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Medicine by the numbers

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Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Buprenorphine Therapy for Opioid Use Disorder - American Family Physician

Mar 1, 2018 - Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p313.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Medications for Alcohol Use Disorder - American Family Physician

Mar 15, 2016 - The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p457.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders - American ...

Nov 1, 2015 - Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p807.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Buprenorphine Maintenance vs. Placebo for Opioid Dependence - Medicine by the Numbers -...

Mar 1, 2017 - Buprenorphine causes lower physical dependence, milder withdrawal symptoms, and is less likely to cause an overdose than methadone in the treatment of opioid dependence.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0301/od1.html

Aripiprazole vs. Placebo or Haloperidol for Schizophrenia - Medicine by the Numbers - ...

Dec 1, 2016 - Aripiprazole was shown to have one major benefit over placebo, but favorable outcomes with haloperidol throw its effectiveness into question. Are the differences merely anomalies?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1201/p877.html

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

The Physician's Role in Managing Acute Stress Disorder - American Family Physician

Oct 1, 2012 - Acute stress disorder is a psychiatric diagnosis that may occur in patients within four weeks of a traumatic event. Features include anxiety, intense fear or helplessness, dissociative symptoms, reexperiencing the event, and avoidance behaviors. Persons with this disorder are at ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1001/p643.html

Treatment of Childhood and Adolescent Depression - American Family Physician

Sep 1, 2012 - Major depressive disorder in children and adolescents is a common condition that affects physical, emotional, and social development. Risk factors include a family history of depression, parental conflict, poor peer relationships, deficits in coping skills, and negative thinking. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0901/p442.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Antidepressant Discontinuation Syndrome - American Family Physician

Aug 1, 2006 - Antidepressant discontinuation syndrome occurs in approximately 20 percent of patients after abrupt discontinuation of an antidepressant medication that was taken for at least six weeks. Typical symptoms of antidepressant discontinuation syndrome include flu-like symptoms, insomnia, ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0801/p449.html

The Patient with Excessive Worry - American Family Physician

Mar 15, 2006 - Worry is a normal response to uncertainty. Education, empathetic support, reassurance, and passage of time usually ameliorate ordinary worries. However, these common-sense strategies for dealing with transient worries often prove ineffective for patients with excessive worry, many of ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0315/p1049.html

Exercise, Yoga, and Meditation for Depressive and Anxiety Disorders - American Family ...

Apr 15, 2010 - Anxiety and depression are among the most common conditions cited by those seeking treatment with complementary and alternative therapies, such as exercise, meditation, tai chi, qigong, and yoga. The use of these therapies is increasing. Several studies of exercise and yoga have ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p981.html

Behavior Disorders of Dementia: Recognition and Treatment - American Family Physician

Feb 15, 2006 - Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. The nature and frequency of psychotic symptoms varies over the course of illness, but in most patients, these symptoms occur more often in the later stages of disease. ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p647.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Oppositional Defiant Disorder - American Family Physician

Oct 1, 2008 - Oppositional defiant disorder is defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., as a recurrent pattern of developmentally inappropriate, negativistic, defiant, and disobedient behavior toward authority figures. This behavior often appears in the preschool...

American Family Physician : Article

https://www.aafp.org/afp/2008/1001/p861.html

Pharmacologic Management of Adult Depression - American Family Physician

Mar 15, 2008 - Major depression is a common and treatable disease. Many patients benefit from pharmacologic treatment and, because there is little variation in antidepressant effectiveness, medication choices should be made based on patient characteristics, safety, and anticipated side effects. Most ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0315/p785.html

Realistic Approaches to Counseling in the Office Setting - American Family Physician

Feb 15, 2009 - Although it is often unrecognized, family physicians provide a significant amount of mental health care in the United States. Time is one of the major obstacles to providing counseling in primary care. Counseling approaches developed specifically for ambulatory patients and traditional ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0215/p277.html

Treatment Options for Insomnia - American Family Physician

Aug 15, 2007 - The frequency of sleep disruption and the degree to which insomnia significantly affects daytime function determine the need for evaluation and treatment. Physicians may initiate treatment of insomnia at an initial visit; for patients with a clear acute stressor such as grief, no ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p517.html

Herbal and Dietary Supplements for Treatment of Anxiety Disorders - American Family ...

