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 …
TMS Guidelines
In the April edition of Brain Stimulation, the Clinical TMS Society published expert consensus guidelines on the use of TMS. This definitive review of the literature identifies both what is known as well as significant areas of uncertainty about the use of TMS in the treatment of depression. The process of developing the guideline is described in the introduction to the …
Adult ADHD Not the Same as Childhood ADHD
Adult ADHD is not the same as childhood ADHD. Most people with adult ADHD never had childhood ADHD and most people with childhood ADHD never will have adult ADHD. This past year what was long thought to be known about adult ADHD turned out not to be true. Indeed, up until DSM-V adult ADHD could not be diagnosed unless someone …
A Better Ketamine
A better ketamine may be coming. That is the conclusion of NEJM Journal Watch Psychiatry reviewer Barbara Geller. A common pathway to identifying new drugs, is looking at metabolites of a medication to see if there is one metabolite that works better than the active drug (desvenlafaxine – one of the metabolites of venlafaxine – may or may not be …
Genetic Tests for Depression Updated 2023
Do Genetic Tests Help? Are genetic tests for depression treatment worthwhile? Or is this an expensive technology that is not ready for routine use? Peter Roy-Byrne, writing in NEJM Journal Watch seems to say that they aren’t worth it. Although some clinicians may argue that such testing “can’t hurt and might help,” current psychopharmacological practice is complex, usually including combinations …
Chronic Insomnia Best Treatments
Chronic Insomnia – What are the Best Treatments? The American College of Physicians just published guidelines on the treatment of chronic insomnia. These guidelines were based on a comprehensive review of the literature. They note that chronic insomnia is very common, but the literature on treatment is relatively poor. Many treatments that are used do not have good evidence …
Mania and Depression Sequence
One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …
Lithium Prevents Suicide
This has been a year with lots of useful information highlighting the continued importance of some of the oldest treatments for bipolar disorder: lithium salts. A New York Times Magazine article (“I Don’t Believe in Good but I Believe in LIthium”) about bipolar focused on lithium, and another New York Times article a year before that asked the question “Should We …