Virtru

Peter Forster GPS Update

I am writing to update you about the security systems that we have been implementing at Gateway Psychiatric to ensure the safety of your data. As you know, the safety of data stored on the net cannot be taken for granted. I was reminded of this when I got an email from WordPress saying that hackers had published the email …

Huge Victory on Mental Health Parity in California

Peter Forster Costs of Treatment, Policy

On September 10th the California Supreme Court let stand a California Appeals Court decision that the California mental health parity law requires coverage of treatment that may have no equivalent in other medical specialties. Specifically, the Appeals Court held that Blue Shield of California must cover residential treatment for eating disorders. The Court noted that residential treatment was among the …

Early Lithium Treatment for Bipolar – Better Outcomes?

Peter Forster Bipolar Treatment

Does early lithium treatment for bipolar lead to better outcomes? This is the question that researchers sought to answer by looking at a Danish database of health information. The Danish registry is a set of nearly complete health information on the population of Denmark (hence, studies using this database are more representative of the general population than studies from many …

Weight Gain with Atypical Antipsychotics – A Review of Strategies

Peter Forster Bipolar Treatment, Physical Conditions and Health

Many antipsychotics, especially some atypical or second generation antipsychotics, like olanzapine (Zyprexa) or quetiapine (Seroquel), cause significant weight gain, as well as insulin resistance (diabetes) and elevated lipids. What to do if the medication is helping (much more than alternatives) but the patient is developing these serious adverse effects? Two recent articles review the literature on strategies for managing these …

Social Intelligence and Oxytocin

Peter Forster Basic Science, General

The nucleus accumbens (NAc) (or ventral striatum) is a central part of the reward system. The reward system has been the focus of much interest and research because of its role in the development and maintenance of addiction and depression. The reward system evolved to motivate survival behaviors and behaviors linked to reproduction and health. Evidence from research in a great number of animal species suggests that social intelligence …

Active Treatment

Peter Forster About GPS

Why are we so insistent that people in “active treatment” at Gateway Psychiatric, have to always have a future appointment, and must discuss with us the issue of visit frequency? Why don’t we let them come in when they feel the need? Today we were meeting with someone who was asking all of those questions and who also, in many …

Genetic Testing Guides Treatment for Bipolar or Depression

Peter Forster Diagnosis, Testing

We have been using a relatively new assay from a company called Genomind (the Genecept test) in some of our patients with bipolar and/or depression. The test involves a saliva sample which is analyzed for ten gene variants that may be useful in guiding treatment. So far we find that in about half of the patients with treatment resistant depression …

Treatment of Fatigue in Patients with Depression or Bipolar

Peter Forster Bipolar Treatment, Diagnosis, Physical Conditions and Health, Treatments of Depression

Treatment of depression in patients with depression or bipolar is often complicated. If medications are prescribed, will they make mood symptoms worse, or have other significant adverse effects? And yet fatigue is common in people with a history of depression (it occurs in up to 10% of the general population and is much more common in women, who have a …

Data Security at Gateway Psychiatric Services

Peter Forster GPS, GPS Update, Website Update

We have been following the stories of data lost or stolen this past year with increasing concern about the safety of the internet. As a result we spent much of the summer hard at work upgrading the level of security at Gateway. This is important work, although not terribly rewarding. Some of these changes – We no longer rely on just user …

RDOCS and DSM 5: Diagnosis and Psychiatry

Peter Forster Diagnosis

Tom Insel, the Director of the National Institute for Mental Health, to celebrate the release of DSM5 in May of 2013, famously announced that the manual was already irrelevant to psychiatric research. This quote from Psychology Today captures the moment fairly well. Just two weeks before DSM-5 is due to appear, the National Institute of Mental Health, the world’s largest funding agency …