Aug 15, 2007 - Use of complementary and alternative medicine has increased over the past decade. A variety of studies have suggested that this use is greater in persons with symptoms or diagnoses of anxiety and depression. Data support the effectiveness of some popular herbal remedies and dietary ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0815/p549.html

Mirtazapine: A Newer Antidepressant - American Family Physician

Jan 1, 1999 - Mirtazapine is a newer antidepressant that exhibits both noradrenergic and serotonergic activity. It is at least as effective as the older antidepressants for treating mild to severe depression. Sedation is the most common side effect. Although agranulocytosis is the most serious side ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0101/p159.html

Risks Associated with Long-Term Benzodiazepine Use - Editorials - American Family ...

Aug 15, 2013 - Many patients underestimate the degree of impairment caused by benzodiazepines. Benzodiazepines increase the risk of addiction, withdrawal, cognitive decline, motor vehicle crashes, and hip fracture. The risk of overdose is particularly great when combined with sedative drugs such as ...

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0815/p224.html

Medications for Treating Alcohol Dependence - American Family Physician

Nov 1, 2005 - Medications for treating alcohol dependence primarily have been adjunctive interventions, and only three medications--disulfiram, naltrexone, and acamprosate--are approved for this indication by the U.S. Food and Drug Administration. Disulfiram, an aversive agent that has been used for ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1775.html

Treatment of Panic Disorder - American Family Physician

Feb 15, 2005 - Panic disorder with or without agoraphobia occurs commonly in patients in primary care settings. This article assesses multiple evidence-based reviews of effective treatments for panic disorder. Antidepressant medications successfully reduce the severity of panic symptoms and eliminate ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p733.html

Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults - Cochrane ...

Sep 1, 2019 - Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p278.html

Individual Behavioral Counseling for Smoking Cessation - Cochrane for Clinicians - ...

Jul 1, 2018 - Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p21.html

Outpatient Detoxification of the Addicted or Alcoholic Patient - American Family Physician

Sep 15, 1999 - Outpatient detoxification of patients with alcohol or other drug addiction is being increasingly undertaken. This type of management is appropriate for patients in stage I or stage II of withdrawal who have no significant comorbid conditions and have a support person willing to monitor ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0915/p1175.html

What to do When SSRIs Fail: Eight Strategies for Optimizing Treatment of Panic Disorder...

Oct 15, 2002 - Selective serotonin reuptake inhibitors (SSRIs) are the drug of choice for treatment of patients with panic disorder. Most patients have a favorable response to SSRI therapy; however, 30 percent will not be able to tolerate these drugs or will have an unfavorable or incomplete response....

American Family Physician : Article

https://www.aafp.org/afp/2002/1015/p1477.html

Social Media Use and Mood Disorders: When Is It Time to Unplug? - Curbside Consultation...

Oct 15, 2017 - Americans spend more time on Facebook, the world's largest online social network, than any other website. On the surface, social media networks provide an invaluable resource for fulfilling the basic human need for social connection. However, rather than enhancing well-being by ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1015/p537.html

How Family Physicians Can Combat the Opioid Epidemic - Editorials - American Family ...

Sep 15, 2017 - Family physicians must commit to responsible prescribing of opioid medications. The decision to initiate opioid therapy should be a careful and deliberate one, especially in patients who are at risk of addiction.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0915/p357.html

Management of the Difficult Patient - American Family Physician

Nov 15, 2005 - All physicians must care for some patients who are perceived as difficult because of behavioral or emotional aspects that affect their care. Difficulties may be traced to patient, physician, or health care system factors. Patient factors include psychiatric disorders, personality ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1115/p2063.html

Extended-Release Bupropion for Preventing Seasonal Affective Disorder in Adults - ...

