Interaction between the default mode network and parts of the pre-frontal cortex may explain some depression phenomena and also links to why TMS and ketamine work
Ketamine for Depression – 2017
I just got back from an inspiring conference in Berkeley on Ketamine for Depression. I am eager to implement some changes in how we work with people we refer or provide ketamine infusion for that may make the treatment more effective. The conference was organized by Alison McInnes, MD, MS, who is in charge of the Kaiser, San Francisco Ketamine Treatment Program, …
Maternal SSRI Use and Autism
The CBS Evening News (4/18, story 9, 1:15, Pelley) reported, “Studies have shown that pregnant women who take antidepressants are more likely to have children with autism.” Newly published studies examine whether the medication is causing this. TIME (4/18, Park) reports that in two studies, investigators “found that other factors, including genes linked to mental illness, may be more strongly …
Ketamine Guidelines
Ketamine guidelines have recently been published by American Psychiatric Association Council of Research Task Force on Novel Biomarkers and Treatments. They highlight what we know and what we don’t know about this treatment. What We Know “Several studies now provide evidence of ketamine hydrochloride’s ability to produce rapid and robust antidepressant effects in patients with mood and anxiety disorders that were previously resistant …
Efficacy or Effectiveness
What is the difference between efficacy and effectiveness? We tend to use these terms interchangeably in our posts on this site, but the two are different and the difference can be important. Efficacy refers to the power of a treatment to achieve a given outcome assuming that the patient is perfectly compliant and completes the treatment. Effectiveness addresses the more …
Neuroscience Based Nomenclature
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 …
TMS Effectiveness Updated
TMS effectiveness for depression is clear. But now there are more machines for providing TMS and more protocols. Is deep TMS better than regular TMS? Or is deep TMS just a marketing phrase? A major review article in JAMA Psychiatry updated our understanding of alternatives to the initial protocol for TMS. JAMA Psychiatry is the most prestigious journal in psychiatry, …
Depression Biology and Treatment
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 …
Long Term Depression Psychotherapy
Effective psychotherapy for depression that has lasted for years is needed because chronic depression (lasting two years or longer) develops in up to a third of people with an episode of major depression. Chronic depression is associated with more suicidality, more impairment in functioning, and more hospitalizations. Chronic depression psychotherapy is often less effective than therapy for other forms of depression. …
Antidepressant Response Linked to Norepinephrine Transporter Genotype
A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …