Consultation-Liaison Interest Group

The goal of the University of Maryland’s Consultation-Liaison Interest Group is to provide medical students and psychiatry residents with the resources and training necessary to critically evaluate emerging trends in psychosomatic medicine.

How to use this site:

This website will highlight ongoing and emerging issues on the frontier of the practice of psychiatry and medicine using clinical case vignettes with accompanying expert commentary.

A common clinical question will be presented under the tab: What would you do? Take a moment to consider your response. When ready, play the accompanying video to see what an expert might do.

What would you do?

Q: A 36 year old woman with bipolar affective disorder plans a pregnancy but is concerned about continuing lithium treatment which she has found to be effective. What advice would you give her?

1. Lithium is contraindicated for women who are pregnant due to the risk of Ebsteins’ anomaly

2. Pregnancy is a time of maternal well-being , as such her bipolar disorder will be in remission

3. Lithium should be discontinued 3 months before conception.

4. She should plan to discontinue lithium as soon as she is pregnant.

5. Lithium is known to increase the risk of serious heart defects but this must be weighed against the risk of untreated bipolar disorder.

The answer may not be so simple. Click the video to see what advice Dr. Harrison-Restelli would provide.

View the Answer >>

Q: An internal medicine colleague consults you. He is planning to begin treating a 55 year old man for hepatitis C with interferon and ribavirin. Your colleague is wondering if prophylactic treatment with antidepressant medication is indicated. What would you suggest?

1. Antidepressant medication is not effective in the treatment of interferon associated depression. Watchful waiting is indicated.

2. Interferon treatment is associated with depression but depression disappears after 12 weeks.

3. Only people with a prior history of depression should be offered prophylactic treatment with antidepressants.

4. Antidepressant medication is effective in the treatment of interferon associated depression but only after depression develops.

5. Prophylactic antidepressant medication is effective in the treatment of interferon associated depression.

The answer may not be so simple. Click the video to see what advice Dr. Himelhoch would advise.

View the Answer >>

Q: A 45 year old African American woman has Stage II ER+ PR+ DCIS (estrogen and progesterone receptor positive ductal carcinoma in situ) and is status post chemotherapy and radiation. She is currently on tamoxifen, and has just been diagnosed with major depressive disorder. Which of the following medications would be most appropriate to offer (in addition to psychotherapy) to treat her depressive disorder?

1. Fluoxetine (Prozac)

2. Paroxetine (Paxil)

3. Citalopram (Celexa)

4. Bupropion (Wellbutrin)

5. Nothing because her depression is the result of her breast cancer, and if the cancer is treated, the depression will resolve

The answer may not be so simple. Click the video to see what advice Dr. Morgan-James would offer.

View the Answer >>

Purpose

How to use this site:

What would you do?

Q: A 36 year old woman with bipolar affective disorder plans a pregnancy but is concerned about continuing lithium treatment which she has found to be effective. What advice would you give her?

Q: An internal medicine colleague consults you. He is planning to begin treating a 55 year old man for hepatitis C with interferon and ribavirin. Your colleague is wondering if prophylactic treatment with antidepressant medication is indicated. What would you suggest?

More Videos

Other Resources:

Societies and Interest Groups

Journals