Jan 1, 2017 - When started in the fall, extended-release bupropion, 300 mg once daily, is effective in preventing recurrent symptoms in high-risk adults with a history of SAD (number needed to treat [NNT] = 5), as well as those at lower risk (NNT = 8). Headaches, nausea, and insomnia may limit ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p10.html

Management of Binge-Eating Disorder in Adults - Implementing AHRQ Effective Health Care...

Mar 1, 2017 - What are the benefits and harms of treatments for adults with binge-eating disorder?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0301/p324.html

Antidepressants: Update on New Agents and Indications - American Family Physician

Feb 1, 2003 - A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and...

American Family Physician : Article

https://www.aafp.org/afp/2003/0201/p547.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Off-Label Applications for SSRIs - American Family Physician

Aug 1, 2003 - Selective serotonin reuptake inhibitors (SSRIs) are widely used because of their safety, tolerability, and demonstrated efficacy across a broad range of clinical conditions. Medical literature supports the use of SSRIs for the treatment of many conditions outside of the indications ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0801/p498.html

St. John's Wort - American Family Physician

Dec 1, 2005 - St. John's wort has been used to treat a variety of conditions. Several brands are standardized for content of hypericin and hyperforin, which are among the most researched active components of St. John's wort. St. John's wort has been found to be superior to placebo and equivalent to ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1201/p2249.html

CDC Develops Guideline for Opioid Prescribing - Practice Guidelines - American Family ...

Jun 15, 2016 - A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0615/p1042.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Therapist-Guided, Internet-Delivered Cognitive Behavior Therapy for Anxiety - FPIN's ...

Oct 1, 2018 - Therapist-guided, Internet-delivered CBT can be used as an effective treatment for anxiety in adults and is similar in effectiveness to face-to-face CBT.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1001/p459.html

Cognitive Therapy for Depression - American Family Physician

Jan 1, 2006 - Cognitive therapy is a treatment process that enables patients to correct false self-beliefs that can lead to negative moods and behaviors. The fundamental assumption is that a thought precedes a mood; therefore, learning to substitute healthy thoughts for negative thoughts will improve...

American Family Physician : Article

https://www.aafp.org/afp/2006/0101/p83.html

Rural Opioid Use Disorder Treatment Depends on Family Physicians - Graham Center Policy...

Oct 1, 2016 - The nation's growing opioid use disorder epidemic disproportionately impacts rural areas, where physicians who can prescribe buprenorphine are scarcest. Among physicians approved to prescribe buprenorphine, family physicians (FPs) are the most likely to work in rural areas.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1001/p546.html

Opioid Abuse and Pain Management - Editorials - American Family Physician

Oct 1, 2012 - Chronic nonmalignant pain affects a significant number of Americans. Concurrent with the increased need for pain management is a considerable increase in the use of prescription pain relievers for nonmedical purposes. Nonmedical use of prescription pain relievers is now the second most ...

American Family Physician : Editorials

https://www.aafp.org/afp/2012/1001/p600.html

School Refusal in Children and Adolescents - American Family Physician

Oct 15, 2003 - School refusal is a problem that is stressful for children, families, and school personnel. Failing to attend school has significant short- and long-term effects on children's social, emotional, and educational development. School refusal often is associated with comorbid psychiatric ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1015/p1555.html

Immediate-Release Methylphenidate for the Treatment of ADHD in Adults - Cochrane for ...

Apr 1, 2015 - In adults with ADHD, immediate-release methylphenidate improves symptoms of hyperactivity, impulsiveness, and inattentiveness compared with placebo. Short-term adverse effects such as weight loss and decreased appetite do not appear to be serious. However, larger studies of longer ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0401/p445.html

Vilazodone (Viibryd) for the Treatment of Depression - STEPS - American Family Physician

Aug 15, 2013 - The available evidence does not support the routine use of vilazodone in the treatment of depression. It is significantly more expensive than generic alternatives and is no more effective for moderate to severe depression than selective serotonin reuptake inhibitors or tricyclic ...

American Family Physician : STEPS

https://www.aafp.org/afp/2013/0815/p263.html

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