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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

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

Opioid Use Disorder: Medical Treatment Options - American Family Physician Restricted content. Login required.

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

Stuttering: Understanding and Treating a Common Disability - American Family Physician Restricted content. Login required.

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

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

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

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

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

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

Adverse Effects of Antipsychotic Medications - American Family Physician

Mar 1, 2010 - The use of antipsychotic medications entails a difficult trade-off between the benefit of alleviating psychotic symptoms and the risk of troubling, sometimes life-shortening adverse effects. There is more variability among specific antipsychotic medications than there is between the ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0301/p617.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

Treatment of Childhood and Adolescent Depression - American Family Physician

Sep 1, 2012 - Major depressive disorder in children and adolescents is a common condition that affects physical, emotional, and social development. Risk factors include a family history of depression, parental conflict, poor peer relationships, deficits in coping skills, and negative thinking. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0901/p442.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

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

Antidepressant Discontinuation Syndrome - American Family Physician

Aug 1, 2006 - Antidepressant discontinuation syndrome occurs in approximately 20 percent of patients after abrupt discontinuation of an antidepressant medication that was taken for at least six weeks. Typical symptoms of antidepressant discontinuation syndrome include flu-like symptoms, insomnia, ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0801/p449.html

Managing Grief and Depression at the End of Life - American Family Physician

Aug 1, 2012 - Psychological distress is common in terminally ill persons and can be a source of great suffering. Grief is an adaptive, universal, and highly personalized response to the multiple losses that occur at the end of life. This response may be intense early on after a loss manifesting ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0801/p259.html

The Physician's Role in Managing Acute Stress Disorder - American Family Physician

Oct 1, 2012 - Acute stress disorder is a psychiatric diagnosis that may occur in patients within four weeks of a traumatic event. Features include anxiety, intense fear or helplessness, dissociative symptoms, reexperiencing the event, and avoidance behaviors. Persons with this disorder are at ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1001/p643.html

Exercise, Yoga, and Meditation for Depressive and Anxiety Disorders - American Family ...

Apr 15, 2010 - Anxiety and depression are among the most common conditions cited by those seeking treatment with complementary and alternative therapies, such as exercise, meditation, tai chi, qigong, and yoga. The use of these therapies is increasing. Several studies of exercise and yoga have ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p981.html

Alcohol Withdrawal Syndrome - American Family Physician

Mar 15, 2004 - The spectrum of alcohol withdrawal symptoms ranges from such minor symptoms as insomnia and tremulousness to severe complications such as withdrawal seizures and delirium tremens. Although the history and physical examination usually are sufficient to diagnose alcohol withdrawal ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0315/p1443.html

Treatment Options for Insomnia - American Family Physician

Aug 15, 2007 - The frequency of sleep disruption and the degree to which insomnia significantly affects daytime function determine the need for evaluation and treatment. Physicians may initiate treatment of insomnia at an initial visit; for patients with a clear acute stressor such as grief, no ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p517.html

Pharmacologic Management of Adult Depression - American Family Physician

Mar 15, 2008 - Major depression is a common and treatable disease. Many patients benefit from pharmacologic treatment and, because there is little variation in antidepressant effectiveness, medication choices should be made based on patient characteristics, safety, and anticipated side effects. Most ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0315/p785.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Treatment-Resistant Depression - American Family Physician

Jul 15, 2009 - Up to two thirds of patients with major unipolar depression will not respond to the first medication prescribed. Depression may be considered resistant to treatment when at least two trials with antidepressants from different pharmacologic classes (adequate in dose, duration, and ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0715/p167.html

Oppositional Defiant Disorder - American Family Physician

Oct 1, 2008 - Oppositional defiant disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., as a recurrent pattern of developmentally inappropriate, negativistic, defiant, and disobedient behavior toward authority figures. This behavior often appears in the preschool...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p861.html

Mirtazapine: A Newer Antidepressant - American Family Physician

Jan 1, 1999 - Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity. It is at least as effective as the older antidepressants for treating mild to severe depression. Sedation is the most common side effect. Although agranulocytosis is the most serious side ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0101/p159.html

The Patient with Excessive Worry - American Family Physician

Mar 15, 2006 - Worry is a normal response to uncertainty. Education, empathetic support, reassurance, and passage of time usually ameliorate ordinary worries. However, these common-sense strategies for dealing with transient worries often prove ineffective for patients with excessive worry, many of ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1049.html

What to do When SSRIs Fail: Eight Strategies for Optimizing Treatment of Panic Disorder...

