A recent study concludes that there may be some good news about the impact of SSRI antidepressants on the fetus in women who are pregnant. The authors used national registry data to examine the relationship between pre-birth SSRI treatment and pregnancy complications while controlling for the effects of the psychiatric diagnoses related to SSRI use. Some previous studies had just compared people who took …
TMS for Tinnitus
About 10 to 15% of adults experience tinnitus, which is the perception of ringing or other phantom sounds in the brain. Of those who experience chronic tinnitus, 20% report that the symptom causes clinically significant distress. Because there is evidence that alterations in the function of the brain, specifically the auditory cortex, may be responsible, in part, for this experience, …
Brexpiprazole Updated
The FDA recently announced approval of the medication (brexpiprazole or Rexulti) both for the treatment of schizophrenia and as an adjunct to antidepressants in the treatment of major depression. The simultaneous approval of the medication for both indications is quite unusual. Brexpiprazole has a complicated pharmacology. Similar to aripiprazole (Otsuka’s atypical antipsychotic which recently came off patent and which this …
Parity Website
We ran across information about a new website that is drawing attention to the issue of mental health parity and that is dedicated to helping people get the behavioral health treatment they need – Paritytrack.org. The essence of the federal law that requires mental health parity in insurance coverage is not that mental health needs to have a certain level of …
Lithium Long Term Risks
Elsewhere we have talked about accumulating evidence that suggests that lithium may have significant long-term beneficial effects for brain function and health in people with bipolar. A recent article in the British journal the Lancet reminds us that lithium remains a medication that requires close monitoring and which has the potential to cause rare but significant adverse effects on kidney, …
Bipolar Depression Treatment
Dr. Peter Forster and Dr. Kelsey Schraufnagel gave a very well attended presentation for an international audience of participants hosted by the International Bipolar Foundation on June 24th. Listeners from India, Taiwan, France, Ireland and all over the United States received an update on the state of the art in the treatment of bipolar depression. Doctor Forster updated the audience about medication …
Refills
“Why do you only give me a month’s supply of medication when you approve refills?” This is a pretty common question and I thought a blog post might be a good way of discussing the issues. After all a refill is a quick thing to handle, right? You call a number and press a few numbers, go onto your iPhone …
Pre visit Questionnaire
For more than a year we’ve been sending out reminders about future appointments along with a link to a pre-visit survey form. The idea for doing this originally came from new documentation requirements that were embedded in a revision of the standard billing codes for psychiatry a couple of years ago. We realize that the new documentation requirements would take …
Frequency of Visits
The frequency of visits to the clinic can be a source of considerable irritation. Why do we recommend that people come in once a week, or once every two weeks, or once a month, or less often? A wonderful young man I have been seeing for several years got very angry when I replied to his request to reschedule his appointment …
Mediterranean Diet Improves Cognitive Function
Many of our patients are concerned about cognitive function, and there is evidence that people with recurrent episodes of depression may be at higher risk of cognitive decline. But what can be done about this? A just published study in JAMA Internal Medicine suggests that a Mediterranean diet enhanced with either olive oil or nuts may prevent and perhaps even …