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 …
Reduced Gene Expression in Reward Center is Linked to Depression
Researchers from the University of Maryland have conducted a series of experiments in mice and humans leading them to conclude that reduced gene expression in the reward center is linked to depression. Specifically, the researchers found that there was reduced expression of the Slc6a15 gene in the brains of people with major depression who committed suicide, and that expression of this …
How Long Should You Take Antidepressants
How Long Should You Take Antidepressants – Factors to consider, the importance of first getting well, how long it takes for the brain to heal after depression.
Functional Brain Imaging in Depression
Is there a role for functional brain imaging in depression? Many people seeking treatment are interested in the notion that the brain imaging, particularly imaging that looks at neural activity, might be useful in guiding treatment. Up until the last couple of years the answer to this question has always been that the role is primarily restricted to research settings …
Default Mode Network and Depression Treatment – Ketamine and TMS
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, …
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 …
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. …
Where is the Outrage About Suicide?
A wonderful editorial in JAMA Psychiatry highlights the overwhelming evidence that stigma is continuing to drive underfunding for treatment and prevention of suicide deaths. Suicide and “accidental” overdose deaths are an epidemic in this country. Since 1999, the rate of suicide deaths increased by 28.2%, and this probably underestimates the increase because there is evidence that coroners are categorizing more and …



