Over the years we have written a lot about the importance of integrating mental health care and medical care and the experience of the past year demonstrates to all of us the importance of having excellent primary care as well as mental health care. For that reason, we are excited to pass on an offer that comes once a year …
Mental Health Awareness 2021
For now over 70 years, Americans have delegated the month of May as “Mental Health Awareness Month” (since 1949). And with medical experts and researchers across the planet sharing their observation that the Covid-19 pandemic is going to continue to have an array of mental health impacts into the foreseeable future, mental health awareness needs to remain in the forefront …
Psychedelic Medicine Association Member
Gateway Psychiatric just joined the Psychedelic Medicine Association. This membership is a continuation of our longstanding interest in alternative treatments for depression. I have been working with Bay Psychiatric Associates and Roberto Estrada for nearly five years providing ketamine infusion and now nasal esketamine to patients with treatment resistant depression. This followed attending the 2017 Ketamine Conference which was held …
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 …
Fasting Mimicking Diet
What is the Fasting Mimicking Diet? We have just begun trying out the ProLon Fasting Mimicking Diet, developed by an expert at the University of Southern California. It’s a new concept in dieting relying on the science behind intermittent fasting, which is a method of dieting by fasting for some hours or days each month. The Fasting Mimicking Diet, however …
Understanding a Prescription Label
How can I figure out if I will need Dr. Forster to write a prescription for me? Don’t refills happen automatically? I set them to refill automatically on Walgreens.. Why does Dr. Forster say I have a prescription approved when the pharmacist says I don’t have any refills? Prescription labels contain a great deal of information, but navigating the intricacies …
CPT Codes and Billing Changes 2021
In January of 2021 the AMA changed the way that physicians must choose the appropriate “CPT” or billing codes for outpatient visits. The changes simplify the process and also make it clear that we have been “undercoding” for psychiatric outpatient visits at Gateway Psychiatric for quite a while. The reason for this is that the previous system for choosing billing …
Prolon and Resuming a Healthy Life Post Covid
Many of us have struggle to stay healthy during a year of Covid. As we contemplate the possibility that there may be some return to “normal” in the next several months we are wondering how we can resume a healthier lifestyle. Prolon may be part of the answer. Several of our patients at Gateway have gained a fair amount of …
New Insomnia Guidelines
The American Academy of Sleep Medicine (AASM) has issued updated guidelines for treatment of insomnia. Chronic insomnia disorder is a serious condition and requires careful diagnosis and treatment. It is often found together with mood disorders such as bipolar, major depression and anxiety, but has traditionally been treated as a less-important and temporary phenomenon. The AASM recommends that chronic insomnia …
Try Cognitive Behavioral Therapy for Insomnia First
Although there is reason for optimism about some of the newer medications for insomnia (orexin antagonists) that are coming to market, it remains true that sleeping medications are not the right answer for many people with insomnia. Cognitive behavioral therapy for insomnia (CBTi) has several advantages as an initial treatment. Cognitive Behavioral Therapy for Insomnia First We have been writing …