Mark A Oldham

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Bright light therapy (BLT) is considered among the first-line treatments for seasonal affective disorder (SAD), yet a growing body of literature supports its use in other neuropsychiatric conditions including non-seasonal depression. Despite evidence of its antidepressant efficacy, clinical use of BLT remains highly variable internationally. In this(More)
Musical hallucinations (MH) have been labeled Oliver Sacks syndrome, and in the majority of cases, they occur in the context of a hearing loss. In these instances, they have been described as auditory Charles Bonnet syndrome because they are thought to represent a cortical release phenomenon. Patients with MH tend to have intact reality testing, and as(More)
BACKGROUND Alcohol withdrawal delirium (AWD) is associated with significant morbidity and mortality. Pellagra (niacin deficiency) can be a cause of delirium during alcohol withdrawal that may often be overlooked. OBJECTIVES We present a three-patient case series of pellagrous encephalopathy (delirium due to pellagra) presenting as AWD. METHODS We(More)
As the number of psychotropics on the market expands, the likelihood increases that a patient requiring anticoagulation with warfarin will receive concurrent treatment with a psychotropic drug. Because warfarin undergoes hepatic metabolism and is highly protein bound, it is particularly prone to drug interactions; in addition, its relatively narrow(More)
BACKGROUND Catatonia is seldom considered in evaluation of altered mental status (AMS) in medical settings. Furthermore, catatonia often meets delirium criteria due to incoherence, altered awareness and behavioral change. Catatonia may co-occur with or be preferentially diagnosed as delirium. METHODS We conducted a systematic literature review of MEDLINE,(More)
Sedation in the intensive care unit (ICU) is a topic that has been frequently researched, and debate still exists as to what are the best sedative agents for critically ill patients. There is increasing interest in sleep and circadian rhythm disturbances in the ICU and how they may impact on outcomes. In addition to patient-related and ICU environmental(More)
BACKGROUND Cognitive and functional impairment increase risk for post-coronary artery bypass graft (CABG) surgery delirium (PCD), but how much impairment is necessary to increase PCD risk remains unclear. METHODS The Neuropsychiatric Outcomes After Heart Surgery (NOAHS) study is a prospective, observational cohort study of participants undergoing elective(More)
Drug interaction between Warfarin and psychiatric agents may have important therapeutic effects for patients undergoing cardiac surgery. We present a case of a patient in whom concurrent treatment with Warfarin and valproic acid resulted in supratherapeutic international normalized ratio values. A discussion of the possible mechanisms for this interaction(More)
BACKGROUND Evidence on the use of bright light therapy for conditions beyond seasonal affective disorder continues to accrue; however, data on the prevalent use of bright light therapy in the community or in hospitals remain limited, particularly in the United States. METHOD We conducted a 5-minute e-mail survey of practicing psychiatrists in(More)
OBJECTIVES Circadian rhythms are severely disrupted among the critically ill. These circadian arrhythmias impair mentation, immunity, autonomic function, endocrine activity, hormonal signaling, and ultimately healing. In this review, we present a modern model of circadian disruption among the critically ill, discuss causes of these circadian arrhythmias,(More)