Transcript

Lee Tetreault:

Hello and welcome to frequently asked questions from the session Cases in Psychiatry: Psychopharmacology for the PCP. We are joined today by Dr. Shirah Vollmer. Doctor, before we start, could you go into some of the key pointers from today's session for our audience? 

Dr. Vollmer:  

Yes, the key pointer is that primary care is now responsible for the mental health of their patients. This has been a radical change since Prozac came out in 1987, that has enabled mental health care to enter into primary care and that has now made it so that primary care physicians and clinicians need to understand mental illness in ways that they didn't need to understand previously.

Lee Tetreault:

Great, let's get into some of these frequently asked questions. First, do you use GeneSight to help selecting therapy? 

Dr. Vollmer:  

The short answer is no. GeneSight is a way of understanding the metabolism of drugs and understanding how the drugs are metabolized through the liver. And although it can be a helpful adjunct, usually you can get that information from the history, from understanding how people are sensitive or not sensitive to other medications that they've taken.

Lee Tetreault:

And let's talk about one of the patient cases that you presented in your session today with Gina. What about Trazodone for Gina? 

Dr. Vollmer:  

Trazodone's an excellent point, and I've added that to my talk, because Trazodone is not an addictive drug and it will help her sleep. The only disadvantage of Trazodone is that... Well, she has to take it two hours before bed. And many people don't think ahead that far in advance.

Lee Tetreault:

Soldiers with PTSD often request ADHD drugs. Do they help? 

Dr. Vollmer:  

The short answer is no. PTSD, it makes people hard to focus, because the traumatic memories interfere with their focus, but stimulant medications usually do not help with that and they need to deal with the trauma in other ways, usually through behavioral therapies.

Lee Tetreault:

Do you see issues in patients on stimulants long-term? 

Dr. Vollmer:  

The short answer again is no. When patients take stimulants according to the way it's prescribed, they usually take a dose, that dose is stable for many, many years and there are no long-term adverse effects.

Lee Tetreault:

And lastly, can you use the gabapentin PRN anxiety? 

Dr. Vollmer:  

The short answer is yes. Gabapentin off-label can be used for PRN anxiety. It is in some states a scheduled drug, but it is helpful for people with anxiety when used appropriately.

Lee Tetreault:

This is great information. Doctor, thank you so much for your time today.