PubMed Health⌕ Search

Biomedical subjects

Theodore A Stern

Publications and source records attributed to Theodore A Stern.

At least 19 recordsLinked to original sources
PubMed2006

Aripiprazole-related tardive dyskinesia.

The low prevalence of extrapyramidal symptoms associated with atypical antipsychotics has led to their widespread use during the past decade. Aripiprazole, the newest medication in this class, has been associated with extrapyramidal symptoms (eg, akathisia) and with improvement of tardive dyskinesia (TD), but to date it has not been associated with the development of TD. We report a case of TD associated with the use of aripiprazole 15 mg/day for 18 months for refractory depression. Symptoms of TD resolved within several weeks of discontinuation of aripiprazole.

Antipsychotic Agents↗
PubMed2005

Delirium-associated disulfiram and ethanol interactions.

BACKGROUND: Disulfiram, an agent used for the treatment of alcohol dependence, can exacerbate psychiatric syndromes (including psychosis, catatonia, delirium, depression, and mania) after extended use. However, delirium has yet to be reported following the short-term use of disulfiram in the setting of alcohol use. OBJECTIVES: We report a case with a neuropsychiatric presentation and discuss the prevention and the progression of delirium associated with an interaction of disulfiram and ethanol. CASE REPORT: We report the case of a 51-year-old woman who developed disorganized speech, diminished communication, a decrease in appetite, and thoughts of suicide 10 days after she began taking disulfiram (250 mg/day), to which she added 1 glass of alcoholic beverage for 2 days. Delirium developed in association with an interaction between disulfiram and alcohol. The patient met DSM-IV criteria for major depressive disorder, alcohol dependence, and delirium. DISCUSSION: Neuropsychiatric manifestations may develop in association with co-administration of disulfiram and alcohol; timely recognition and treatment are recommended.

Journal Article↗
PubMed2005

Psychotic symptoms in the elderly.

Lessons Learned at the Interface of Medicine and PsychiatryThe Psychiatric Consultation Service at Massachusetts General Hospital (MGH) sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. Such consultations require the integration of medical and psychiatric knowledge. During rounds, Dr. Stern and the chief resident discuss the diagnosis and management of conditions confronted. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Journal Article↗
PubMed2004

Using Psychostimulants to Treat Depression in the Medically Ill.

LESSONS LEARNED AT THE INTERFACE OF MEDICINE AND PSYCHIATRY: The Psychiatric Consultation Service at Massachusetts General Hospital (MGH) sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. Such consultations require the integration of medical and psychiatric knowledge. During their thrice-weekly rounds, Dr. Huffman and Dr. Stern discuss the diagnosis and management of conditions confronted. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Journal Article↗
PubMed2003

The use of benzodiazepines in the treatment of chest pain: a review of the literature.

Benzodiazepines, although not listed in the American Heart Association's guidelines for the treatment of chest pain, are often used to provide symptomatic relief to patients who experience chest pain. To investigate the utility of benzodiazepines in the treatment of chest pain, the pharmacologic actions and cardiovascular effects of benzodiazepines were reviewed. In addition, a literature search regarding the use of benzodiazepines to treat patients with chest pain was conducted. The results indicated that benzodiazepines reduce anxiety, pain, and cardiovascular activation. Benzodiazepines amplify gamma-aminobutyric acid (GABA) throughout the central nervous system, and act more peripherally to reduce catecholamines. In addition, preliminary evidence indicates that benzodiazepines may cause coronary vasodilatation, prevent dysrhythmias, and block platelet aggregation, though further study is needed. Both non-cardiac chest pain (associated with musculoskeletal, esophageal, neurologic, and psychiatric conditions) and cardiac chest pain (associated with acute and chronic myocardial ischemia) seem to be effectively treated with benzodiazepines. Benzodiazepines are safe and well tolerated when administered alone or in combination with other medications. Moreover, the risk of dependence is minimal when benzodiazepines are prescribed on a short-term basis. Further study of benzodiazepines in the treatment of acute chest pain is needed to confirm these favorable actions and better define their use in the acute medical setting.

Acute Disease↗
PubMed2002

Central pontine myelinolysis manifested by temporary blindness: a possible complication of lithium toxicity.

Central pontine myelinolysis (CPM) is removal of myelin material from neural elements in a way that is not clearly known as yet. In this case of CPM, blindness was encountered and was thought to be "hysterical." The blindness went away after four months. After reviewing the literature we suggest the CPM was a complication of lithium toxicity which affected the lateral geniculate nucleus which produced blindness.

Adult↗
PubMedDate not supplied

The diagnosis and treatment of Munchausen's syndrome.

Patients with Munchausen's syndrome--a syndrome characterized by the intentional production of physical symptoms to gain the sick role-present a variety of challenges to health care providers. Their treaters quickly become frustrated by their demanding interpersonal styles, by deception and manipulation, and by multiple unrevealing diagnostic procedures. These difficulties can lead to poor outcomes for patients and staff alike. We present the case of a young woman whose presentation and subsequent evaluation led to significant distress among the hospital staff responsible for her care, and discuss the epidemiology, diagnosis, and management of patients with Munchausen's syndrome. The most important role of the psychiatrist in the treatment of Munchausen's syndrome is to help the primary treatment team manage the patient in the safest and most appropriate way. Such management includes avoiding unnecessary procedures, preventing further self-harm, and avoiding angry or threatening interactions with the patient. The prognosis for patients with Munchausen's syndrome appears to be poor; flexible and creative approaches that emphasize consistency of care and regular outpatient psychiatric treatment have had the greatest success.

Adult↗
PubMedDate not supplied

Psychiatric considerations in the patient receiving organ transplantation: a clinical case conference.

Psychiatric consultations to evaluate a patient's suitability to receive organ transplantation can require the integration of multiple types and sources of information. A patient's social support network, history of treatment compliance, ongoing Axis I and Axis II disorders, and understanding of the procedure and follow-up required must all be evaluated during such a consultation. This article presents the case of a woman with borderline personality disorder who developed hepatic failure following a drug overdose, and discusses her evaluation for liver transplantation. The discussion frames the pertinent issues in the transplant evaluation and describes the perioperative (transplant) management of the borderline patient.

Acetaminophen↗
PubMedDate not supplied

Clinical experience with the management of schizophrenia in the general hospital.

On the basis of experience with 74 psychiatric consultations involving patients with schizophrenia admitted to a general hospital medical or surgical ward over a 17-month period (3% of the psychiatric consultations during that period), the authors identified 10 types of problems leading to requests for consultation. The authors used these categories to organize recommendations for management of patients with schizophrenia in the general medical hospital. In addition to conducting conventional consultations, the consultation psychiatrist in such cases often has a role in educating hospital staff about schizophrenia and in serving as a physician for the mentally ill.

Antipsychotic Agents↗