From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.
At Psychiatry Grand Rounds in February 2000, Douglas G. Jacobs, MD,
discussed a suicidal 52-year-old man.1 The
patient, Mr D, almost jumped in front of a train after piling up gambling
debts and losing his family's support. During a psychiatric hospitalization,
Mr D related his history of compulsive gambling. He described his mood as
"hopeless" with feelings of shame and guilt about his life failures. He received
fluoxetine hydrochloride, 40 mg/d, and trazodone, 50 mg at bedtime. Due to
refractory depression, he received a course of electroconvulsive therapy that
continued after his discharge from the hospital.
Parker RA, Hartman EE. A 52-Year-Old Suicidal Man, 1 Year Later. JAMA. 2001;285(13):1757. doi:10.1001/jama.285.13.1757