cbasp

CBASP Advanced Training and Certification for Gateway Therapists – Update

Peter Forster About GPS, Best Practices, Major Depression, Treatments of Depression Leave a Comment

Gateway Psychiatric was established with the belief that in order to give our patients the best care possible, it is necessary to invest heavily in training for the clinical staff. We particularly focus on evidence based practices that have been shown to address significant problems facing our patients. Since chronic depression is one of the most common problems seen in …

How Long Does It Take to Get Well with TMS

Peter Forster Major Depression, Treatments of Depression Leave a Comment

The most common question that people ask when they start TMS is how long it will take to get well with TMS. A recent article published in the American Journal of Psychiatry looked at the results from a six week study designed to compare theta burst and regular TMS in order to assess patterns of response over time. The authors …

Treatment Resistant Depression – More Clues to Predicting Response – VAST-D

Peter Forster Major Depression, Treatments of Depression Leave a Comment

Clues that can help us provide more effective care for those with treatment resistant depression are urgently needed. Sidney Zisook and colleagues report an analysis of the data from a large study of veterans with chronic depression (VAST-D) and conclude that two clinical features can help predict likely response to medications changes for some patients who have failed at least …

Ketamine Short Term Treatment Strategies

Peter Forster GPS, 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 Forster Major 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 …

TMS Effectiveness Updated

Peter Forster Best Practices, Major Depression, Treatments of Depression

TMS effectiveness for depression is clear. But now there are more machines for providing TMS and more protocols. Is deep TMS better than regular TMS?  Or is deep TMS just a marketing phrase? A major review article in JAMA Psychiatry updated our understanding of alternatives to the initial protocol for TMS. JAMA Psychiatry is the most prestigious journal in psychiatry, …

Long Term Depression Psychotherapy

Peter Forster Best Practices, Major Depression, Treatments of Depression

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. …

Why SSRIs May Increase Anxiety Short Term

Peter Forster Psychobiology, Treatments of Depression

SSRIs are among the most commonly prescribed medications for chronic anxiety, but not infrequently these medications may be associated with a short term increase in symptoms that precedes the long term benefit. In an elegant series of studies published online in late August 2016 in the premier scientific journal, Nature, researchers from the NIH and the University of North Carolina at …

Genesight – Genetic Testing to Predict Medication Response

Peter Forster GPS Update, Psychobiology, Testing

We have been using the Genecept Assay from Genomind for several years to help guide treatment selection in patients with either unusually high rates of side effects from medications or those who have failed multiple trials of medications. Although the test can be expensive, costing anywhere from a couple of hundred dollars to five hundred dollars or more, it is our experience …