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Episode 363: Depression in primary care – talk first and prescribe later – PART II

In episode 363, James, Mike, Bruce and Helena continue to talk about depression in primary care. The key messages are that instead of calling it depression we should consider telling people they are “stuck”, negotiate non drug therapies like behavioural activation, do follow-up phone calls and basically NEVER prescribe an antidepressant on the first visit.

Show notes

An Evidence-Based First Consultation for Depression

Episode 362: Depression in primary care – talk first and prescribe later

In episode 362, James and Mike invite Bruce Arroll back to talk about his latest systematic review on antidepressants for treatment of depression in primary care. We quickly come to the realization that primary care is different than specialty care and that we need to talk first and prescribe later and have the clinician be the drug.

Show notes

1) Antidepressants for treatment of depression in primary care: a systematic review and meta-analysis 

J Prim Health Care 2016;8:325–34

2) Effective management of depression in primary care: a review of the literature

BJGP Open 2017; DOI: 10.3399/bjgpopen17X101025

Episode 361: PREMIUM – The answer to what you should eat is completely obvious

In episode 361, James and Mike pull out the PREMIUM card and we digest two recent publications – a cohort study looking at the relation between percent of macronutrients ingested and CVD and mortality and then a much smaller trial of intensive lifestyle in T2DM. At the end we realize that if nutrition guidelines just stuck to looking at the evidence all would be good in the world – at least around eating.

Show notes

Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.

Lancet 2017 Aug 28

Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial

JAMA 2017 Aug 15;318:637-46

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