Chronotherapy refers to treatments for depression, mania, or both, that focus on changing sleep and wakefulness patterns. This blog post provides an update of this important area. Background The International Society of Bipolar Disorders (ISBD) task force on chronobiology and chronotherapy published a comprehensive review of chronotherapy techniques and their effectiveness in bipolar disorder in 2019. This article summarizes the …
New Los Altos Office Replaces Mountain View
Our Mountain View Office is moving to Los Altos. The last day in the current office will be Friday, January 17th. The first day in the new office will be Tuesday, January 21 (the day after the MLK holiday). The Los Altos office is newer, has convenient parking on site, and has two excellent coffee shops across the road. We …
Stimulus Control Therapy for Insomnia
Disrupted sleep rhythms may drive mood instability and sleep and insomnia are some of the most frequently cited problems of people seeking help for mood disorders. Research has shown that most frequently prescribed medications are not very helpful – they may lengthen sleep times by only 15 – 45 minutes per night. Cognitive Behavioral Therapy for Insomnia Cognitive Behavior Therapy …
CBASP Advanced Training and Certification for Gateway Therapists – Update
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 …
Can a Change in Diet Affect Psychiatric Disorders?
Can a change in diet affect mood and anxiety? What dietary changes or interventions may be effective in treatment or management of mental or mood disorders? Diet is more than weight loss, and has been invoked, modified and studied for a wide variety of physical and mental ills and conditions. We have written a summary of what we know about …
Predicting Lithium Response
Lithium is usually considered the most effective treatment for bipolar disorder. However, at least 30% of lithium-treated patients do not have a clinically significant response; and only 30% have a long-lasting full response. Since close laboratory monitoring is required, and adverse effects are not uncommon, identifying predictors of lithium response is highly desirable. In this largest-ever study of lithium recipients …
Lithium Associated Hypothyroidism May Be Reversible
People who develop hypothyroidism while using the mood stabilizer lithium may return to normal thyroid function after the drug is discontinued, according to a study in the Journal of Psychopharmacology. Hypothyroidism—a condition in which the thyroid gland does not produce enough thyroid hormone—has long been known to be associated with the use of lithium. Recent studies have clarified the nature of this association. …
When We Can’t Accept New Patients
We are truly sorry. We are a small clinic and so at times we are not able to accept new patients. We don’t believe in waiting lists. We think that people should be seen when they need the help rather than being told to wait for a future appointment. Whenever we can accept new patients we are committed to offering …
Insurance Coverage of TMS for Bipolar Depression
A patient represented by an attorney obtained AETNA health insurance coverage for rTMS treatment of bipolar depression. The patient satisfied the insurer’s policy guidelines for rTMS treatment of major depression by demonstrating failed trials of 4 different medications. Reimbursement was based on the plan’s allowed percentage of the “covered amount”. The AETNA Appeals Decision stated – “TMS treatment is being …
GABA-A Agent SAGE-217: A New Antidepressant?
Psychiatrists and patients alike are hungry for new antidepressants. Few new medications have been developed in the last 10 years that are effective antidepressants, and those that have come to the market have all been variants of existing medications. The only really novel treatments for depression in the last 15 years in psychiatry are ketamine and TMS, both of which …