep 1, 2018 - What are the effectiveness, comparative effectiveness, and adverse effects of interventions for insomnia disorder in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0901/p319.html

Individual Behavioral Counseling for Smoking Cessation - Cochrane for Clinicians - ...

Jul 1, 2018 - Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p21.html

Injectable Extended-Release Naltrexone Effective for Opioid Use Disorder - POEMs - ...

Jun 15, 2018 - Injectable extended-release naltrexone administered every four weeks is similar in efficacy to daily oral buprenorphine/naloxone for the treatment of opioid use disorder. Patients using extended-release naltrexone reported higher satisfaction with treatment and were more likely to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819.html

Atypical Antipsychotics for Disruptive Behavior Disorders in Children and Adolescents -...

Jun 1, 2018 - Risperidone reduces measures of aggression and improves conduct in children with disruptive behavior disorders; however, only short-term use is recommended. Weight gain of 2 to 2.5 kg (4.4 to 5.5 lb) is common. There is insufficient evidence to evaluate the benefits of other ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p715.html

Implantable Buprenorphine (Probuphine) for Maintenance Treatment of Opioid Use Disorder...

May 15, 2018 - Implantable buprenorphine is an expensive alternative for patients on a stable dosage of transmucosal buprenorphine. Based on current research and guidance, implantable buprenorphine should not be used as initial treatment for opioid dependence or as a substitute for medication-assisted...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0515/p668.html

One-Third of Patients with Anxiety Disorder Will Relapse When Antidepressant Treatment ...

May 1, 2018 - Discontinuing the antidepressant treatment in patients with anxiety disorders will cause a relapse in almost one-third of them. One in six patients previously treated successfully will also relapse despite continued treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605.html

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

Buprenorphine Therapy for Opioid Use Disorder - American Family Physician

Mar 1, 2018 - Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p313.html

Treating Opioid Use Disorder as a Family Physician: Taking the Next Step - Editorials -...

Mar 1, 2018 - An AHRQ review showed that there are different ways in which buprenorphine-based MAT can be safely and effectively delivered in primary care settings.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0301/p302.html

Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer ...

Feb 15, 2018 - Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od4.html

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Tapering Patients Off of Benzodiazepines - Curbside Consultation - American Family ...

Nov 1, 2017 - When prescribed at a low dosage for a short time (fewer than 30 days), benzodiazepines can effectively treat generalized and social anxiety, panic disorder, and sleep disorders. Long-term use for anxiety and sleep disorders is not supported by research because it is associated with the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1101/p606.html

Interventions for Tobacco Cessation in Patients Being Treated for or Recovering from ...

Nov 1, 2017 - Pharmacotherapy alone and pharmacotherapy plus counseling are effective for tobacco cessation among patients being treated for or recovering from alcohol and substance use disorders. Counseling interventions without pharmacotherapy are not effective for tobacco cessation among patients ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1101/p572.html

Social Media Use and Mood Disorders: When Is It Time to Unplug? - Curbside Consultation...

Oct 15, 2017 - Americans spend more time on Facebook, the world's largest online social network, than any other website. On the surface, social media networks provide an invaluable resource for fulfilling the basic human need for social connection. However, rather than enhancing well-being by ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1015/p537.html

How Family Physicians Can Combat the Opioid Epidemic - Editorials - American Family ...

Sep 15, 2017 - Family physicians must commit to responsible prescribing of opioid medications. The decision to initiate opioid therapy should be a careful and deliberate one, especially in patients who are at risk of addiction.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0915/p357.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.html

No Increased Risk of ASD, ADHD, or SGA with First-Trimester Antidepressant Use - POEMs ...

Aug 15, 2017 - This study found that maternal antidepressant use during the first trimester of pregnancy is associated with an increased risk of preterm birth, but not SGA, ASD, or ADHD. Another study in the same issue also reported no increased risk of ASD with in utero exposure to selective ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p261.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Treatment of Chronic Insomnia in Adults: ACP Guideline - Practice Guidelines - American...

May 15, 2017 - The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0515/p669.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

Management of Binge-Eating Disorder in Adults - Implementing AHRQ Effective Health Care...

Mar 1, 2017 - What are the benefits and harms of treatments for adults with binge-eating disorder?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0301/p324.html

Buprenorphine Maintenance vs. Placebo for Opioid Dependence - Medicine by the Numbers -...

Mar 1, 2017 - Buprenorphine causes lower physical dependence, milder withdrawal symptoms, and is less likely to cause an overdose than methadone in the treatment of opioid dependence.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0301/od1.html

Sertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury - POEMs - ...

Feb 1, 2017 - This study found that sertraline is more effective than placebo (number needed to treat = 6) in preventing the onset of a major depressive disorder in adults following a TBI. This study included patients with mild, moderate, and severe TBI.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194.html

Extended-Release Bupropion for Preventing Seasonal Affective Disorder in Adults - ...

