A new drug that stimulates the glycine site of NMDA receptors had rapid antidepressant effects in the just released results of a phase II clinical trial. The drug substantially reduced depression symptoms, with no severe side effects. The NMDA receptor has 2 sites that are involved in its activation. One site is stimulated by glutamate or aspartate. Another site is stimulated by glycine. For …
Chronic Pain and Depression
Chronic pain and depression often co-occur in the relationship between the two experiences can be hard to separate. An important article just published in Biological Psychiatry (Barthas, et al) identifies 2 sets of circuits in the brain for processing pain: One is located in the anterior cingulate cortex and seems to be involved in the emotional experience of pain, the …
Fee Changes
It is time to update our fee list. The last time we revised our fees was in November of 2013. In preparation for this task we reviewed data on health care costs in the Bay Area from the Bureau of Labor Statistics and we compared our fees to average fees in San Francisco for the same services (CPT codes) using …
LOCUS and Level of Care
LOCUS© and CALOCUS© instruments were developed by the American Association of Community Psychiatrists (AACP). They are clinical tools that evaluate and determine level of care placements for psychiatric and addiction services for both adult and child/adolescent populations. We use these tools when we are working with the patient or family who is seriously symptomatic, failing to improve despite aggressive outpatient treatment, …
ECT for Bipolar Depression
ECT for bipolar depression may be much more effective than psychiatric medications. That is the conclusion of the recently published, well designed study of 73 in patients with bipolar depression who had failed adequate trials with mood stabilizers. In the initial 2 months after the patients were randomized to either ECT or algorithm based pharmacotherapy (psychiatric medications carefully managed and …
Bipolar Depression
The recent presentation that I gave at UCSF on this topic allowed me to review all of the controlled clinical trials related to the treatment of bipolar depression. In a follow-up post I plan on talking about some of the exciting new developments that suggest that we will soon, and to some extent do already, have some very promising approaches …
Hidden Work
The hidden work that goes into even a modest website such as our own can be huge. I am going to reward myself for a weekend of work by mentioning some of the stuff we have been working on – Keywords – The miracle of modern searches rests in part on the huge work that webmasters put into indexing all …
Online Office
We don’t exactly have a robot like Siri who can answer all your questions and do all your tasks online. But we have tried to put together a list of ways of getting information and taking care of routine tasks that cuts down the number of steps it takes if you just try to trade voicemails, or even emails with …
What happened to the website?
Some of you may have gone to our website this past weekend and been surprised to learn that the site was “dangerous.” Although some of the ideas that we talk about here might be viewed that way, the reason this happened had to do with the challenges of maintaining SSL encryption and the highest level of security. Basically, for 3 …
Bipolar Depression Update
On Thursday at noon Dr. Peter Forster, our clinical director, will be giving a presentation to the UCSF Department of Psychiatry Mood Disorder Grand Rounds on the topic of “Bipolar Depression: An Update.” He will be reviewing the recent literature on new treatment options and will summarize some of the talk findings in a future blog post.