Oct 15, 2002 - Selective serotonin reuptake inhibitors (SSRIs) are the drug of choice for treatment of patients with panic disorder. Most patients have a favorable response to SSRI therapy; however, 30 percent will not be able to tolerate these drugs or will have an unfavorable or incomplete response....

American Family Physician : Article

https://www.aafp.org/afp/2002/1015/p1477.html

Realistic Approaches to Counseling in the Office Setting - American Family Physician

Feb 15, 2009 - Although it is often unrecognized, family physicians provide a significant amount of mental health care in the United States. Time is one of the major obstacles to providing counseling in primary care. Counseling approaches developed specifically for ambulatory patients and traditional ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0215/p277.html

Treating Eating Disorders in Primary Care - American Family Physician

Jan 15, 2008 - Binge-eating disorder, bulimia nervosa, and anorexia nervosa are potentially life-threatening disorders that involve complex psychosocial issues. A strong therapeutic relationship between the physician and patient is necessary for assessing the psychosocial and medical factors used to ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0115/p187.html

Treatment of Panic Disorder - American Family Physician

Feb 15, 2005 - Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder. Antidepressant medications successfully reduce the severity of panic symptoms and eliminate ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p733.html

Herbal and Dietary Supplements for Treatment of Anxiety Disorders - American Family ...

Aug 15, 2007 - Use of complementary and alternative medicine has increased over the past decade. A variety of studies have suggested that this use is greater in persons with symptoms or diagnoses of anxiety and depression. Data support the effectiveness of some popular herbal remedies and dietary ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p549.html

A 'Stages of Change' Approach to Helping Patients Change Behavior - American Family ...

Mar 1, 2000 - Helping patients change behavior is an important role for family physicians. Change interventions are especially useful in addressing lifestyle modification for disease prevention, long-term disease management and addictions. The concepts of

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1409.html

Medications for Treating Alcohol Dependence - American Family Physician

Nov 1, 2005 - Medications for treating alcohol dependence primarily have been adjunctive interventions, and only three medications--disulfiram, naltrexone, and acamprosate--are approved for this indication by the U.S. Food and Drug Administration. Disulfiram, an aversive agent that has been used for ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1775.html

Cognitive Therapy for Depression - American Family Physician

Jan 1, 2006 - Cognitive therapy is a treatment process that enables patients to correct false self-beliefs that can lead to negative moods and behaviors. The fundamental assumption is that a thought precedes a mood; therefore, learning to substitute healthy thoughts for negative thoughts will improve...

American Family Physician : Article

https://www.aafp.org/afp/2006/0101/p83.html

St. John's Wort - American Family Physician

Dec 1, 2005 - St. John's wort has been used to treat a variety of conditions. Several brands are standardized for content of hypericin and hyperforin, which are among the most researched active components of St. John's wort. St. John's wort has been found to be superior to placebo and equivalent to ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1201/p2249.html

Managing Opioid Addiction with Buprenorphine - American Family Physician

May 1, 2006 - Legislation has enabled physicians to treat opioid-dependent patients with an office-based maintenance program using buprenorphine, a partial mu-opioid receptor agonist. Clinical studies indicate buprenorphine effectively manages opioid addiction. Buprenorphine is more effective than ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0501/p1573.html

Addiction: Part I. Benzodiazepines-Side Effects, Abuse Risk and Alternatives - American...

