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 …

How Long Does It Take to Get Well with TMS

Peter Forster Major Depression, Treatments of Depression Leave a Comment

The most common question that people ask when they start TMS is how long it will take to get well with TMS. A recent article published in the American Journal of Psychiatry looked at the results from a six week study designed to compare theta burst and regular TMS in order to assess patterns of response over time. The authors …

Treatment Resistant Depression – More Clues to Predicting Response – VAST-D

Peter Forster Major Depression, Treatments of Depression Leave a Comment

Clues that can help us provide more effective care for those with treatment resistant depression are urgently needed. Sidney Zisook and colleagues report an analysis of the data from a large study of veterans with chronic depression (VAST-D) and conclude that two clinical features can help predict likely response to medications changes for some patients who have failed at least …

Ketamine Short Term Treatment Strategies

Peter Forster GPS, Major Depression, Treatments of Depression Leave a Comment

What are the best strategies for using ketamine to treat major depression in the short term? Although we know that ketamine (and, now, esketamine) can be helpful we really don’t know that much about what strategy works best. The most commonly used ketamine infusion protocol is adapted from studies using ketamine to treat chronic pain. An article in the March …

Deaths of Despair Anthony Bourdain Suicide

Deaths of Despair – Suicide & Self Injury Crisis in US

Peter Forster Major Depression, Policy Leave a Comment

The news of Anthony Bourdain and Kate Spade’s death by suicide as well as the CDC’s report on increasing suicide rates in the US reminds us of a larger public health crisis that was given the name “deaths of despair” by researchers Case and Deaton (see below). We have been collecting information on this topic in preparation for an effort …