Dr. Descartes Li, an expert in Bipolar Disorder at UCSF runs an excellent 8 session program for people with bipolar who are interested in learning more. Here is the latest information about the group which starts at the end of February. The UCSF bipolar psychoeducational group starts on February 27, 2017. It runs for 8 sessions, Mondays 12pm to 115pm. …
Antidepressant Response Linked to Norepinephrine Transporter Genotype
A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …
Controlled Substance Refills
Controlled substances are medications with a potential for abuse or misuse. They are often, also, medications that have powerful effects on brain function. Common controlled substances that doctors prescribe include: Narcotic pain medications (Demerol, Norco, Tyco, etcetera) Stimulant medications (Adderall, Ritalin, Concerta, etcetera) Benzodiazepines and similar sedating and anti-anxiety medications (Xanax, Valium, Ativan, Ambien, etcetera) Testosterone and some other hormone …
TMS for Depression – Repeat Treatment
TMS is an expensive, time-consuming, but effective treatment for depression, but how should it be used for treating patients with chronic depression? And for those who have an initial positive response when should we consider another course of TMS (known as reintroduction therapy)? These are all questions which have not been adequately addressed in the research literature. A study published in …
Pregnancy and Bipolar
Pregnancy Outcomes in Women with Bipolar Disorder A recent review of the topic of bipolar and pregnancy from the MGH Center For Women’s Mental Health on November 14, 2016 sparked us to write this post. When talking with a bipolar woman contemplating pregnancy there are two considerations: what additional risks to the unborn child are created by taking psychiatric medication and what risks exist …
Insomnia Relief
How to find insomnia relief is a question that many people we work with struggle with. A recent editorial in JAMA Psychiatry and the accompanying research article suggests that the online program that we’ve been recommending to our patients for years (SHUTi) is the treatment of choice for insomnia. We have been extremely pleased with the results from this program which can …
Requesting Out of Network Coverage for Psychiatrist
EXTENDING MEDICAL BENEFITS TO NON-PREFERRED PROVIDER PHYSICIANS Some of the most heartrending calls that we receive from potential patients have to do with people who are unable to find psychiatrists who are covered under their insurance plan. One solution may be to request out of network coverage for a psychiatrist. Background There are several problems that make this a common …
Lithium Thyroid Effects
A young woman who has had a relatively good response to low dose lithium treatment has labs that suggest she may be developing hypothyroidism (low thyroid) and asks what her options are. What can be done to treat the problem? What risks are there for developing it? And what would happen if she decided to taper off the lithium, would …
Lithium Weight Gain
Does lithium cause weight gain? It is remarkable how difficult it can be to find out the answers to relatively simple questions on the internet. One of my patients asked me about the effect of lithium on weight and, while I was explaining my experience with many hundreds of patients treated with lithium (not a significant cause of weight gain …
CBT for Insomnia Reduces Depression – Somryst
An online sleep program using CBT for insomnia (Cognitive Behavioral Therapy for Insomnia – CBTi) has been shown to reduce depression in a study published in the April 2016 edition of Lancet Psychiatry. CBT for Insomnia CBTi is the most effective program for treating chronic insomnia and chronic insomnia is a major risk factor for developing depression. Unfortunately, CBTi is …