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Chronic Insomnia Best Treatments

Peter Forster Insomnia, Insomnia Treatment

Chronic Insomnia – What are the Best Treatments? The American College of Physicians just published guidelines on the treatment of chronic insomnia. These guidelines were based on a comprehensive review of the literature. They note that chronic insomnia is very common, but the literature on treatment is relatively poor. Many treatments that are used do not have good evidence supporting …

Mania and Depression Sequence

Peter Forster Best Practices, Bipolar Treatment

One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …

Early intervention for depression helps

Peter Forster Best Practices, Major Depression, Treatments of Depression

In a review of an article published in JAMA Psychiatry in early March 2016, Dr. Steven Dubovsky writes about encouraging findings about treatment efficacy of patients with major depression from a large study in Denmark. In the study, researchers reviewed 10 years worth of national data from the extensive population records capped in Denmark which provides nearly universal access to …

New Antidepressant Stimulates Neuron Growth

Peter Forster Treatments of Depression

The results of a clinical trial published in December in Molecular Psychiatry suggest that a new medication (NSI-189) which has been shown to increase the production of cells in the hippocampus and the amygdala in pre-clinical studies may help treat major depression. The results highlight the evidence that has been accumulating that stimulating the production of new cells in the hippocampus (neurogenesis) …

SAMe – S-adenosyl-methionine

Peter Forster Major 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 …

Natural Isn’t Necessarily Safe

Peter Forster Physical Conditions and Health

23,000 emergency room visits per year are the result of taking “natural supplements.” Natural does not mean safe. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), with heavy backing from industry. By defining herbal supplements and botanicals as dietary supplements, DSHEA exempted them from the more rigorous standards used by the FDA in regulating food, drugs, and …

Bipolar Depression Treatment

Peter Forster Bipolar Treatment, GPS Update

Dr. Peter Forster and Dr. Kelsey Schraufnagel gave a very well attended presentation for an international audience of participants hosted by the International Bipolar Foundation on June 24th. Listeners from India, Taiwan, France, Ireland and all over the United States received an update on the state of the art in the treatment of bipolar depression. Doctor Forster updated the audience about medication …

Ketamine for Depression – Mechanism of Action

Peter Forster Basic Science, Major Depression, Treatments of Depression

Ketamine for Depression: How does it work? We ran across a useful review of the basic science literature in an interview of David Nichols on the Psych Congress Network. http://www.psychcongress.com/video/ketamine-quick-guide-receptors-19116 Although ketamine blocks the NMDA subtype of glutamate receptors (blocks an excitatory neurotransmitter) the net effect seems to be an increase in excitatory neurotransmission. This image from Nature may help …

TMS Outcomes – Long Term Study

Peter Forster Major Depression, Treatments of Depression

TMS outcomes have seemed favorable for patients with treatment resistant major depression, but what are the long term effects of TMS (transcranial magnetic stimulation)? TMS is a non-invasive technique for stimulating brain activity in parts of the brain that seem to be turned off in depression – the dorsolateral prefrontal cortex. TMS uses magnets to stimulate the brain and the …

TMS Improves Memory

Peter Forster Psychobiology, Treatments of Depression

TMS improves memory. According to a study published in the Aug. 29 issue of the journal Science, “electrically stimulating a portion of the brain that coordinates the way the mind works can enhance memory and improve learning.” The researchers used Transcranial Magnetic Stimulation (TMS) to indirectly stimulate activity in the hippocampus, a key part of the brain involved in the storage …