Covid-19 Mental Health Effects

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Neurological and psychiatric symptoms are common in COVID-19 infections A recent meta-analysis looked at 215 studies from 30 countries and found that neurological and psychiatric symptoms such as depression and anxiety are common in patients, and are found as much or more in mild cases as in acute cases requiring hospitalization. Loss of sense of smell and taste, weakness, fatigue …

Brexpiprazole (Rexulti) in Bipolar Disorder

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Brexpiprazole (Rexulti) is a medication that has similar effects to two other atypical antipsychotics, cariprazine (Vraylar) and aripiprazole (Abilify) but brexpiprazole does not have approval in the United States for treating bipolar mania. Why is this, and how should it guide clinical practice? A recent review of all of the studies of brexpiprazole in bipolar mania that are listed on …

Primary Care – Getting Good Care for Less

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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

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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

Psychedelic Medicine Association Member

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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?

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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

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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

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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

CPT Codes and Billing Changes 2021

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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 Healthier You in 5 Days

Prolon and Resuming a Healthy Life Post Covid

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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 …