There is nothing like a patient’s request to spur me on to tackle a long delayed project. Noting that a significant percent of the patients I see have bipolar, one of my patients wondered why I did not have any information on this website that addressed, in an organized way, the considerations that go into selecting a mood stabilizer. I …
Antipsychotic Medications in Pregnancy
After decades during which the accepted medical dogma was that pregnant women should avoid all medications, the last 10 years have shown a significant increase in the quality of information available to help guide pregnant women in making decisions about which medications to continue taking during pregnancy. A recent editorial in the JAMA Psychiatry gives a sense of the context and …
Mindfulness Based Cognitive Therapy for Bipolar
Mindfulness Based Cognitive Therapy for Bipolar May Reduce Anxiety and Improved Cognitive Function Researchers in the Departments of Biology and Psychiatry at University of Cape Town, in Western Cape, South Africa, recently reported results from a study in which 23 bipolar patients received neuropsychological tests and functional MRI scans before and after a Mindfulness Based Cognitive Therapy 8 week program. The study showed increased …
Mania and Depression Sequence
One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …
Lithium Prevents Suicide
This has been a year with lots of useful information highlighting the continued importance of some of the oldest treatments for bipolar disorder: lithium salts. A New York Times Magazine article (“I Don’t Believe in Good but I Believe in LIthium”) about bipolar focused on lithium, and another New York Times article a year before that asked the question “Should We …
“I am looking for a doctor who can treat me with Ketamine infusions for treatment resistant depression.”
I was inspired to write this blog post by the third patient in three days to contact me about Ketamine infusions. She wanted to know if I could provide her with Ketamine infusions for her treatment resistant depression. Ketamine infusions are one of the treatments for depression that we provide access to for our patients. Among the other treatments are …
Lithium and Genes
Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …
Pramipexole in Unipolar and Bipolar Depression
For many years we’ve been impressed with the response in some patients with bipolar depression to relatively high doses of pramipexole. Pramipexole is an agent that enhances dopamine neurotransmission and has been approved for the treatment of Parkinson’s disease. There are relatively few medications that significantly affect dopamine, one of the three monoamine neurotransmitters associated with depression and pramipexole is …
Sheri Johnson Presents on Mania
Every month the clinical team at Gateway Psychiatric gets together to review cases and to hear presentations on topics related to the treatment of patients with mood disorders and this past month we heard from Dr. Sheri Johnson at the University of California, Berkeley who talk to us about the CalMania project and her own work with patients with bipolar. …
Lurasidone for Depression with Mixed Features
Lurasidone (Latuda) May Treat Depression with Mixed Features A recently published clinical trial suggests that lurasidone, which is an atypical antipsychotic with strong evidence for efficacy in treating bipolar depression, may be associated with response in patients who, according to DSM5, do not meet criteria for bipolar disorder, but do have evidence of mixed features. The study points to the importance …