What is the link between glaucoma and depression? There is a circular link. Patients with glaucoma have higher risk of becoming depressed, and being exposed to antidepressants; some antidepressants can precipitate acute angle closure glaucoma (1). Why is this important…
Snorting your depression out? Stimulants in the treatment of depression
Stimulants have been intuitively considered as treatment options for depression for a very long time. It is often said that Freud treated his own depression by snorting cocaine. Methylphenidate (Ritalin) was first systematically studied in the treatment of depression in…
The problem of irritable legs
Do you know of a condition “which causes such suffering that it should be known by every physician”?(1) That is what Ekbom, the neurologist who described this condition, said in 1960. This condition, used to be known as anxietas tibiarum…
‘Breaking Bad’: The case of innocent urine amphetamines
Often we request urine drug screening when we suspect possible drug use, but cannot trust what the patient says. What if this test declares a non-user as being positive? Who will you believe in – the test or the tested? …
The fire of psychosis
Journalists write a lot. I mean, a lot. They cannot afford to wait for the ‘writing’ mood. But how can you write meaningfully when your “brain is on fire”? A 24 year old New York Post reporter, Susannah Cahalan, had…
Clozapine and New-Onset Obsessions
Clozapine as a treatment option has many strengths. But it also has some weaknesses. This week I had a patient who has been stable on clozapine for ages, but now has a new problem related to this drug. My patient…
The new world of intranasal interventions
In psychiatry, we have been trying to reach the brain via various parenteral routes for a long time. Some historians claim that Neolithic ‘trephination’ observed in the Stone Age skulls may in fact be an attempt to treat psychiatric conditions…
Dealing with a patient facing financial hardships
This is not an uncommon problem. In some cases the psychiatric symptoms may indeed be precluding success in securing jobs (e.g. ADHD), working capacity (depression) or contributing to debts (mania). But in most cases, treating the psychiatric symptoms along is…
The story of a casino
Twenty five years ago, there were 2 groups of children. Some were poor, others were not. They all lived in a rural region, and their families agreed for regular annual research interviews for 8 years to track symptoms of mental…