Publications by authors named "D N Osser"

Telemental health via videoconferencing (TMH-V) can overcome many of the barriers to accessing quality mental health care. Toward this end, in 2011, the U.S.

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Article Synopsis
  • A new algorithm from Harvard focuses on treating generalized anxiety disorder (GAD) specifically in older adults, reviewing relevant studies to determine medication effectiveness.
  • Selective serotonin reuptake inhibitors (SSRIs), especially sertraline and escitalopram, are recommended as the first-line treatments, with alternatives like buspirone suggested for minimizing sexual side effects.
  • If initial treatments don’t work, other options include different SSRIs, SNRIs, and medications like pregabalin or gabapentin, while caution is advised with benzodiazepines and hydroxyzine due to potential risks in elderly patients.
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Algorithms for posttraumatic stress disorder were published by this team in 1999 and 2011. Developments since then warrant revision. New studies and review articles from January 2011 to November 2021 were identified via PubMed and analyzed for evidence supporting changes.

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Purpose Of Review: To provide updated guidance for the medication treatment of acute agitation in the setting of psychosis or mania on inpatient psychiatric units.

Recent Findings: This topic presented challenges: studies are sparse, tend to be under-powered, and are difficult to compare. Though there have been few recent studies, there have been several recent meta-analyses, Cochrane reviews, and published guidelines that sift through the primarily older evidence as well as more recent trials.

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Geriatric patients with dementia frequently present with agitation, aggression, psychosis, and other behavioral and psychological symptoms of dementia (BPSD). We present an update of our previously published algorithms for the use of psychopharmacologic agents in these patients taking into account more recent studies and findings in meta-analyses, reviews, and other published algorithms. We propose three algorithms: BPSD in an emergent, urgent, and non-urgent setting.

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