When I hear debate over the association between SSRIs (selective serotonin re-uptake inhibitors, a class of antidepressant medication) and suicidal behavior in children and adolescents, I am immediately brought back to a night in the early 2000s.  As the covering pediatrician I was called to the emergency room to see a young man, a patient of a pediatrician in a neighboring town, who had attempted suicide by taking a nearly ...

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Today, I saved a life. And I wish I could tell you a story about fancy heroics -- about an exploratory laparatomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life.  But I can’t.  But I can tell you that I saved a life. She was 16-years-old, and moved here four years ago from a different ...

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I was shocked and deeply saddened when my daughter announced at the dinner table that Robin Williams had died of an apparent suicide. My wife and I and the three of our children home at the time all pretty much gasped audibly in unison, and then for a moment after, you could have heard a pin drop. For a bit after that, we talked about our shock and sorrow. And then after that, ...

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We are civilized people in the United States. We don't set up leper colonies or concentration camps or psychiatric snake pits to banish people with severe mental illness. Instead we send them to jail or prison -- almost 400,000 of them, more than 10 times the number receiving care in hospitals. And we also blithely ignore the fact that additional hundreds of thousands live homeless on the streets or in ...

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Top stories in health and medicine, August 20, 2014From MedPage Today:

  1. Moving Target for BP Guidelines. The current blood pressure target recommendations may need to be revisited in hypertensive patients with coronary artery disease who are 60 years and older.
  2. Transcatheter Mitral Valve Repair Rivals Surgery. Survival rates with catheter-based mitral valve repair are comparable to classic surgery and better ...

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A wise friend who had completed residency told me prior to my starting training that the key to having fun was “never sit down when you get home from work.” Three years out of fellowship and practicing as a psychiatrist in Brooklyn, the words still resonate today.  The residents and medical students that rotate with me marvel at the stories of my full time acting career as a resident performing in ...

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As doctors we prescribe a lot for our patients -- pain relievers, medications for specific ailments, exercise, or vitamins. However, too often we forget the power of vitamin C: human connection. As a therapist and medical doctor for children and adults with ADHD, I don’t underestimate the power of employing a variety of treatments that treat the patient as a whole; this may include medication, recommendations about diet, exercise and lifestyle ...

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OpenNotes is “a national initiative working to give patients access to the visit notes written by their doctors, nurses, or other clinicians.”  According to their website, three million patients now have such access, generally online.  Participating institutions include the MD Anderson Cancer Center in Texas, Beth Israel Deaconess in Boston, Penn State Hershey Medical Group, Kaiser Permanente Northwest, and several others. Patients with a premium account in the My HealtheVet program at the VA have access to outpatient primary ...

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Somewhere late morning, after rounding on my first day of internship, I received a call from my sister. “She wants to kill herself. What do I do?” We had been through this before with our mother, fifteen years ago, the week I moved out of her house. She ended up in the psychiatric unit as we packed our bags to move in with our grandmother. This time, fifteen years later, things were ...

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At the recent gubernatorial candidates forum on mental health, Martha Coakley repeated the oft-heard phrase that depression is like diabetes. Her motivation was good, the idea being to reduce the stigma of mental illness, and to offer "parity" or equal insurance coverage, for mental and physical illness. However, I am concerned that this phrase, and its companion, "ADHD is like diabetes," will, in fact, have the exact opposite effect. A ...

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