A better ketamine may be coming. That is the conclusion of NEJM Journal Watch Psychiatry reviewer Barbara Geller. A common pathway to identifying new drugs, is looking at metabolites of a medication to see if there is one metabolite that works better than the active drug (desvenlafaxine – one of the metabolites of venlafaxine – may or may not be …
Mindfulness for Depression – Research Update
Mindfulness has received a lot of attention recently as an approach to improving mental health in a number of conditions. But is it really effective as part of a strategy for treating serious depression? And, if so, how can we best incorporate it into treatment, given the great difficulty that many people with depression have doing even a small amount …
“I am looking for a doctor who can treat me with Ketamine infusions for treatment resistant depression.”
I was inspired to write this blog post by the third patient in three days to contact me about Ketamine infusions. She wanted to know if I could provide her with Ketamine infusions for her treatment resistant depression. Ketamine infusions are one of the treatments for depression that we provide access to for our patients. Among the other treatments are …
Acceptance and Commitment Therapy Part 1: Acceptance and Willingness
Acceptance and Commitment Therapy (or ACT, pronounced as the word, not A-C-T) is a comprehensive, empirically driven model developed by Steve Hayes, PhD and colleagues with nearly 200 randomized controlled trials (methodologically sound studies) supporting its efficacy for numerous problems and concerns. I recently attended the Anxiety and Depression Association of America conference in Philadelphia, where I offered a two-hour …
Early intervention for depression helps
In a review of an article published in JAMA Psychiatry in early March 2016, Dr. Steven Dubovsky writes about encouraging findings about treatment efficacy of patients with major depression from a large study in Denmark. In the study, researchers reviewed 10 years worth of national data from the extensive population records capped in Denmark which provides nearly universal access to …
Testosterone for Older Men
Does testosterone supplementation help older men with low testosterone improve their quality of life, mood and energy? Some of the “low T” advertisements on TV made it seem like the magic hormone that conquered aging. More recently the FDA has been expressing its concern about over-prescribing by, among other things, adding black box warnings on the labels of gel formulations of …
Norepinephrine dopamine and depression
In an elegant set of studies published in February 2016 in Nature Neuroscience the team of Bruno Giros, a researcher at the Douglas Mental Health University Institute and Professor of Psychiatry at McGill University, reports the first-ever connection between noradrenergic neurons and vulnerability to depression. The study involved research using probably the most well developed animal model for depression – chronic or …
Buprenorphine for Depression – A Combination Approach
While we were in the midst of a seeming epidemic of concern about opiate prescribing and possible overuse of opiates by physicians, it is ironic that we are also seeing a small stream of articles being published about the potential effectiveness of opiate agonists in treating patients with treatment resistant depression. I’ve been interested in this topic since Enoch Callaway, …
Pramipexole in Unipolar and Bipolar Depression
For many years we’ve been impressed with the response in some patients with bipolar depression to relatively high doses of pramipexole. Pramipexole is an agent that enhances dopamine neurotransmission and has been approved for the treatment of Parkinson’s disease. There are relatively few medications that significantly affect dopamine, one of the three monoamine neurotransmitters associated with depression and pramipexole is …
Rapastinel for Depression
The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to rapastinel, which follows the medication receiving a 2014 Fast Track Designation from the FDA. Rapastinel, an investigational medication for adjunctive treatment of major depressive disorder, is an intravenous drug that is a novel NMDA receptor agonist. It is being developed by Allergan. The Breakthrough Therapy designation is a new …