One of the questions that has bedevilled clinicians ever since the introduction of the first SSRI (Prozac, fluoxetine) is whether there is any relationship between SSRI doses and effectiveness. In other words, do higher doses result in greater effectiveness. I can recall about 20 years ago reading the first clinical trial looking at this question. It was an article published …
Fasting Mimicking Diet
What is the Fasting Mimicking Diet? We have just begun trying out the ProLon Fasting Mimicking Diet, developed by an expert at the University of Southern California. It’s a new concept in dieting relying on the science behind intermittent fasting, which is a method of dieting by fasting for some hours or days each month. The Fasting Mimicking Diet, however …
Understanding a Prescription Label
How can I figure out if I will need Dr. Forster to write a prescription for me? Don’t refills happen automatically? I set them to refill automatically on Walgreens.. Why does Dr. Forster say I have a prescription approved when the pharmacist says I don’t have any refills? Prescription labels contain a great deal of information, but navigating the intricacies …
CPT Codes and Billing Changes 2021
In January of 2021 the AMA changed the way that physicians must choose the appropriate “CPT” or billing codes for outpatient visits. The changes simplify the process and also make it clear that we have been “undercoding” for psychiatric outpatient visits at Gateway Psychiatric for quite a while. The reason for this is that the previous system for choosing billing …
Prolon and Resuming a Healthy Life Post Covid
Many of us have struggle to stay healthy during a year of Covid. As we contemplate the possibility that there may be some return to “normal” in the next several months we are wondering how we can resume a healthier lifestyle. Prolon may be part of the answer. Several of our patients at Gateway have gained a fair amount of …
February 2022: COVID-19 or Coronavirus and GPS
The current projections for COVID-19 coronavirus infections in California look hopeful. We track this using the IHME model. As of mid-February 2022, it appears that infections are likely to be back to the levels seen in the fall of 2021 by mid to late March 2022. Other sources of information mirror this prediction. For example, Covid in sewage tends to …
New Insomnia Guidelines
The American Academy of Sleep Medicine (AASM) has issued updated guidelines for treatment of insomnia. Chronic insomnia disorder is a serious condition and requires careful diagnosis and treatment. It is often found together with mood disorders such as bipolar, major depression and anxiety, but has traditionally been treated as a less-important and temporary phenomenon. The AASM recommends that chronic insomnia …
SSRI and Other Antidepressants and Pregnancy – 2020
We have several other posts on this topic which trace the evolution of our thinking about the risks of using antidepressants during pregnancy. Generally, the data continues to support our view that the risks of depression during pregnancy, both in terms of effects on the mother and effects on the child, usually outweigh the risks of antidepressant use. Another large …
Jet Lag Calculator by Sleep Junkie
Jet lag, although temporary affects both physical and mental performance. Travelling across multiple time zones disrupts your body’s circadian rhythm and a result it may cause fatigue, dizziness and other symptoms including changes in mood. We found this app that could help you recover from jet lag on a wonderful site called Sleepjunkie.org. You can use the calculator to change …
Psychotherapy is Important for Depression Prevention
Psychotherapies — particularly cognitive-behavioral approaches used as adjunctive treatments — can play a critical role in helping people with a history of depression avoid relapse. For many people, major depression is a chronic illness. Even when they are no longer depressed, people who have had several episodes of depression have to be concerned about a significant risk of a recurrence …