Primary care companion to the Journal of clinical psychiatry
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Prim Care Companion J Clin Psychiatry · Jan 2004
Neuroleptic Malignant Syndrome: A Primary Care Perspective.
In recent years, there has been an increased use of neuroleptic agents in the primary care setting. Neuroleptic malignant syndrome (NMS) is a rare complication of neuroleptic therapy that can be missed if not suspected. ⋯ There is a lack of prospective data, and most of the information is obtained from case series. Physicians need to have a high index of suspicion with regard to excluding NMS in patients taking neuroleptics and presenting with hyperthermia.
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Prim Care Companion J Clin Psychiatry · Jan 2004
Undiagnosed Bipolar Disorder: New Syndromes and New Treatments.
Recent studies have indicated that bipolar disorder is more common than previously believed. The socioeconomic and personal burdens of this illness are significant, and the lifetime risk of suicide attempts by patients with bipolar II disorder is high. It is not uncommon for patients with bipolar disorder, especially those presenting with depression, to be seen first in a primary care setting; therefore, primary care physicians need to be ready to diagnose and manage patients with these mental illnesses. ⋯ A systematic and detailed initial history from the patient and a reliable family member is essential to making the correct diagnosis. The Mood Disorder Questionnaire, a validated screening instrument for bipolar disorder, may help primary care physicians make an appropriate diagnosis. Long-term management of patients with bipolar disorder should involve close liaison with a psychiatrist.