Several people recently requested medications to have on hand in case an emergency disrupts the supply. Here are some guidelines for these requests. This is from a useful post written by a doctor after a local emergency… “Ask your doctor for an additional prescription, explain what you’re doing and tell your doctor the meds will be going into storage,” says …
Inflammation Testing and Antidepressant Selection
Inflammation and C Reactive Protein Inflammation is often seen in people with depression. And there is evidence to suggest that it predicts treatment response. The most widely accepted standard test to measure inflammation is the C-reactive protein, or CRP. This is a protein that is produced by the liver in inflammatory states. The American Heart Association and the Centers for …
Telemedicine Coverage Mandatory in California
California Governor Signs New Telehealth Insurance Law On October 11, 2019, California Governor Gavin Newsom signed a new law requiring commercial health insurance coverage and payment parity for telehealth services, unfortunately the law won’t take effect until 2021. However, in consideration of the State of Emergency declared by the Governor and the Secretary for Health and Human Services, an industry trade group, America’s …
Webcam Appointments March 2020
I will be seeing my patients via webcam for at least the next two weeks. Your appointment will be at the same time, but to join the meeting you will need a smartphone or computer with Chrome, Safari or Firefox and a camera. Most smartphones and computers (except for work computers that block video conferencing) should work. You can find out …
One of the Best Doctors in America Again
I am proud to say that I have been selected as one of the Best Doctors in America again. The Best Doctors poll was set up in 1989 by doctors from Harvard’s School of Medicine and is one of the largest ongoing peer-to-peer physician polls in healthcare. Because a physician cannot apply or pay to become a Best Doctors physician …
Refill Dilemmas
“Why do you only give me a month’s supply of medication when you approve refills?” This is a pretty common question and this blog post explains why “automatic refills” are no necessarily the magic solution to the problem of getting your medications. A refill is a quick thing to handle, right? You call a number and press a few numbers, …
Mobile Monitoring Systems for Depression Care
Passive tracking of vocal and behavioral indicators of symptoms via a smartphone app can be an effective way to treat depression in a time-sensitive and accurate fashion. A recent randomized clinical trial compared the use of an app to track indicators with “usual care” for depression, and, although the sample size is small, the results are very promising. For the …
Chronotherapy and Bipolar Disorder
Chronotherapy refers to treatments for depression, mania, or both, that focus on changing sleep and wakefulness patterns. This blog post provides an update of this important area. Background The International Society of Bipolar Disorders (ISBD) task force on chronobiology and chronotherapy published a comprehensive review of chronotherapy techniques and their effectiveness in bipolar disorder in 2019. This article summarizes the …
New Los Altos Office Replaces Mountain View
Our Mountain View Office is moving to Los Altos. The last day in the current office will be Friday, January 17th. The first day in the new office will be Tuesday, January 21 (the day after the MLK holiday). The Los Altos office is newer, has convenient parking on site, and has two excellent coffee shops across the road. We …
Stimulus Control Therapy for Insomnia
Disrupted sleep rhythms may drive mood instability and sleep and insomnia are some of the most frequently cited problems of people seeking help for mood disorders. Research has shown that most frequently prescribed medications are not very helpful – they may lengthen sleep times by only 15 – 45 minutes per night. Cognitive Behavioral Therapy for Insomnia Cognitive Behavior Therapy …