GP Voice

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Montelukast and neuropsychiatric events in kids with asthma – is there a link?

10th June 2019, Dr Chee L Khoo

Children with moderate to severe asthma often needs more than the usual bronchodilators. Even the newer long acting beta agonists (LABA) or long acting muscarinic antagonists (LAMA) may not be enough to control the symptoms and reduce exacerbations and inhaled corticosteroids (ICS) are often needed. But we are careful to keep the total daily dose of corticosteroids to a minimum.…

Anti-depressants – what to do when it comes time to discontinue

13th February 2019, Dr Chee L Khoo

The bulk of patients with depression is managed in primary care. A significant proportion of these patients do well with the usual anti-depressants. At some point in time, many will no longer need their medications and we usually wean them off their drugs. Why do we need to wean them off? How do we wean them off?…

Refractory depression – does adding mirtazapine help?

10th December 2018, Dr Chee L Khoo

Treatment resistant depression is not that uncommon in general practice. We have quite a few patients that don’t respond to maximal dose of our usual SSRI or SNRIs. Naturally, we need to check adherence to medications and alcohol intake. A review of the history is important as there may be hidden skeletons unresolved (including sexual abuse).…

Prenatal programming – can it affect offspring mental outcomes?

11th October 2018, Dr Chee L Khoo

Epigenetics is the modification of the DNA that changes a gene’s expression without altering the nucleotide sequence. DNA methylation and histone modifications are the most commonly studied epigenetic mechanisms by which cell structure and function can be altered during embryogenesis. The in-utero environment can lead to prenatal programming by which genes are activated or deactivated.…

Interventional Radiology – so many places you can stick a needle at!

July 1st, 2018, Spectrum Radiology

It’s absolutely amazing where and what they can inject or biopsy these days. The list is just mind boggling. Ok, not everyone is equipped and experienced to do those procedures. And the outcome does depend on the expertise of the operator. Have a look at the list of interventional procedures possible here.

Dr. Glen Schlaphoff and Associates, in collaboration with Spectrum Medical Imaging have established an integrated clinical service for interventional radiology. …

Prazosin in PTSD – does it help?

July 1st, 2018, Dr Chee L Khoo

We all know Prazosin (Minipress) as an alpha 1 blocker used to treat hypertension. Prazosin is also useful in treating urinary hesitancy associated with prostatic hyperplasia by blocking the alpha-1 receptors which control constriction of both the prostate and urethra. Obviously, we now have better and newer agents for hypertension and bladder problems. As such, Prazosin is a long-forgotten agent.…

Weight gain with anti-depressants – is it real?

June 15, 2018, Dr Chee L Khoo

In primary care, we have to battle with the increasing incidence of obesity amongst our patients. We also have to battle with the patients with depression where anti-depressants are increasingly being prescribed. Obesity is associated with depression, which is particularly common in patients with severe obesity. Antidepressant treatment may also add on to our patients’ weight.…


March 15, 2018
Dr Jenny James
General Practice Drug and Alcohol Advice and Support Service

The Opioid Treatment Accreditation Course is currently being restructured by the University of Sydney, Discipline of Addiction Medicine. The new format training is expected to commence by 1 June 2018.

As a measure to manage the waiting list for accreditation training,  an interim course is being be offered.…

GP Drug & Alcohol Advice & Support Service

We all have patients troubled by alcohol or drugs. We are either approached by the patient or more often than not, family members who are lost in the maze of services out there. Despite being a GP in the area for more than 25 years, I still don’t know what is out there, who needs what, let alone who or where to get help for these patients.…

Treatment resistance depression – a solution finally?

Jan 2018, Dr Chee L Khoo

The mainstay for the treatment of major depression disorder (MDD) has been SSRIs since the 1980s. But up to a third of patients with MDD don’t respond to the usual treatment for depression. This is commonly referred to as treatment resistant depression (TRD). The NDMA glutamate receptor antagonist, ketamine is known to have an efficacious and rapid-onset anti-depressant effect in patients with TRD.…

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