Lithium and Kidney Damage

Peter ForsterBipolar Treatment, Physical Conditions and Health

Lithium may be effective as a mood stabilizer, but questions often come up about its safety, particularly with regard to kidney or renal effects. A recent very large study published in November 2015 in JAMA Psychiatry looked at a huge dataset from Denmark in order to provide the best information we have now about these risks. The study consisted of records …

Lithium Long Term Risks

Peter ForsterBipolar Treatment

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

Peter ForsterBipolar Treatment, GPS Update

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 …

ECT for Bipolar Depression

Peter ForsterBipolar Treatment, Treatments of 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

Peter ForsterBipolar Treatment, Treatments of 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 …

Bipolar Depression Update

Peter ForsterBipolar Treatment, GPS 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.    

Anhedonia and Ketamine

Peter ForsterBipolar Treatment, Psychobiology, Treatments of Depression

Anhedonia, meaning the loss of the normal experience of pleasure in life, can be one of the most troubling symptoms of depression. And also one for which we have relatively few treatments. We know that a small group of dopamine neurons in the ventral tegmentum (limbic system) which project to the prefrontal cortex, among other locations in the brain, are …

Anhedonia Treatment with Ketamine

Peter ForsterBipolar Treatment, Treatments of Depression

The treatment of anhedonia and bipolar depression can be very difficult. An article published in Translational Psychiatry in October of 2014 highlights the role of glutametergic transmission in anhedonia and points to the potentially unique efficacy of ketamine in treating this stubborn problem. Anhedonia, the lack (an-) of pleasure (-hedonia), is one of the 2 main symptoms of a major …

Bipolar Education Program

Peter ForsterBipolar Treatment, Website Update

Doctors often do a poor job of educating their patients about their health problems. That is particularly troubling when you are talking about a condition as complicated as bipolar. We have been working on an educational program for this site based on the Barcelona psycho-education program for bipolar, to be called Bipolar 101. The Barcelona program has clearly been shown, …

Bipolar Depression Neurobiology – 2014 ISBD Update

Peter ForsterBipolar Treatment, Psychobiology

Bipolar depression neurobiology is an area that urgently needs more research. The treatment of a depression that follows an energized (hypomanic or manic) state remains one of the most difficult areas in psychiatry. Mark Frye, Chair of the Department of Psychiatry at the Mayo Clinic, gave a presentation on this topic at the 2014 International Society of Biological Society conference that was …