Get your brain unstuck There have been many important developments in the science of depression in the past few years, but understanding of these has not become widespread in the general public, or even among patients with major depressive disorder (MDD). The “serotonin deficit” or “chemical imbalance” theories of the cause of depression remain more widely understood and commonly used …
SSRI Doses and Effectiveness – High Dose vs Low Dose, Is There a Difference?
One of the questions that has bedevilled clinicians ever since the introduction of the first SSRI (Prozac, fluoxetine) is whether there is any relationship between SSRI doses and effectiveness. In other words, do higher doses result in greater effectiveness. I can recall about 20 years ago reading the first clinical trial looking at this question. It was an article published …
Ketamine Short Term Treatment Strategies
What are the best strategies for using ketamine to treat major depression in the short term? Although we know that ketamine (and, now, esketamine) can be helpful we really don’t know that much about what strategy works best. The most commonly used ketamine infusion protocol is adapted from studies using ketamine to treat chronic pain. An article in the March …
Antidepressant Diet Cookbook
Two recent studies suggest that the Mediterranean diet may be an antidepressant diet as well as the diet that reduces heart disease, inflammation, and the risk of dementia. In the SMILES trial 65 patients with depression were randomized to a Mediterranean diet based intervention (a diet support group) or a social support group. The group excluded people who were treatment …
Depression Resilience and Neural Connectivity
Much has been written about risk factors for depression but we know less about depression resilience factors. Why do some people at high risk develop depression, while others do not. A study conducted at Stanford by Adina S. Fischer, MD PhD, and colleagues, suggests that increased regulation of limbic areas (the parts of the brain that are most directly involved in …
TMS Predictors of Outcome in Bipolar Depression and Unipolar Major Depression
What TMS predictors of outcome in bipolar depression and unipolar major depression can we use to identify those who are likely to respond to treatment? An article in 2017 in the journal Clinical Neurophysiology reports data from a very large series of patients with both types of depression who were treated with TMS. The study looked at records from 105 …
Shared Gene Expression in Mental Disorders
Four distinct psychiatric disorders – autism, schizophrenia, bipolar disorder and depression – have shared gene expression, according to research published online Feb. 8 in the journal Science. Researchers arrived at the study’s findings by analyzing RNA in 700 tissue samples from the brains of dead people who had autism, schizophrenia, bipolar disorder, major depression or alcohol abuse disorder, then comparing those samples …
State and Trait Brain Function in Depression
Understanding the neurobiology of depression involves more than just knowing about serotonin, we need to know how state and trait brain function in depression is different from brain functioning in those who have never had a major depression. State and trait are key concepts in understanding psychiatric conditions: state refers to those alterations in functioning that occur when someone is …
Negative Self-Appraisal and Brain Activity
Negative Self-Appraisal and Brain Activity: Altered Function in Depression Within the Default Mode Network (DMN) are three structures that link negative self-appraisal and brain activity: The medial prefrontal cortex (MPFC) The posterior cingulate cortex (PCC) And the inferior parietal lobule (IPL) Negative self-appraisal refers to the relentless critical self talk that occurs in many people with depression. Many patients report …
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 …
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