I was wondering: How common is it for neurologists to manage psychiatric issues in their patients? Say a patient with a terminal disease is depressed, or say someone with parkinson's is having hallucinations; do you manage that?
In my rather limited experience, I've seen some neurologists do it; I've seen a pediatric neurologist manage ADD in some patients, as well as other common psychiatric issues.
I was wondering how common it was, or what's your stance on this sort of thing.
It's pretty common, but it depends a lot on personal comfort and confidence levels.
Also depends on what you consider "neurologic" vs "psychiatric" . . . remember, the BRAIN is the common organ of ALL behavior. Those hallucinations in a parkinson's patient? Maybe they're because you've got them jacked up on too much levodopa -- not really a "psych" problem, is it?
Personally, there's no way I would treat what I think of as "pure" psychiatric stuff (bipolar, schizophrenia, hard-core anxiety or suicidal-level depression, etc).
I will sometimes treat people who I think have mild depression (especially if "reactive" to some other illness), mild anxiety, or ADD, but it depends a lot on the "vibe" I get from the patient. If I'm getting that "this-person-is-probably-even-crazier-than-they-look" feeling, I won't do it.
And keep in mind, we prescribe a lot of "multi-functional" meds -- depakote, lamictal, topamax, etc, all great for both seizures and depression; benzos for seizures and sleep also help anxiety, etc. So we tend to do a lot of the "two birds with one stone" thing.
