We often tell our patients that the treatment of anxiety is primarily through psychotherapy, in contrast to the treatment of mood disorders which is often based on medications or brain stimulation. In fact, it is one of the more frustrating aspects of psychiatry that there has been so little progress in terms of the biological treatments of anxiety and fear …
Why SSRIs May Increase Anxiety Short Term
SSRIs are among the most commonly prescribed medications for chronic anxiety, but not infrequently these medications may be associated with a short term increase in symptoms that precedes the long term benefit. In an elegant series of studies published online in late August 2016 in the premier scientific journal, Nature, researchers from the NIH and the University of North Carolina at …
Measurement Based Care Improves Outcomes
Patients at Gateway Psychiatric are sometimes perplexed by the amount of time and energy we devote to tracking how they are doing. It can seem annoying to answer questions repeatedly or to fill out forms. An article in the journal Psychiatric Services summarizes the data that shows that this process (known as “measurement based care” or MBC) is associated with significantly …
Prescription Savings
We have just updated the “links” page on this site with information about prescription medication savings and costs based on online research and an online discussion on the Psychopharmacology listserve. Pharmacist Stephen Saklad summarized information about local pharmacies – “Many of the Pharmacy Benefits Managers that are used by the insurers forbid the pharmacy to charge the lowest price, but …
Genesight – Genetic Testing to Predict Medication Response
We have been using the Genecept Assay from Genomind for several years to help guide treatment selection in patients with either unusually high rates of side effects from medications or those who have failed multiple trials of medications. Although the test can be expensive, costing anywhere from a couple of hundred dollars to five hundred dollars or more, it is our experience …
Antipsychotic Medications in Pregnancy
After decades during which the accepted medical dogma was that pregnant women should avoid all medications, the last 10 years have shown a significant increase in the quality of information available to help guide pregnant women in making decisions about which medications to continue taking during pregnancy. A recent editorial in the JAMA Psychiatry gives a sense of the context and …
Antidepressants Alter Gene Expression
An interesting study looked at similarities and differences in the effects of two medications that have anti-depressant effects and yet are extremely different in terms of how they work: ketamine and imipramine (a tricyclic antidepressant). This industry supported study looked at the effects of these two agents on a reward circuit (involving the prefrontal cortex (PFC), nucleus accumbens, hippocampus, and amygdala – …
Marijuana Use and Mental Health – 2022 Update
In the summer of 1996 proposition 216, California’s Compassionate Use Act, essentially legalized marijuana use with a prescription by a physician (“medical marijuana”) and in 2012, Colorado passed Amendment 64 (which legalized marijuana use in Colorado without any requirement for a prescription) – all of a sudden we were conducting a population based study of the impact of marijuana use …
Pregnancy Related Mental Health Information
I really like Anna Glezer’s website Mind Body Pregnancy as a resource for women who are pregnant, trying to get pregnant, or thinking about getting pregnant and wondering about the mental health issues they may face. I’ve highlighted three new articles on Mind Body Pregnancy and I encourage you to follow the links to the full articles and also to …
Mindfulness Based Cognitive Therapy for Bipolar
Mindfulness Based Cognitive Therapy for Bipolar May Reduce Anxiety and Improved Cognitive Function Researchers in the Departments of Biology and Psychiatry at University of Cape Town, in Western Cape, South Africa, recently reported results from a study in which 23 bipolar patients received neuropsychological tests and functional MRI scans before and after a Mindfulness Based Cognitive Therapy 8 week program. The study showed increased …