The frequency of visits to the clinic can be a source of considerable irritation. Why do we recommend that people come in once a week, or once every two weeks, or once a month, or less often? A wonderful young man I have been seeing for several years got very angry when I replied to his request to reschedule his appointment …
Mediterranean Diet Improves Cognitive Function
Many of our patients are concerned about cognitive function, and there is evidence that people with recurrent episodes of depression may be at higher risk of cognitive decline. But what can be done about this? A just published study in JAMA Internal Medicine suggests that a Mediterranean diet enhanced with either olive oil or nuts may prevent and perhaps even …
Liz Ren – Welcome
I’m very excited to announce that a new psychiatric and mental health nurse practitioner, Liz Ren, will be joining our staff in April. I think you can get a sense of her enthusiasm and perhaps her intelligence and excellent qualifications from the paragraphs that she wrote for me about why she is excited to be joining Gateway… “Gateway is the …
Weight Loss Medication
A new pill with the brand name Contrave was recently approved for the treatment of obesity by the FDA. This pill is an extended release, fixed dose, combination of two previously approved medications: bupropion, a commonly used antidepressant which has also been approved as an aid to those were trying to stop smoking, and naltrexone, a medication that blocks the …
ABCB1 Gene Predicts Antidepressant Response
An article that will soon appear in the American Journal of Psychiatry suggests that it may be possible to predict who will respond to different antidepressants using a genetic test. The study looked at whether by testing for specific genetic variants of a protein involved in transporting drugs and other potentially toxic substances into and out of cells and across the blood …
Another Blood Test for Depression
We ran across a recent article that promised a “blood test for depression” and thought how strange it was that this article was being republished in the Journal of Clinical Psychiatry. After all we wrote about a blood test for depression based on an article that appeared in translational psychiatry just a few months ago. Imagine my surprise when I …
MAOI Diet Update
MAOI diet information on the Internet can be very confusing for someone just starting one of these antidepressant medications. Monoamine oxidase inhibitors (MAOIs) are medications that inhibit the action of the enzyme monoamine oxidase. breaks down the three chemicals in the brain which may be deficient in people with depression: norepinephrine, serotonin, and dopamine. Almost all antidepressants in use today work, …
Stimulants and Geriatric Depression
Stimulants and Geriatric Depression May be Underused. A well designed study showed that adding methylphenidate (Ritalin and others) to citalopram (Celexa) improve the likelihood of complete remission from depression in older patients. In general older depressed patients are more likely to have some cognitive impairment and are less likely to respond to antidepressants. A number of reports suggests that adding stimulants to antidepressants can …
Methylfolate and Depression
Depression and Methylfolate The role of methylfolate in the treatment of patients with depression has once again been highlighted by an article published in the American Journal of Psychiatry in 2016. After successfully treating treatment resistant depression in a patient deficient in cerebrospinal fluid (CSF) tetrahydrobiopterin (necessary for biosynthesis of several neurotransmitters) with sapropterin (a synthetic form of tetrahydrobiopterin’s active isomer), …
Mediterranean Diet Anti Aging Effect
The Mediterranean Diet appears to have an anti aging effect in a just published study. The study, in the December 2014 edition of the British Medical Journal, found that the Mediterranean Diet was associated with telomere length, a biological marker of aging. Telomeres are DNA sequences at the end of chromosomes that protect the chromosomes from damage and allow healthy cell …