Dr. Forster will be presenting an update on “Telehealth and Psychiatry in an Era of COVID-19,” as part of the Seventh Annual Mood Disorders Summit webcast. Those interested in signing up for this free Continuing Medical Education event visit the Global Medical Education site. The program will include many presentations including… Program Agenda *All times listed are ET Day 1 …
Psychotherapy for Bipolar
People with bipolar disorder are much less likely to receive psychotherapy (26-50% of patients in one study got therapy) as opposed to psychiatric medications (46-90% were treated with medications) according to a study sponsored by the Depressive and Bipolar Support Association. This is not surprising since many mental health professionals were taught when we were in training that bipolar depression …
Limbic and Prefrontal Connectivity and Treatment Selection for Depression
Boadie Dunlop, M.D., M.S., and Helen Mayberg, M.D., both of Emory University School of Medicine, and colleagues assessed resting-state functional connectivity between the subcallosal cingulate cortex (SCC) and three other brain regions—the dorsal midbrain, the ventrolateral prefrontal cortex and anterior insula, and the ventromedial prefrontal cortex—in 122 patients with depression. The patients were then randomized to 12 weeks of cognitive-behavioral …
Impaired Decision Making in Depression – Treatment Implications
Why do depressed people make choices that are unlikely to be rewarded. And why aren’t they willing to make choices that are likely to be rewarded. In fact, why are depressed people less likely than people who are not depressed to choose to take an antidepressant, or begin psychotherapy, or follow the advice of a therapist? A meta-analysis of many …
Functional Connectivity Predicts Response to CBT or Antidepressant
In this study of previously untreated adults with major depression, outcomes after 12 weeks of treatment with randomly assigned medication or CBT were associated with the degree of resting-state functional connectivity between brain regions involved in mood regulation—specifically, the SCC and 1) the left frontal operculum (incorporating the BA47 in the ventrolateral prefrontal cortex [VLPFC] and anterior insula); 2) the …
Generic Medications
I have long been a strong proponent of generic medications. Recently, however, several of my patients have expressed concerns about the generic medications that they have received. This led me to do some research on generic pharmaceutical companies. The first thing to know about generics is that they are made by many different manufacturers in many different countries. This is …
Starting Lithium – Instructions for GPS Patients
Take lithium near your bedtime and take it with a little food to reduce GI discomfort. If you are particularly sensitive to medications you can start by taking either ½ of the 300 mg tablet or capsule or you can ask for your doctor to write for a couple of 150 mg tablets for the first day or two. If …
Vital Signs and Blood Pressure Home Monitoring
Since getting in to see a doctor these days can be very difficult, now seems like a good time to get a home monitoring kit. For around 200$ you can purchase a set of devices that will measure your blood pressure, heart rate, weight, temperature and blood oxygenation. Quite a miracle of technology, if you think about it. Blood Pressure …
TSH or Free T4 for Assessing Thyroid Function?
There are many reasons why thyroid status is important in a clinic treating people with mood disorders. For one thing, hypothyroidism and hyperthyroidism can mimic some of the symptoms of mood disorders. For another, lithium, a medication we often prescribe, is associated with hypothyroidism in a significant minority of patients taking the medicine. One of the questions we wrestle with …
New Biomarker for Treatment Response in Depression – GPR56/ADGRG1
What happens in the body when antidepressants work. An international group of researchers, led by Professor Gustavo Turecki of McGill University and the Douglas Mental Health University Institute, examined changes in the activity of genes (measured using mRNA) in the blood in over 400 patients who were being treated with antidepressants. They identified one gene that was significantly more active …