Although there is reason for optimism about some of the newer medications for insomnia (orexin antagonists) that are coming to market, it remains true that sleeping medications are not the right answer for many people with insomnia. Cognitive behavioral therapy for insomnia (CBTi) has several advantages as an initial treatment. Cognitive Behavioral Therapy for Insomnia First We have been writing …
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 …
Coping with Coronavirus
For the past two weeks we have been collecting stories from our patients. Some of them are doing well in the face of the turbulence caused by coronavirus and some of them are struggling. We decided to collect stories from those who are doing well in order to identify ways of coping with this stress and perhaps have some suggestions …
Make an Appointment with Dr. Forster in 1 Minute – April 2020
Here I’m going to show you that you can make an appointment with me, Dr. Forster, in a minute using the online office tools. This example applies only to appointments made in April 2020. During April, because of coronavirus, all of our appointments will be telehealth and you can make a telehealth appointment in any available time slot. First go …
Genomind Genetic Testing by Mail
We are happy to report that at least one of the services that we use for genetic testing, as part of our comprehensive evaluation for patients who had trouble finding an appropriate medication, is modifying the procedure for their tests so that we can order the test online and the test kit will be shipped directly to your home. Genomind …