Apr 1, 2000 - Benzodiazepines are widely prescribed for a variety of conditions, particularly anxiety and insomnia. They are relatively safe and, with overdose, rarely result in death. However, used chronically, benzodiazepines can be addicting. These agents are often taken in combination with other ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0401/p2121.html

Management of the Difficult Patient - American Family Physician

Nov 15, 2005 - All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders, personality ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2063.html

Outpatient Detoxification of the Addicted or Alcoholic Patient - American Family Physician

Sep 15, 1999 - Outpatient detoxification of patients with alcohol or other drug addiction is being increasingly undertaken. This type of management is appropriate for patients in stage I or stage II of withdrawal who have no significant comorbid conditions and have a support person willing to monitor ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0915/p1175.html

Ambulatory Detoxification of Patients with Alcohol Dependence - American Family Physician

Feb 1, 2005 - Detoxification from alcohol can be undertaken in ambulatory settings with patients who are alcohol-dependent and show signs of mild to moderate withdrawal when they are not drinking. An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p495.html

Off-Label Applications for SSRIs - American Family Physician

Aug 1, 2003 - Selective serotonin reuptake inhibitors (SSRIs) are widely used because of their safety, tolerability, and demonstrated efficacy across a broad range of clinical conditions. Medical literature supports the use of SSRIs for the treatment of many conditions outside of the indications ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0801/p498.html

School Refusal in Children and Adolescents - American Family Physician

Oct 15, 2003 - School refusal is a problem that is stressful for children, families, and school personnel. Failing to attend school has significant short- and long-term effects on children's social, emotional, and educational development. School refusal often is associated with comorbid psychiatric ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1015/p1555.html

Smoking Cessation: Integration of Behavioral and Drug Therapies - American Family ...

Mar 15, 2002 - Family physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0315/p1107.html

Approaching the Suicidal Patient - American Family Physician

Nov 1, 2003 - The suicide of a patient can be devastating to the family and to the family physician. The patient's death may shake the physician's confidence, undermine any willingness to work with patients with a mental illness, and provoke professional and legal review. In an attempt to help the ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1101/p1814.html

Antidepressants: Update on New Agents and Indications - American Family Physician

Feb 1, 2003 - A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and...

American Family Physician : Article

https://www.aafp.org/afp/2003/0201/p547.html

Management of Bipolar Disorder - American Family Physician

Sep 15, 2000 - Bipolar disorder most commonly is diagnosed in persons between 18 and 24 years of age. The clinical presentations of this disorder are broad and include mania, hypomania and psychosis. Frequently associated comorbid conditions include substance abuse and anxiety disorders. Patients with...

American Family Physician : Article

https://www.aafp.org/afp/2000/0915/p1343.html

Management of Withdrawal Syndromes and Relapse Prevention in Drug and Alcohol Abuse - ...

Jul 1, 1998 - The primary care physician is in a good position to diagnose, manage and intervene with patients who are undergoing the process of treatment and recovery from alcohol and drug disorders. Medications such as benzodiazepines are effective in the treatment of withdrawal syndromes, and ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0701/p139.html

Panic Disorder: Effective Treatment Options - American Family Physician

May 15, 1998 - Panic disorder is a distressing and debilitating condition with a familial tendency; it may be associated with situational (agoraphobic) avoidance. The diagnosis of panic disorder requires recurrent, unexpected panic attacks and at least one of the following characteristics: persistent ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0515/p2405.html

Psychotherapy in Primary Care: The BATHE Technique - American Family Physician

May 1, 1998 - The family physician occupies a front-line position in the detection and treatment of emotional problems and psychiatric illnesses. The practice pattern of the family physician necessitates an efficient, effective model of psychotherapy The BATHE technique is a brief psychotherapeutic ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0501/p2131.html

Benefits and Risks of Psychiatric Medications During Pregnancy - American Family Physician

Aug 15, 2002 - Traditionally, psychiatric medications were withheld during pregnancy because of fear of teratogenic and other effects. The emergence of evidence of the safety of most commonly used psychiatric medications, the availability of this information in the form of online databases, and the ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p629.html

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