Ketamine for Depression – Mechanism of Action

Peter Forster Basic Science, Major Depression, Treatments of Depression

Ketamine for Depression: How does it work? We ran across a useful review of the basic science literature in an interview of David Nichols on the Psych Congress Network. http://www.psychcongress.com/video/ketamine-quick-guide-receptors-19116 Although ketamine blocks the NMDA subtype of glutamate receptors (blocks an excitatory neurotransmitter) the net effect seems to be an increase in excitatory neurotransmission. This image from Nature may help …

TMS Outcomes – Long Term Study

Peter Forster Major Depression, Treatments of Depression

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 …

TMS Improves Memory

Peter Forster Psychobiology, Treatments of Depression

TMS improves memory. According to a study published in the Aug. 29 issue of the journal Science, “electrically stimulating a portion of the brain that coordinates the way the mind works can enhance memory and improve learning.” The researchers used Transcranial Magnetic Stimulation (TMS) to indirectly stimulate activity in the hippocampus, a key part of the brain involved in the storage …

Huge Victory on Mental Health Parity in California

Peter Forster Costs of Treatment, Policy

On September 10th the California Supreme Court let stand a California Appeals Court decision that the California mental health parity law requires coverage of treatment that may have no equivalent in other medical specialties. Specifically, the Appeals Court held that Blue Shield of California must cover residential treatment for eating disorders. The Court noted that residential treatment was among the …

Early Lithium Treatment for Bipolar – Better Outcomes?

Peter Forster Bipolar Treatment

Does early lithium treatment for bipolar lead to better outcomes? This is the question that researchers sought to answer by looking at a Danish database of health information. The Danish registry is a set of nearly complete health information on the population of Denmark (hence, studies using this database are more representative of the general population than studies from many …

Weight Gain with Atypical Antipsychotics – A Review of Strategies

Peter Forster Bipolar Treatment, Physical Conditions and Health

Many antipsychotics, especially some atypical or second generation antipsychotics, like olanzapine (Zyprexa) or quetiapine (Seroquel), cause significant weight gain, as well as insulin resistance (diabetes) and elevated lipids. What to do if the medication is helping (much more than alternatives) but the patient is developing these serious adverse effects? Two recent articles review the literature on strategies for managing these …

Low Frequency Magnetic Stimulation is Rapid Antidepressant

Peter Forster Bipolar Treatment, Treatments of Depression

There is a lot of interest in an article that just appeared in Biological Psychiatry about a new magnetic stimulation technique that may be associated with rapid antidepressant effects in both unipolar and bipolar depression. Researchers at McLean Hospital were studying Low Frequency Magnetic Stimulation as a way of imaging the brains of bipolar patients and discovered that many of …

New Drug with New Mechanism for Insomnia – Suvorexant

Peter Forster Insomnia, Insomnia Treatment

Belsomra (suvorexant) was approved earlier this week by the FDA for use as needed to treat difficulty in falling and staying asleep. ​ The drug blocks receptors for orexin – also known as hypocretin – the master hypothalamic regulator of the sleep-wake cycle. There are, in fact, two forms of orexin, A and B; hence it is a dual orexin …

Depression Costs US 200 Billion Dollars Per Year

Peter Forster Costs of Treatment, Treatments of Depression

A meta-analysis of more than 60 clinical studies covering almost 60,000 adult patients estimates that the total cost in the United States of the treatment of patients with depression is in the range of $188 billion to $200 billion. Roughly a third of all costs ($64 billion) are related to people with treatment-resistant depression, who represent only a fraction of all cases. The article, “A Review of the Clinical, Economic, …

Lithium Treats Bipolar Depression

admin Bipolar Treatment

In a special symposium on bipolar disorder at the 2014 meeting of the American Psychiatric Association, researcher Mike Bauer reviewed a new meta-analysis that showed lithium not only has significant effects in preventing manias, but also depressions. Mike Bauer is currently the Director and Executive Chair of the Department of Psychiatry and Psychotherapy, and the Physician-in-Chief, at the Psychiatric Hospital …