Several recent articles provide additional information about the effects on the infant of exposure to SSRI antidepressants during pregnancy. A large study published in Pediatrics adds to information that suggests that exposure to SSRI antidepressants, particularly late in pregnancy, may be associated with birth complications. As with other studies, one major limitation in the design of the study is that it …
Mood Stabilizers
There is nothing like a patient’s request to spur me on to tackle a long delayed project. Noting that a significant percent of the patients I see have bipolar, one of my patients wondered why I did not have any information on this website that addressed, in an organized way, the considerations that go into selecting a mood stabilizer. I …
CBT for Seasonal Affective Disorder
CBT May Be More Durable Treatment for SAD Than Light Therapy Six weeks of cognitive-behavioral therapy sessions tailored for seasonal affective disorder (CBT-SAD) may lead to longer-lasting effects than those seen with light therapy, according to a recent study in AJP in Advance. Light therapy is a proven approach to treat acute SAD, but previous studies show that most patients …
Telepsychiatry at Gateway – An Update
An American contractor in Iraq suffering from the after effects of a violent attack needs help to prevent him from developing acute post-traumatic stress disorder. A young man who has been in the throes of an acute psychotic mania and who is now living with his father in remote Humboldt County is trying to rebuild his life. An older woman …
Oxytocin and Spirituality
Oxytocin is a fascinating neurohormone which has been linked to parent-child bonding as well as romantic love, and to darker emotions such as the rejection of “foreigners”. A recent article suggests that it may also be an important factor in the development of spirituality. Joel Yager, writing in the NEJM Journal Watch Psychiatry, summarizes the study this way: Investigators enrolled …
Welcome Gina Gregory – New Staff Member
We are very pleased to welcome Gina Gregory to Gateway Psychiatric. Gina will be working full time in our San Francisco office. Gina is a licensed clinical social worker (LCSW) (#73689) who specializes in trauma-related concerns, mood disorders, anxiety disorders and co-occurring substance use disorders. She uses evidence-based approaches, such as cognitive-behavioral therapy and motivational interviewing. She earned a Master’s in …
Neurocognitive Testing Online
Neurocognitive Testing Online Now Available Problems with memory, inattention, distractibility and cognitive function are common symptoms of mood and anxiety disorders. They may also be side effects of the medications used to treat those conditions. Or they may be a sign of some other condition that needs to be evaluated. How can these evaluated? A key part of a comprehensive assessment …
Where is the Outrage About Suicide?
A wonderful editorial in JAMA Psychiatry highlights the overwhelming evidence that stigma is continuing to drive underfunding for treatment and prevention of suicide deaths. Suicide and “accidental” overdose deaths are an epidemic in this country. Since 1999, the rate of suicide deaths increased by 28.2%, and this probably underestimates the increase because there is evidence that coroners are categorizing more and …
Depression, Anhedonia, Glutamate, and Inflammation
That depression may be linked to alterations in glutamate circuits is suggested by the observation that ketamine (which is an NMDA glutamate receptor antagonist) may rapidly reverse depression in some patients. Depression has also been found to be associated in some people with various markers for inflammation (c reactive protein, tumor necrosis factor, interleukin 1 beta, and interleukin 6). As …
Depression and Inflammation: Treatment Options
A host of conditions have been associated with mild to moderate levels of inflammation in the body. Depression is one of these. Elsewhere in this blog we have discussed the relationship between depression and inflammation, evidence that treatment with an antidepressant (escitalopram) reduces inflammation in depression, and talked about how exercise prevents depression. We have also noted that elevated levels of inflammation (simple …