Recently there has been a lot of interest in using psilocybin as a treatment for depression, anxiety and alcohol use disorder. We certainly need more safe and effective treatments. It may be worth considering where we are in the evaluation of these agents. Right now there is a growing literature supporting the potential value of these agents, but there is …
Psychedelic Medicine Association Member
Gateway Psychiatric just joined the Psychedelic Medicine Association. This membership is a continuation of our longstanding interest in alternative treatments for depression. I have been working with Bay Psychiatric Associates and Roberto Estrada for nearly five years providing ketamine infusion and now nasal esketamine to patients with treatment resistant depression. This followed attending the 2017 Ketamine Conference which was held …
Walgreens Doesn’t Care – Why I Don’t Approve Refills Automatically
Today one of my patients had a simple request – “Doc, I don’t know if you need to write new prescriptions, but my pharmacy will ask for a refill if I do.” I said that I it is my policy to always write refills in session so that I can make sure that I and my patients understand what medications …
Long Term Effects of Ketamine
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 …
Lithium Thyroid Effects
A young woman who has had a relatively good response to low dose lithium treatment has labs that suggest she may be developing hypothyroidism (low thyroid) and asks what her options are. What can be done to treat the problem? What risks are there for developing it? And what would happen if she decided to taper off the lithium, would …
SSRI Antidepressants and Pregnancy – 2015
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 …