This document discusses common presentations in primary care practice, including aches and pains, headaches, fatigue, gastrointestinal symptoms, hyperventilation, and pseudo-neurological symptoms. It notes that cases are often due to the interaction of mind, body, and mental state. The document provides guidance on managing anxiety, depression, and pain-predominant cases with medications like SSRIs, mirtazapine, antipsychotics, and benzodiazepines. It cautions about risks like manic switching, alcohol withdrawal, and addiction when treating insomnia.

2.  Discussing common presentations in
practice
 Discuss special situations
 Managing cases at first level of contact
 Pitfalls

3.  Mind & Body duality
 Organic/ medical vs
Functional/psychological
 Experiences = Sensory stimulus + mental
state

4.  Aches, pains, headache, dizziness, burning
 Ideas of harboring a serious illness
 Unexplained tiredness
 Gastro-intestinal symptoms
 Dyspnea Hyperventilation (upper/lower)
 Pseudo-neurological presentation
 Others ( factitious, malingering )

5.  Anxiety predominant cases : “worry”/
restless
Mirtazapine (mirtaz/mirnite) low dose SSRI
 Depression predominant cases: “unhappy” /
lack of energy
SSRI (nexito, Serta, Flunil) Desvenlafaxine (D-
veniz/Ventab-DXT), Duloxetine (symbal/Duzela),
Prothiaden
 Pain, dysesthesia predominant cases
 Low dose of antipsychotics, benzodiazepines

6.  Risk of manic switch
 Alcohol withdrawal
 Check for suicidal tendencies
 Suspect addiction to hypnotics
 Safer alternatives for insomnia ( trazonil10mg,
Atarax 10mg, Doxepin 25mg, Qutipin 25mg)

7. Thank you for patient listening