Antidepressants Update

Peter ForsterMajor Depression, Treatments of Depression, Website Update

I just wanted to make a quick note that I recently posted a major update of the information on this site about antidepressants. This follows the recent introduction of a few interesting new antidepressant medications. I hope to expand that by adding a page talking about atypical antipsychotics and perhaps other classes of medications routinely used in this practice. Since …

TMS Updates May 2015

Peter ForsterTreatments of Depression

The editors of Bipolar News reported on some interesting presentations related to transcranial magnetic stimulation (TMS) at the Biological Psychiatry meetings this past May. TMS for geriatric depression – “Researcher Daniel Blumberger reported that he has found repeated transcranial magnetic stimulation (rTMS) to be effective for depression in late life. Blumberger noted thatit may be necessary to use higher intensity …

SAMe – S-adenosyl-methionine

Peter ForsterMajor Depression, Treatments of Depression

S-adenosylmethionine, or SAM-e for short, is one of the few nutritional supplements that has good clinical research to support its safety and effectiveness. Although SAM-e is used for many purposes, we are particularly interested in it as a compound that may have antidepressant properties. S-adenosylmethionine (SAMe) is involved in many reactions that involve methylating chemicals (transferring a methyl group to the …

Psychotherapy for Depression – New Data

Peter ForsterTreatments of Depression

Many reviews have pointed out that there is a significant “publication bias” that affects studies of antidepressants: because studies that don’t find an effect tend not to be published a review of the published literature would suggest that these medications are more effective than they really are. Indeed this is been the basis of a great debate in the popular and …

Aripiprazole for Late Life Depression

Peter ForsterMajor Depression, Treatments of Depression

A study suggests that aripiprazole augmentation may be an effective strategy for treating major depression in older adults. The article has generated a lot of interest because of evidence suggesting that late life major depression may be different from major depression in early adulthood. Cognitive impairment, including memory troubles and trouble with planning and decision making (executive function), seems to …

Cognitive Behavioral Analysis System of Psychotherapy

Peter ForsterBest Practices, GPS Update, Major Depression, Treatments of Depression

I have just posted another page on the site devoted to orienting patients to types of psychotherapy that we may recommend for them. This most recent page talks about Cognitive Behavioral Analysis System of Psychotherapy, an approach to the treatment of patients with chronic depression that many people have benefitted from during the course of their treatment at Gateway Psychiatric. …

Ketamine for Depression Update

Peter ForsterGPS Update, Major Depression, Treatments of Depression

Probably the most exciting development in psychopharmacology in years is the discovery of the dramatic effects of ketamine on depression. However, a recent report from the American Psychiatric Association (APA) Task Force on Novel Biomarkers and Treatments highlights not only the reason for the excitement about ketamine but also the significant areas of uncertainty that make it not yet ready to …

Collaboration with Your Clinician

Peter ForsterAbout GPS, Best Practices, Self Care, Treatments of Depression

There are a number of things about the clinical practice at Gateway that are a little bit different.  If you have seen another psychiatrist or psychotherapist it might be helpful to read this blog post to orient yourself to those differences and also to see if this is the right place for you to be receiving treatment. We strive to …

SSRI Antidepressants and Pregnancy – 2015

Peter ForsterMajor Depression, Physical Conditions and Health, Treatments of Depression

A recent study concludes that there may be some good news about the impact of SSRI antidepressants on the fetus in women who are pregnant. The authors used national registry data to examine the relationship between pre-birth SSRI treatment and pregnancy complications while controlling for the effects of the psychiatric diagnoses related to SSRI use. Some previous studies had just compared people who took …

Brexpiprazole Updated

Peter ForsterMajor Depression, Treatments of Depression

The FDA recently announced approval of the medication (brexpiprazole or Rexulti) both for the treatment of schizophrenia and as an adjunct to antidepressants in the treatment of major depression. The simultaneous approval of the medication for both indications is quite unusual. Brexpiprazole has a complicated pharmacology. Similar to aripiprazole (Otsuka’s atypical antipsychotic which recently came off patent and which this …