Pre-Diabetes Weight Gain and Depression

Insulin Resistance, Pre-Diabetes, Central Obesity, Elevated Triglycerides and Depression

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Three different findings associated with insulin resistance and pre-diabetes are predictive of developing depression according to a study published online from the American Journal of Psychiatry. Study Summary MedPage Today (9/23/2021) writes that, “Three surrogate measures for insulin resistance all showed a significant link with developing a major depressive disorder [MDD] over a nine-year follow-up period,” researchers concluded. The 601-participant study …

SSRI Doses and Effectiveness – High Dose vs Low Dose, Is There a Difference?

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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 …

SSRI and Other Antidepressants and Pregnancy – 2020

Peter Forster Major Depression, Physical Conditions and Health, Treatments of Depression Leave a Comment

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 …

Psychotherapy is Important for Depression Prevention

Peter Forster Best Practices, Major Depression, Treatments of Depression Leave a Comment

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 …

Limbic and Prefrontal Connectivity and Treatment Selection for Depression

Peter Forster Basic Science, Best Practices, Major Depression, Psychobiology, Treatments of Depression

Boadie Dunlop, M.D., M.S., and Helen Mayberg, M.D., both of Emory University School of Medicine, and colleagues assessed resting-state functional connectivity between the subcallosal cingulate cortex (SCC) and three other brain regions—the dorsal midbrain, the ventrolateral prefrontal cortex and anterior insula, and the ventromedial prefrontal cortex—in 122 patients with depression. The patients were then randomized to 12 weeks of cognitive-behavioral …

Impaired Decision Making in Depression – Treatment Implications

Peter Forster Major Depression, Treatments of Depression Leave a Comment

Why do depressed people make choices that are unlikely to be rewarded. And why aren’t they willing to make choices that are likely to be rewarded. In fact, why are depressed people less likely than people who are not depressed to choose to take an antidepressant, or begin psychotherapy, or follow the advice of a therapist? A meta-analysis of many …

New Biomarker for Treatment Response in Depression – GPR56/ADGRG1

Peter Forster Basic Science, Major Depression, Treatments of Depression Leave a Comment

What happens in the body when antidepressants work. An international group of researchers, led by Professor Gustavo Turecki of McGill University and the Douglas Mental Health University Institute, examined changes in the activity of genes (measured using mRNA) in the blood in over 400 patients who were being treated with antidepressants. They identified one gene that was significantly more active …

Inflammation Testing and Antidepressant Selection

Peter Forster Best Practices, Major Depression, Physical Conditions and Health, Testing Leave a Comment

Inflammation and C Reactive Protein Inflammation is often seen in people with depression. And there is evidence to suggest that it predicts treatment response. The most widely accepted standard test to measure inflammation is the C-reactive protein, or CRP. This is a protein that is produced by the liver in inflammatory states. The American Heart Association and the Centers for …

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CBASP Advanced Training and Certification for Gateway Therapists – Update

Peter Forster About GPS, Best Practices, Major Depression, Treatments of Depression Leave a Comment

Gateway Psychiatric was established with the belief that in order to give our patients the best care possible, it is necessary to invest heavily in training for the clinical staff. We particularly focus on evidence based practices that have been shown to address significant problems facing our patients. Since chronic depression is one of the most common problems seen in …

GABA-A Agent SAGE-217: A New Antidepressant?

Peter Forster Major Depression, Treatments of Depression Leave a Comment

Psychiatrists and patients alike are hungry for new antidepressants. Few new medications have been developed in the last 10 years that are effective antidepressants, and those that have come to the market have all been variants of existing medications. The only really novel treatments for depression in the last 15 years in psychiatry are ketamine and TMS, both of which …