Jan 1, 2017 - When started in the fall, extended-release bupropion, 300 mg once daily, is effective in preventing recurrent symptoms in high-risk adults with a history of SAD (number needed to treat [NNT] = 5), as well as those at lower risk (NNT = 8). Headaches, nausea, and insomnia may limit ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p10.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Aripiprazole vs. Placebo or Haloperidol for Schizophrenia - Medicine by the Numbers - ...

Dec 1, 2016 - Aripiprazole was shown to have one major benefit over placebo, but favorable outcomes with haloperidol throw its effectiveness into question. Are the differences merely anomalies?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1201/p877.html

Pet Therapy: Enhancing Patient Care Through Time with Animals - Curbside Consultation -...

Nov 1, 2016 - A 16-year-old girl and her parents presented to my office for her wellness evaluation. The patient has generalized anxiety disorder with comorbid major depression, for which she has been prescribed a serotonergic antidepressant. She is a high school student, lives with her parents, and ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/1101/p737.html

Rural Opioid Use Disorder Treatment Depends on Family Physicians - Graham Center Policy...

Oct 1, 2016 - The nation's growing opioid use disorder epidemic disproportionately impacts rural areas, where physicians who can prescribe buprenorphine are scarcest. Among physicians approved to prescribe buprenorphine, family physicians (FPs) are the most likely to work in rural areas.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1001/p546.html

CBT Effective in Adolescents with Depression Who Do Not Want Medication - POEMs - ...

Sep 1, 2016 - In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Pharmacotherapy for Adults with Alcohol Use Disorder - Implementing AHRQ Effective ...

Jul 15, 2016 - What are the potential benefits and adverse effects of medications used to treat alcohol use disorder (AUD) in adult outpatients?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2016/0715/p155.html

Suvorexant (Belsomra) for Insomnia - STEPS - American Family Physician

Jun 15, 2016 - Suvorexant effectively increases total sleep time and decreases time to sleep onset. Because of its risk of abuse, significant incidence of next-day impairment, and high cost, it should be reserved for use in patients for whom other insomnia therapies, such as cognitive behavior therapy...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0615/p1016.html

CDC Develops Guideline for Opioid Prescribing - Practice Guidelines - American Family ...

Jun 15, 2016 - A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0615/p1042.html

The Opioid Epidemic: AMA’s response - Editorials - American Family Physician

Jun 15, 2016 - With Lembke article and opioid PG

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p975.html

Using the CDC Guideline and Tools for Opioid Prescribing in Patients with Chronic Pain ...

Jun 15, 2016 - The new CDC guideline is intended to help clinicians decide whether and how to prescribe opioids for chronic pain; offer safer, more effective care for patients with chronic pain; improve clinician-patient communication; and prevent opioid use disorder and opioid-related overdose.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p970.html

Nonpharmaceutical Treatment of Anxiety in Institutionalized Older Adults - FPIN's Help ...

Apr 1, 2016 - Cognitive behavior therapy (CBT) or relaxation training, alone or in combination, can be used to treat anxiety in older adults. Music therapy can also be used to reduce anxiety in older adults. Appropriate training of institutional caregivers is also helpful in reducing anxiety in older...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0401/p592.html

Medications for Alcohol Use Disorder - American Family Physician

Mar 15, 2016 - The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p457.html

Therapist-Supported Online Cognitive Behavior Therapy for Adult Anxiety - Cochrane for ...

Jan 1, 2016 - Therapist-supported online CBT is more effective than no treatment and as effective as face-to-face CBT for reducing overall anxiety as well as symptoms, and improving quality of life in adults with anxiety disorders.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0101/p19.html

CBT Effective for Chronic Insomnia - POEMs - American Family Physician

Jan 1, 2016 - A five-component approach to changing patients' beliefs and behaviors surrounding sleep is effective, at least in the short term, in getting persons to fall asleep and stay asleep, although total sleep time is not increased.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p60.html

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

Psychological Interventions for Medically Unexplained Physical Symptoms - Cochrane for ...

Dec 1, 2015 - Psychological therapy, specifically cognitive behavior therapy (CBT), has been shown to reduce the severity of medically unexplained physical symptoms in patients with somatoform disorders. The effect is small to moderate in magnitude, but in these studies CBT was as acceptable as usual...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1201/p975.html

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders - American ...

Nov 1, 2015 - Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p807.html

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p820.html

Levomilnacipran (Fetzima) for Major Depressive Disorder - STEPS - American Family ...

Oct 15, 2015 - Levomilnacipran should not be used in patients with mild to moderate depression until studies have proven its effectiveness. It is somewhat effective in patients with moderate to severe depression. The short-term adverse effect profile of levomilnacipran is similar to that of other SNRIs.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/1015/p727.html

Tricyclic Antidepressants for the Treatment of ADHD in Children and Adolescents - ...

Sep 1, 2015 - TCAs, specifically desipramine and nortriptyline (Pamelor), are superior to placebo at reducing ADHD symptoms in the short term (two to six weeks); however, the quality of evidence is low. Increased heart rate and diastolic blood pressure may be noted with treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0901/p352.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Are Some Antidepressants Safer than Others Regarding Suicide Risk? - POEMs - American ...

