Bright light may work for non-seasonal depression. This is the conclusion of a study published in the prestigious psychiatric journal JAMA Psychiatry. Researchers at the University of Toronto and the University of British Columbia in Canada conducted a randomized, double-blind, placebo- and sham-controlled, 8-week trial in adults (aged 19-60 years) with major depression of at least moderate severity. 122 patients were …
Ending Treatment
We have a short list of rules and Gateway Psychiatric, and one of those rules may seem a little bit odd to people when they first come in for treatment. We ask people to agree to “say goodbye in person.” What do we mean by this? We don’t mean that when someone who has been seeing us for a while …
Serotonin Reuptake Inhibitors Dose
One of the questions that often comes up has to do with the patient who has a partial response to a serotonin antidepressant but who remains depressed. Should we increased the dose about the standard initial dose, should wait and see if there’s further improvement? Should we add a new medication, or should we switch to a different antidepressants? Because …
TMS Cost Effectiveness
“Is TMS Cost-Effective?” His provocative title of an article just published in psychiatric times which summarizes an Australian pharmaco-economic study. In case you don’t want to read through the rest of this article, here is the summary: “Australian researchers compared the cost-effectiveness of rTMS with pharmacotherapy in treatment-resistant patients with MDD (ie, those who have failed at least 2 courses …
Antidepressants Update
I just wanted to make a quick note that I recently posted a major update of the information on this site about antidepressants. This follows the recent introduction of a few interesting new antidepressant medications. I hope to expand that by adding a page talking about atypical antipsychotics and perhaps other classes of medications routinely used in this practice. Since …
TMS Updates May 2015
The editors of Bipolar News reported on some interesting presentations related to transcranial magnetic stimulation (TMS) at the Biological Psychiatry meetings this past May. TMS for geriatric depression – “Researcher Daniel Blumberger reported that he has found repeated transcranial magnetic stimulation (rTMS) to be effective for depression in late life. Blumberger noted thatit may be necessary to use higher intensity …
SAMe – S-adenosyl-methionine
S-adenosylmethionine, or SAM-e for short, is one of the few nutritional supplements that has good clinical research to support its safety and effectiveness. Although SAM-e is used for many purposes, we are particularly interested in it as a compound that may have antidepressant properties. S-adenosylmethionine (SAMe) is involved in many reactions that involve methylating chemicals (transferring a methyl group to the …
Lithium and Kidney Damage
Lithium may be effective as a mood stabilizer, but questions often come up about its safety, particularly with regard to kidney or renal effects. A recent very large study published in November 2015 in JAMA Psychiatry looked at a huge dataset from Denmark in order to provide the best information we have now about these risks. The study consisted of records …
Natural Isn’t Necessarily Safe
23,000 emergency room visits per year are the result of taking “natural supplements.” Natural does not mean safe. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), with heavy backing from industry. By defining herbal supplements and botanicals as dietary supplements, DSHEA exempted them from the more rigorous standards used by the FDA in regulating food, drugs, and …
Do We Need 8 Hours of Sleep?
A recently published study that looked at patterns of sleep in three different hunter gatherer societies challenges the long-held notion that we all need to sleep 8 to 9 hours a night and that many of us in Western society are chronically sleep deprived. The results are summarized in an article we just published in our companion website MoodSurfing.com. Tantalizing …