Anhedonia, meaning the loss of the normal experience of pleasure in life, can be one of the most troubling symptoms of depression. And also one for which we have relatively few treatments. We know that a small group of dopamine neurons in the ventral tegmentum (limbic system) which project to the prefrontal cortex, among other locations in the brain, are …
TMS Media – The Doctors
TMS Media – “The Doctors” December 3 I am excited to share with you that on December 3rd “The Doctors” featured a segment on TMS. Todd Hutton, MD, Medical Director, Southern California TMS Center, was invited to appear with a patient who is doing great 18 months post TMS treatment. I hope you can watch and that this contributes to further awareness …
Anhedonia Treatment with Ketamine
The treatment of anhedonia and bipolar depression can be very difficult. An article published in Translational Psychiatry in October of 2014 highlights the role of glutametergic transmission in anhedonia and points to the potentially unique efficacy of ketamine in treating this stubborn problem. Anhedonia, the lack (an-) of pleasure (-hedonia), is one of the 2 main symptoms of a major …
Chronotherapy for Depression Treats Suicidality
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 …
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 …
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 …
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 …
Therapy or Medication for Depression
Therapy or medication for depression? Which is more effective? When might you want to consider both treatments? These are among the most frequent questions that we are asked. A recent study published in JAMA Psychiatry provides the best information available about how to make this decision. The study involved 452 patients who received antidepressant medication treatment for depression with or …
TMS Mechanism of Action – Changes in Brain Connectivity?
TMS’s mechanism of action has been unclear. Transcranial magnetic stimulation affects activity locally in the region of the brain that is stimulated, but does that explain how it works? Since it affects local activity in every patient, why does it not work for everyone? A new article in Biological Psychiatry suggests that it may be changes in brain connectivity that …
Exercise and Stress – How Exercise Prevents Depression
Exercise seems to reduce stress. But how does this work? And what about exercise effects on depression? An article in the New York Times summarizes a recent publication in the journal Cell which may explain how exercise prevents depression. A wealth of research shows that regular exercise reduces the risk of depression. A very large study in Britain, for example, suggested that …