Lithium is usually considered the most effective treatment for bipolar disorder. However, at least 30% of lithium-treated patients do not have a clinically significant response; and only 30% have a long-lasting full response. Since close laboratory monitoring is required, and adverse effects are not uncommon, identifying predictors of lithium response is highly desirable. In this largest-ever study of lithium recipients …
Lithium Associated Hypothyroidism May Be Reversible
People who develop hypothyroidism while using the mood stabilizer lithium may return to normal thyroid function after the drug is discontinued, according to a study in the Journal of Psychopharmacology. Hypothyroidism—a condition in which the thyroid gland does not produce enough thyroid hormone—has long been known to be associated with the use of lithium. Recent studies have clarified the nature of this association. …
When We Can’t Accept New Patients
We are truly sorry. We are a small clinic and so at times we are not able to accept new patients. We don’t believe in waiting lists. We think that people should be seen when they need the help rather than being told to wait for a future appointment. Whenever we can accept new patients we are committed to offering …
Insurance Coverage of TMS for Bipolar Depression
A patient represented by an attorney obtained AETNA health insurance coverage for rTMS treatment of bipolar depression. The patient satisfied the insurer’s policy guidelines for rTMS treatment of major depression by demonstrating failed trials of 4 different medications. Reimbursement was based on the plan’s allowed percentage of the “covered amount”. The AETNA Appeals Decision stated – “TMS treatment is being …
GABA-A Agent SAGE-217: A New Antidepressant?
Psychiatrists and patients alike are hungry for new antidepressants. Few new medications have been developed in the last 10 years that are effective antidepressants, and those that have come to the market have all been variants of existing medications. The only really novel treatments for depression in the last 15 years in psychiatry are ketamine and TMS, both of which …
Pharmacy Apps
One of the most perplexing things about our healthcare system is how complicated it can make even simple tasks. This is particularly true when the issue involves sharing information among providers of care. Elsewhere we have talked about the “silo” problem and why it has motivated us to develop a clinic that tries to provide integrated care. Here I want …
“Are You Living a Life You Value?”
Sometimes our lives can become so full of the myriad items to manage and tend to that we lose track of what is most meaningful. Rarely do we afford ourselves the time to stop and ask, “How do I really want to be spending my time? What is it that I value?” The end-result of this way of functioning tends …
Crisis Resources in the Bay Area
Colleagues at UCSF shared this list of resources for people in a crisis in the Bay Area. We share this here in the hope that it can be helpful. Please let us know if there are corrections or updates… Alameda National Suicide Prevention Lifeline: Call 1-800-273-TALK Substance Use Treatment & Referral Helpline: 1-844-682-7215 Crisis Support Services Suicide Prevention: (800) 309-2131 …
Recognizing Depression – Nancy
Seems like everybody ought to be able to recognize depression, and that it’s so widespread that it can hardly be hidden, but the reality is that many people with major clinical depression are not diagnosed, or are given insufficient treatment to address the realities of their situation. Major depression is defined as an episode in which for at least two …
Exercise and Mental Health – A Therapist’s Guide
This is a great resource from Psychology Tools, with a huge amount of information about the use of exercise in treatment of mental illness, and a long bibliography of articles describing evidence related to the use of exercise, impact of physical exercise on mental health, ways of encouraging clients to exercise, and biological, psychological and social mechanisms by which exercise …