Inflammation and C Reactive Protein Inflammation is often seen in people with depression. And there is evidence to suggest that it predicts treatment response. The most widely accepted standard test to measure inflammation is the C-reactive protein, or CRP. This is a protein that is produced by the liver in inflammatory states. The American Heart Association and the Centers for …
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 …
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 …
How Long Does It Take to Get Well with TMS
The most common question that people ask when they start TMS is how long it will take to get well with TMS. A recent article published in the American Journal of Psychiatry looked at the results from a six week study designed to compare theta burst and regular TMS in order to assess patterns of response over time. The authors …
Treatment Resistant Depression – More Clues to Predicting Response – VAST-D
Clues that can help us provide more effective care for those with treatment resistant depression are urgently needed. Sidney Zisook and colleagues report an analysis of the data from a large study of veterans with chronic depression (VAST-D) and conclude that two clinical features can help predict likely response to medications changes for some patients who have failed at least …
Ketamine Short Term Treatment Strategies
What are the best strategies for using ketamine to treat major depression in the short term? Although we know that ketamine (and, now, esketamine) can be helpful we really don’t know that much about what strategy works best. The most commonly used ketamine infusion protocol is adapted from studies using ketamine to treat chronic pain. An article in the March …
Deaths of Despair – Suicide & Self Injury Crisis in US
The news of Anthony Bourdain and Kate Spade’s death by suicide as well as the CDC’s report on increasing suicide rates in the US reminds us of a larger public health crisis that was given the name “deaths of despair” by researchers Case and Deaton (see below). We have been collecting information on this topic in preparation for an effort …
Intranasal Esketamine is Effective for Depression
Intranasal esketamine is effective for treating severe depression and suicidality when added to comprehensive standard of care treatment in patients who were felt to be at imminent risk of suicide. 68 patients seen in an emergency department were randomized to receive esketamine or placebo as well as comprehensive treatment including inpatient care and antidepressant medications. Patients receiving esketamine had a …
Antidepressant Diet Cookbook
Two recent studies suggest that the Mediterranean diet may be an antidepressant diet as well as the diet that reduces heart disease, inflammation, and the risk of dementia. In the SMILES trial 65 patients with depression were randomized to a Mediterranean diet based intervention (a diet support group) or a social support group. The group excluded people who were treatment …
Depression Resilience and Neural Connectivity
Much has been written about risk factors for depression but we know less about depression resilience factors. Why do some people at high risk develop depression, while others do not. A study conducted at Stanford by Adina S. Fischer, MD PhD, and colleagues, suggests that increased regulation of limbic areas (the parts of the brain that are most directly involved in …