“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 – Updated 2/2025
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 very large study published in November 2015 in JAMA Psychiatry looked at a huge dataset from Denmark in order to provide us with information about these risks. The study consisted of records from 1.5 million …
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 …
Psychotherapy for Depression – New Data
Many reviews have pointed out that there is a significant “publication bias” that affects studies of antidepressants: because studies that don’t find an effect tend not to be published a review of the published literature would suggest that these medications are more effective than they really are. Indeed this is been the basis of a great debate in the popular and …
Aripiprazole for Late Life Depression
A study suggests that aripiprazole augmentation may be an effective strategy for treating major depression in older adults. The article has generated a lot of interest because of evidence suggesting that late life major depression may be different from major depression in early adulthood. Cognitive impairment, including memory troubles and trouble with planning and decision making (executive function), seems to …
Cognitive Behavioral Analysis System of Psychotherapy
I have just posted another page on the site devoted to orienting patients to types of psychotherapy that we may recommend for them. This most recent page talks about Cognitive Behavioral Analysis System of Psychotherapy, an approach to the treatment of patients with chronic depression that many people have benefitted from during the course of their treatment at Gateway Psychiatric. …