Delayed Circadian Rhythms

Peter Forster Insomnia, Insomnia Treatment, Psychobiology

Delayed circadian rhythms occur in a condition known as delayed sleep-wake phase disorder (DSWPD). This condition needs to be distinguished from disrupted circadian rhythms, a condition in which there are no strong circadian rhythms and therefore it’s hard for people to fall asleep, and when they do fall asleep they tend to have fragmented or light sleep. People with delayed …

A Possible Cause of Bipolar Mania

Peter Forster Basic Science, Psychobiology

A recently published article by a group of Korean researchers hints at a possible cause of bipolar mania. The finding underlines the complex biology of bipolar disorder and perhaps why coming up with a biological mechanism for the dramatic shifts in behavior in bipolar has been so difficult. Background A number of pieces of evidence have suggested that phospholipase C signaling may be …

Neuroscience Based Nomenclature

Peter Forster Best Practices, Psychobiology, Treatments of Depression

Neuroscience Based Nomenclature is an initiative by a number of prestigious organizations supporting research in neuroscience and psychiatry to change the way that we talk about psychotropic / psychiatric medications. Why this might be useful is illustrated by conversations that are likely familiar to all psychiatrists… A severely depressed patient with bipolar 1 is discussing her need for a change …

Depression Biology and Treatment

Peter Forster Anxiety, Basic Science, Major Depression, Psychobiology, Treatments of Depression

New research on depression biology and treatment highlights the rapid increase in knowledge in this area in the last decade. In this post we will summarize some of these research findings briefly. This brief tour will take us to a newly discovered protein that may be a vital link between stress and depression. A genome wide search for changes associated …

Significance of Events and Serotonin 2A

Peter Forster Basic Science, Psychobiology

Making sense of the constant bombardment of information and sensory experience that all of us face requires the ability to determine the significance of events, and an elegant study suggests that the serotonin 2A receptor plays a critical role in determining significance. Many psychiatric conditions and human experiences are associated with the misattribution of meaning to events. For example, delusional disorder …

Oxytocin and Spirituality

Peter Forster Psychobiology

Oxytocin is a fascinating neurohormone which has been linked to parent-child bonding as well as romantic love, and to darker emotions such as the rejection of “foreigners”. A recent article suggests that it may also be an important factor in the development of spirituality. Joel Yager, writing in the NEJM Journal Watch Psychiatry, summarizes the study this way: Investigators enrolled …

Depression, Anhedonia, Glutamate, and Inflammation

Peter Forster Basic Science, Major Depression, Psychobiology

That depression may be linked to alterations in glutamate circuits is suggested by the observation that ketamine (which is an NMDA glutamate receptor antagonist) may rapidly reverse depression in some patients. Depression has also been found to be associated in some people with various markers for inflammation (c reactive protein, tumor necrosis factor, interleukin 1 beta, and interleukin 6). As …

Depression Therapeutics and Mechanisms

Peter Forster Major Depression, Psychobiology, Treatments of Depression

The September 15, 2016 edition of Biological Psychiatry is devoted to updates in the area of psychobiology that relate to depression and its treatment. In this blog post I will summarize some of those studies to give you a sense of what is going on in the field. Some of these studies may not be replicated in follow-up research, but some …

A New Model of Anxiety and Fear

Peter Forster Anxiety, Psychobiology

We often tell our patients that the treatment of anxiety is primarily through psychotherapy, in contrast to the treatment of mood disorders which is often based on medications or brain stimulation. In fact, it is one of the more frustrating aspects of psychiatry that there has been so little progress in terms of the biological treatments of anxiety and fear …

Why SSRIs May Increase Anxiety Short Term

Peter Forster Psychobiology, Treatments of Depression

SSRIs are among the most commonly prescribed medications for chronic anxiety, but not infrequently these medications may be associated with a short term increase in symptoms that precedes the long term benefit. In an elegant series of studies published online in late August 2016 in the premier scientific journal, Nature, researchers from the NIH and the University of North Carolina at …