Chronotherapy for depression may be a very fast and effective treatment for suicidality, according to a preliminary study just published in the Journal of Psychiatric Research. 10 inpatients received what was called “triple chronotherapy” and showed dramatic and rapid reductions in suicidal ideation and depression. Of course this is a very small sample and only one study. But it points …
Bipolar Education Program
Doctors often do a poor job of educating their patients about their health problems. That is particularly troubling when you are talking about a condition as complicated as bipolar. We have been working on an educational program for this site based on the Barcelona psycho-education program for bipolar, to be called Bipolar 101. The Barcelona program has clearly been shown, …
Bipolar Depression Neurobiology – 2014 ISBD Update
Bipolar depression neurobiology is an area that urgently needs more research. The treatment of a depression that follows an energized (hypomanic or manic) state remains one of the most difficult areas in psychiatry. Mark Frye, Chair of the Department of Psychiatry at the Mayo Clinic, gave a presentation on this topic at the 2014 International Society of Biological Society conference that was …
Melatonin and Sleep
What is the relationship between melatonin and sleep? And why are the results that people have from taking melatonin supplements to help induce sleep so variable? A recent article has suggested that the two melatonin receptors, melatonin one (M1) and melatonin two (M2) that have been shown to existing humans may have different effects on sleep. A quick review may …
Antidepressants May Blunt Feelings of Romance
Antidepressants may blunt feelings of romance when taken long-term according to a recent study, but the way this effect shows up may be quite different in men and women. Researchers presented a study at the European College of Neuropsychopharmacology (ECNP) Congress which used a newly developed Sex-Attachment-Love Test (SALT) questionnaire. They looked at almost 200 adults with mild or moderate depression …
Institute for Psychiatric Services
The Institute for Psychiatric Services, the American Psychiatric Association’s smaller and more collegial educational program, is coming to San Francisco next week. The meeting will be in San Francisco’s Moscone Center from Thursday through Sunday and promises to be a not to miss educational and social program for clinicians with an interest in treating major depression, bipolar, and other serious mental illnesses. …
TMS Effectiveness
TMS effectiveness is something I have spent a fair amount of time researching. Last year I gave two Grand Rounds presentations on this topic at the University of California, San Francisco and at the California Pacific Medical Center. But despite the compelling evidence that, if you have failed two (or maybe three) antidepressant trials for the treatment of your depression, your …
Prior Authorization Form – New Law in California
Prior authorization forms for medications, and the entire prior authorization process, can be a nightmare. In my experience, with at least one company, the rule seemed to be, if you filled out a form you were told that you needed to call to obtain the OK, and if you called you were told to fill out a form. It was …
Bipolar or Unipolar Depression?
Bipolar or unipolar depression: How to distinguish between these two conditions, which can have very different treatment response remains a difficult question without really satisfying answers. As noted in the picture to the right, misdiagnosis is common and can have serious consequences. An article in European Psychiatry adds to the literature pointing to certain features that increase the odds that someone …
Genetic Testing for Depression Drugs
Genetic testing for depression drugs is a new approach to selecting medications that may have value, especially in patients with treatment resistant depression. We have been using the Genecept Assay for patients with treatment resistant depression and have found that the results improve our ability to choose effective treatments. Patients who have failed multiple adequate trials of medications are much less likely to …