SSRI Doses and Effectiveness – High Dose vs Low Dose, Is There a Difference?

adminBest Practices, Major Depression, Treatments of Depression Leave a Comment

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

Peter ForsterGPS, Major Depression, Treatments of Depression Leave a Comment

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

Antidepressant Diet Cookbook

Peter ForsterMajor Depression, Physical Conditions and Health, Self Care, Treatments of Depression Leave a Comment

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

Peter ForsterBasic Science, Major Depression, Psychobiology Leave a Comment

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

TMS Predictors of Outcome in Bipolar Depression and Unipolar Major Depression

Peter ForsterBipolar Treatment, Major Depression, Treatments of Depression Leave a Comment

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

Shared Gene Expression in Mental Disorders

Peter ForsterDiagnosis, Psychobiology Leave a Comment

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

State and Trait Brain Function in Depression

Peter ForsterBasic Science, Major Depression, Psychobiology Leave a Comment

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

Peter ForsterBasic Science, Major Depression, Psychobiology Leave a Comment

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

Peter ForsterAnxiety, Basic Science, Major Depression, Psychobiology, Treatments of Depression

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 …

Antidepressant Response Linked to Norepinephrine Transporter Genotype

Peter ForsterBest Practices, Major Depression, Testing, Treatments of Depression

A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …