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 …
Disability
Given the severity of mood and anxiety symptoms and some of the people we treat, we often deal with issues related to short-term or long-term work disability. In this post we will talk about common questions that come up when someone is impaired as the result of a psychiatric condition. Functional Assessment It often comes as a surprise to our …
Doxy.me Telepsychiatry
This blog post provides information about Doxy.me a HIPAA compliant tele-psychiatry platform that we use at Gateway Psychiatric. Doxy.me is a simple and secure Web-based video solution designed for telemedicine. Doxy.me automatically works with popular internet browsers, such as Google Chrome and Mozilla Firefox, without requiring additional downloads or plug-ins to install. Doxy.me does not work with Safari or Internet Explorer. …
Testosterone for Older Men
Does testosterone supplementation help older men with low testosterone improve their quality of life, mood and energy? Some of the “low T” advertisements on TV made it seem like the magic hormone that conquered aging. More recently the FDA has been expressing its concern about over-prescribing by, among other things, adding black box warnings on the labels of gel formulations of …
Norepinephrine dopamine and depression
In an elegant set of studies published in February 2016 in Nature Neuroscience the team of Bruno Giros, a researcher at the Douglas Mental Health University Institute and Professor of Psychiatry at McGill University, reports the first-ever connection between noradrenergic neurons and vulnerability to depression. The study involved research using probably the most well developed animal model for depression – chronic or …
Lithium and Genes
Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …
Buprenorphine for Depression – A Combination Approach
While we were in the midst of a seeming epidemic of concern about opiate prescribing and possible overuse of opiates by physicians, it is ironic that we are also seeing a small stream of articles being published about the potential effectiveness of opiate agonists in treating patients with treatment resistant depression. I’ve been interested in this topic since Enoch Callaway, …
Lowering Medication Costs – Update
The New York Times recently reviewed two websites that offered to substantially reduce the cost of psychiatric medications for those without adequate insurance coverage. We’ve updated the section of this website that provides links to information about lowering the costs of medications and that mentions the option of purchasing medications from Canada as well as information about these two sites. …
Pramipexole in Unipolar and Bipolar Depression
For many years we’ve been impressed with the response in some patients with bipolar depression to relatively high doses of pramipexole. Pramipexole is an agent that enhances dopamine neurotransmission and has been approved for the treatment of Parkinson’s disease. There are relatively few medications that significantly affect dopamine, one of the three monoamine neurotransmitters associated with depression and pramipexole is …
Rapastinel for Depression
The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to rapastinel, which follows the medication receiving a 2014 Fast Track Designation from the FDA. Rapastinel, an investigational medication for adjunctive treatment of major depressive disorder, is an intravenous drug that is a novel NMDA receptor agonist. It is being developed by Allergan. The Breakthrough Therapy designation is a new …