Jul 1, 2015 - Mirtazapine (Remeron) and venlafaxine are associated with higher rates of completed suicide in primary care patients. Rates of suicide attempts and completion are similar with the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52a.html

Immediate-Release Methylphenidate for the Treatment of ADHD in Adults - Cochrane for ...

Apr 1, 2015 - In adults with ADHD, immediate-release methylphenidate improves symptoms of hyperactivity, impulsiveness, and inattentiveness compared with placebo. Short-term adverse effects such as weight loss and decreased appetite do not appear to be serious. However, larger studies of longer ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0401/p445.html

Vortioxetine (Brintellix) for the Treatment of Depression - STEPS - American Family ...

Mar 1, 2015 - Current evidence does not support the routine use of vortioxetine in the treatment of depression. Family physicians most often encounter patients with mild to moderate depression, and vortioxetine has not been studied in this population. There is no clear benefit of using vortioxetine ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0301/p325.html

Buprenorphine Maintenance vs. Methadone Maintenance or Placebo for Opioid Use Disorder ...

Feb 1, 2015 - At dosages greater than 2 mg per day, buprenorphine maintains treatment retention better than placebo. When flexible dosing (doses adjusted based on patient symptoms) is used, the effectiveness of buprenorphine is comparable to that of methadone in suppressing opioid use.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0201/p165.html

Psychological Therapies for Chronic Posttraumatic Stress Disorder - Cochrane for ...

Oct 1, 2014 - Trauma-focused cognitive behavior therapy (CBT) and eye movement desensitization and reprocessing (EMDR) are more effective than other therapies in reducing PTSD symptom severity up to four months after treatment, but more robust studies are needed to evaluate the long-term effectiveness.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1001/p454.html

Collaborative Care for Depression and Anxiety - Cochrane for Clinicians - American ...

Apr 1, 2014 - The collaborative care model is effective for treating adults with depression and/or anxiety using a multiprofessional approach to patient care, a structured management plan, scheduled patient follow-ups, and enhanced interprofessional communication.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0401/p524.html

Exercise Effective for Depression in Older Patients - POEMs - American Family Physician

Dec 15, 2013 - An organized exercise program for older patients, which may include strength training, endurance training, or both, may be helpful for some patients with symptoms of depression. The results will not be striking, but exercise is an option for patients willing to participate.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/od2.html

Second-Generation Antidepressants for Depression in Adults - Implementing AHRQ ...

Nov 15, 2013 - What are the comparative effectiveness and adverse effects of second-generation antidepressants for treating depression in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2013/1115/p687.html

Outpatient Management of Alcohol Withdrawal Syndrome - American Family Physician

Nov 1, 2013 - Approximately 2% to 9% of patients seen in a family physician’s office have alcohol dependence. These patients are at risk of developing alcohol withdrawal syndrome if they abruptly abstain from alcohol use. Alcohol withdrawal syndrome begins six to 24 hours after the last intake of ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1101/p589.html

After Detoxification: Levels of Treatment for Alcohol Dependence - Editorials - ...

Nov 1, 2013 - Detoxification is just the tip of the iceberg, and the postdischarge treatment program is key in determining whether patients will abstain from alcohol.

American Family Physician : Editorials

https://www.aafp.org/afp/2013/1101/p576.html

Management of ADHD in Preschool-Aged Children - FPIN's Clinical Inquiries - American ...

Sep 15, 2013 - Behavior therapy interventions, such as parent training, are first-line treatment for ADHD in preschool-aged children (three to five years of age). Medication is an option for children with moderate to severe ADHD if behavior therapy has not been effective and if the benefits outweigh ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0915/p398.html

Risks Associated with Long-Term Benzodiazepine Use - Editorials - American Family ...

Aug 15, 2013 - Many patients underestimate the degree of impairment caused by benzodiazepines. Benzodiazepines increase the risk of addiction, withdrawal, cognitive decline, motor vehicle crashes, and hip fracture. The risk of overdose is particularly great when combined with sedative drugs such as ...

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0815/p224.html

Vilazodone (Viibryd) for the Treatment of Depression - STEPS - American Family Physician

Aug 15, 2013 - The available evidence does not support the routine use of vilazodone in the treatment of depression. It is significantly more expensive than generic alternatives and is no more effective for moderate to severe depression than selective serotonin reuptake inhibitors or tricyclic ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0815/p263.html

Treating Patients with Borderline Personality Disorder in the Medical Office - Curbside...

Jul 15, 2013 - The prevalence of borderline personality disorder in the general population is thought to be between 1% and 2%. As family physicians, we often treat these patients for chronic medical conditions. There are multiple obstacles to caring for these patients because of their difficult ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2013/0715/p140.html

Generalized Anxiety Disorder - Clinical Evidence Handbook - American Family Physician

Jan 15, 2013 - What are the effects of treatments for generalized anxiety disorder in adults and children and adolescents?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2013/0115/p122.html

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