Category Archives: First Comments

Learning from Dr. Fauci

Listening to Dr. Fauci’s portion of the Covid 19 response team briefing on March 5, 2021 on MS-NBC gives the wonderful experience of being taught by a world-class scientist. He suggested some homework, reading an article by John P Moore, … Continue reading

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On using continuous glucose monitors (CGMs)

Bret Scher, MD of Dietdoctor.com recently interviewed Casey Means, MD, a Stanford-educated physician (both BA and MD). Dietdoctor podcast # 59 https://www.youtube.com/watch?v=336fjAmY8JQ Dr. Means was doing an ENT surgical residency at Oregon Health Sciences Center when she realized that most … Continue reading

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A meme for the coronavirus pandemic

In Stanley Kubrick’s classic war movie Full Metal Jacket, there is a scene in a conference room one day after the Tet offensive began in 1968 (the Tet offensive demonstrated that the Vietnam war was unwinnable, and that the enemy … Continue reading

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Thinking about marijuana

  A writer asked me to respond to some questions about marijuana. Here’s what I wrote 1. Is there any evidence that cannabis has mental health benefits? There is one high-quality paper (multi-center, randomized, double-blind, placebo controlled; American Journal of … Continue reading

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Stoll redux, or for real?

I just read a potentially practice changing  article in Bipolar Disorders: Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: A randomized controlled trial, by Dickerson et al. https://onlinelibrary.wiley.com/doi/pdf/10.1111/bdi.12652   Sixty-six patients hospitalized for mania were randomized to … Continue reading

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To prevent lost time: on using the most effective medication first, not last

Joseph Goldberg has written an important article for clinicians who treat patients with mood disorders. Goldberg JF. Should we reserve big gun antimanic drugs for only big gun manias? Bipolar Disord. 2018; 20:7–8. https://doi.org/10.1111/bdi.12597 He suggests, writing primarily about olanzapine, … Continue reading

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ADHD, Accidents, and Premature Death

Occasionally insurance companies make doctors fill out forms for  medications  not on their formularies, and on the form will be  a statement that asks the doctor to check a box if a ‘standard review timeline’ of 72 hours might seriously … Continue reading

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How lithium helps prevent suicide: one patient’s experience

How lithium helps prevent suicide: a patient’s experience   Lithium is one of the most effective anti-suicide medications psychiatrists have to treat patients with mood disorders. http://www.bmj.com/content/346/bmj.f3646   How it works is unknown. [i]   Recently, a patient of mine … Continue reading

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Psychopharmacology Made Simple: What’s it like when an SSRI[i] works?

Psychopharmacology Made Simple: What’s it like when an SSRI[1] works? What benefit can one expect from a medication? While it’s easy enough to find information online about side effects and diagnostic indications (approved uses), it’s much more difficult to learn … Continue reading

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Psychopharmacology Made Simple: What’s it like when Wellbutrin works?

Wellbutrin (bupropion) works quite differently from SSRIs such as Lexapro (escitalopram), the subject of a previous blog post. How does it work? Per UpToDate[1], “like other antidepressants the mechanism of bupropion’s activity is not fully understood”. [2]   Clinically, it’s … Continue reading

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