Pharmacologic aids to smoking cessation.

Nicotine replacement and bupropion have shown significant benefits for those seeking pharmacologic assistance with smoking cessation. This discussion reviews the efficacy literature for both treatments, including potential side effects.

Raising questions about antidepressants.

Antidepressant medication has apparently become the most popular treatment for depression in the USA. Several beliefs about the efficacy of antidepressant medications prevail among mental health professionals and the public. This paper explores relevant research data and raises questions about these beliefs. Many of the common beliefs about these medications are not adequately supported by scientific data. The following issues are raised: (1) industry-funded research studies which result in negative findings sometimes do not get published; (2) placebo washout procedures may bias results in some studies; (3) there are serious questions about the integrity of the double-blind procedure; (4) the 'true' antidepressant drug effect in adults appears to be relatively small; (5) there is minimal evidence of antidepressant efficacy in children; (6) side effects are fairly common even with the newer antidepressants; (7) combining medications raises the risk for more serious complications; (8) all antidepressants can cause withdrawal symptoms; (9) genetic influences on unipolar depression appear to be weaker than environmental influences; (10) biochemical theories of depression are as yet unproven; (11) biological markers specific for depression have been elusive; (12) dosage and plasma levels of antidepressants have been minimally related to treatment outcome; (13) preliminary evidence suggests that patients who improve with cognitive-behavioral psychotherapy show similar biological changes as those who respond to medication, and (14) the evidence suggests that psychological interventions are at least as effective as pharmacotherapy in treating depression, even if severe, especially when patient-rated measures are used and long-term follow-up is considered.

Pharmacologic management of patients using smoking cessation aids.

There is currently no "magic bullet" available for individuals interested in smoking cessation. There are, however, many techniques that may help these individuals, some involving drug therapy. Research has shown that the habitual use of cigarettes and other tobacco products poses a serious health threat to millions of Americans. Because smoked and smokeless tobacco use produces many changes to the oral cavity and nasopharynx, dentists are in a unique position to observe changes and point out these changes to their patients. Patients who smoke should be given information about malignant, precancerous, and nonmalignant changes in the oral and perioral areas. This proactive activity can be helpful to encourage patients to terminate their smoking addiction.

The case against prescription privileges for psychologists.

The right to prescribe psychoactive medications could have major effects on the practice of psychology, on its education and training, on the marketing of psychological services, and on the public's perception of the field. This article presents the case against psychologists pursuing prescription privileges, including discussion of several arguments advanced by proponents of prescription privileges. Although APA has endorsed the effort to secure prescriptive authority, there is no requirement that states actually change their licensing laws so that their psychologists can prescribe. The costs (and potential risks) involved in pursuing prescription privileges are discussed.