Drug and Alcohol Rehabilitation: Doctor Shopping: A Phenomenon of Many Themes.
Doctor Shopping: A Phenomenon of Many Themes.
Filed under: Drug and Alcohol Rehabilitation
Innov Clin Neurosci. 2012 11; 9(11-12): 42-46
Sansone RA, Sansone LA
Doctor shopping is defined as seeing multiple treatment providers, either during a single illness episode or to procure prescription medications illicitly. According to the available literature, prevalence rates of doctor shopping vary widely, from 6.3 to 56 percent. However, this variability is partially attributable to research methodology, including the study definition of doctor shopping as well as the patient sample. The reasons for doctor shopping are varied. Some patient explanations for this phenomenon relate to clinician factors, such as inconvenient office hours or locations, long waiting times, personal characteristics or qualities of the provider, and/or insufficient communication time between the patient and clinician. Some patient explanations relate to personal factors and include both illness factors (e.g., symptom persistence, lack of understanding or nonacceptance of the diagnosis or treatment) as well as psychological factors (e.g., somatization, prescription drug-seeking). Importantly, not all doctor shopping is driven by suspect motivations. Being aware of these various patient justifications for doctor shopping is important in understanding and managing these challenging patients in the clinical setting, whether they emerge in psychiatric or primary care environments.
HubMed – drug
Successful use of rasagiline in combination with two antidepressants: a case report.
Filed under: Drug and Alcohol Rehabilitation
Innov Clin Neurosci. 2012 Nov; 9(11-12): 39-41
Kaur N, Madan R, Sharma A
Parkinson’s disease is the second most common neurodegenerative disorder, affecting 1 to 2 percent of people older than 60 years. Recent reviews show that depression is a common and potentially debilitating aspect of Parkinson’s disease, affecting 40 to 50 percent of patients. Depression in Parkinson’s disease is demonstrably different from ordinary major depression in terms of gender ratio, age, symptom profile, comorbidity, and chronicity. Pharmacotherapy for depression in Parkinson’s disease entails special concerns related to side effects and drug-drug interactions. Rasagiline is a novel, potent, and irreversible monoamine oxidase type B (MAO-B) inhibitor that has recently been approved by the Food and Drug Administration for treatment of Parkinson’s disease. Current rasagiline labeling advises the avoidance of coadministration of rasagiline and antidepressants, which is a challenge in itself for patients with co-morbid depression. We present a case of a 58-year-old woman who failed most of the pharmacologic treatments for Parkinson’s disease, including deep brain stimulation, and was recently prescribed rasagiline with good response. She also met the Diagnostic and Statistical Manual, Fourth Edition, Text Revision criteria of major depressive disorder, which was treated with venlafaxine and bupropion. To our knowledge, this is first clinical case report of successful use of a combination of antidepressants and rasagiline in a patient with Parkinson’s disease.
HubMed – drug
‘Omics’ approaches to understanding interstitial cystitis/painful bladder syndrome/bladder pain syndrome.
Filed under: Drug and Alcohol Rehabilitation
Int Neurourol J. 2012 Dec; 16(4): 159-68
You S, Yang W, Anger JT, Freeman MR, Kim J
Recent efforts in the generation of large genomics, transcriptomics, proteomics, metabolomics and other types of ‘omics’ data sets have provided an unprecedentedly detailed view of certain diseases, however to date most of this literature has been focused on malignancy and other lethal pathological conditions. Very little intensive work on global profiles has been performed to understand the molecular mechanism of interstitial cystitis/painful bladder syndrome/bladder pain syndrome (IC/PBS/BPS), a chronic lower urinary tract disorder characterized by pelvic pain, urinary urgency and frequency, which can lead to long lasting adverse effects on quality of life. A lack of understanding of molecular mechanism has been a challenge and dilemma for diagnosis and treatment, and has also led to a delay in basic and translational research focused on biomarker and drug discovery, clinical therapy, and preventive strategies against IC/PBS/BPS. This review describes the current state of ‘omics’ studies and available data sets relevant to IC/PBS/BPS, and presents opportunities for new research directed at understanding the pathogenesis of this complex condition.
HubMed – drug
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