Gateway Staff attend APA Annual Conference in San Francisco – Chris

Nathaniel Abad About GPS, Best Practices, GPS Update, Treatments of Depression Leave a Comment

Recently the American Psychological Association (APA) held their annual conference here in San Francisco and Gateway staff was there to take advantage of the opportunity to update our knowledge of the most recent developments in the field. Gina Gregory, LCSW and I spent the long weekend attending workshops, presentations, and discussions in order to align ourselves with the current research …

Gerard Sancora Esketamine is Effective

Intranasal Esketamine is Effective for Depression

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

Intranasal esketamine is effective for treating severe depression and suicidality when added to comprehensive standard of care treatment in patients who were felt to be at imminent risk of suicide. 68 patients seen in an emergency department were randomized to receive esketamine or placebo as well as comprehensive treatment including inpatient care and antidepressant medications. Patients receiving esketamine had a …

Antidepressant Diet

Antidepressant Diet Cookbook

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

Two recent studies suggest that the Mediterranean diet may be an antidepressant diet as well as the diet that reduces heart disease, inflammation, and the risk of dementia. In the SMILES trial 65 patients with depression were randomized to a Mediterranean diet based intervention (a diet support group) or a social support group. The group excluded people who were treatment …

TMS Predictors of Outcome

TMS Predictors of Outcome in Bipolar Depression and Unipolar Major Depression

Peter Forster Bipolar Treatment, Major Depression, Treatments of Depression Leave a Comment

What TMS predictors of outcome in bipolar depression and unipolar major depression can we use to identify those who are likely to respond to treatment? An article in 2017 in the journal Clinical Neurophysiology reports data from a very large series of patients with both types of depression who were treated with TMS. The study looked at records from 105 …

Maintenance TMS

Maintenance TMS

Peter Forster Major Depression, Treatments of Depression Leave a Comment

A patient with treatment resistant depression and an excellent initial response to TMS asked me about the value of maintenance TMS. The question is a reasonable one given what we know generally about the treatment of chronic and/or treatment resistant depression. Almost all of the effective treatments (psychotherapy, medications, ECT, etcetera) have acute and maintenance treatment components. And for all …

Ketamine Reduces Suicidal Thoughts

Peter Forster Treatments of Depression Leave a Comment

A single infusion of ketamine reduces suicidal thoughts in depressed patients in one day, with benefits lasting for up to one week, according to a meta-analysis reported in the American Journal of Psychiatry. Further, ketamine did not seem to be just treating depression, it seemed to have an effect on suicidal thinking that was greater than its effect on depression “This suggests that …

Bipolar Depression Light Therapy

Peter Forster Bipolar Treatment, Treatments of Depression Leave a Comment

The news that bipolar depression light therapy may be effective is good news and follows a series of studies this past year highlighting the importance of treatments that affect circadian rhythms by manipulating light and dark in treating mood disorders. Bipolar depression is one of the hardest conditions to treat effectively. Antidepressant medications may have significant side effects, including inducing mania, …

ketamine long term effects

Long Term Effects of Ketamine

Peter Forster Major Depression, Treatments of Depression Leave a Comment

One of my patients asked me what the long term effects of ketamine are. She was particularly interested in long-term adverse effects. The last time I did a review of the literature I noted that there seem to be very little information available. This is not surprising with the psychiatric literature since ketamine and its use for chronic depression are …

Genetic Tests for Antidepressants – CNS Dose

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

About a year ago we reviewed the data on the use of genetic tests for antidepressants as well as other medications and identified three pharmacogenetic panels that seem to have research support: Genecept by Genomind, Genesight, and CNS Dose. Of these three we have been using Genecept and Genesight with some success but now we are happy to add to …

Enlyte methylfolate and more

Enlyte – methylfolate and more

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

Enlyte is a therapeutic food that has been designed to help people at risk of functional deficits in folate and methylfolate that may be associated with treatment resistant depression. It contains a mixture of folate, folinic acid and l-methylfolate as well as other co-factors. EnLyte/EnBrace HR/EnLyte-D helps with concentration, motivation, and sleep. Symptoms include depressed mood, loss of interest, problems concentrating, insomnia, …