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 …
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 …
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 …
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 …
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 …
TMS Outcomes – Long Term Study
TMS outcomes have seemed favorable for patients with treatment resistant major depression, but what are the long term effects of TMS (transcranial magnetic stimulation)? TMS is a non-invasive technique for stimulating brain activity in parts of the brain that seem to be turned off in depression – the dorsolateral prefrontal cortex. TMS uses magnets to stimulate the brain and the …
Blood Test for Depression
How many times has a new patient in the clinic asked, “isn’t there a blood test for depression?” Always in the past we had to say that there were no reliable tests that could identify depression. There was some evidence that functional brain imaging could do so but the technique was expensive and experimental. In an article published in the …