There are many reasons why thyroid status is important in a clinic treating people with mood disorders. For one thing, hypothyroidism and hyperthyroidism can mimic some of the symptoms of mood disorders. For another, lithium, a medication we often prescribe, is associated with hypothyroidism in a significant minority of patients taking the medicine. One of the questions we wrestle with …
Inflammation Testing and Antidepressant Selection
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 …
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. …
Pharmacy Apps
One of the most perplexing things about our healthcare system is how complicated it can make even simple tasks. This is particularly true when the issue involves sharing information among providers of care. Elsewhere we have talked about the “silo” problem and why it has motivated us to develop a clinic that tries to provide integrated care. Here I want …
Biofeedback at Gateway Psychiatric
Biofeedback is a stress management technique that uses devices that give you information about your body’s physiologic response to stress. The idea is to provide you with information that would ordinarily be outside of your conscious awareness, such as your body temperature, blood pressure, or heart rate. Generally, there are three stages of biofeedback: Developing increased awareness of the body …
Home Blood Draws
Would home blood draws (or office blood draws for that matter) be helpful? Obtaining routine blood work can be an essential part of your treatment if you have a mood disorder and are on medications as it is very important to know the levels in your blood reached by mood-stabilizing drugs. Finding time however to get your labs done can …
Finger Stick Lab Tests
Finger stick lab tests have the potential to significantly improve the quality of the care at Gateway Psychiatric. Regular monitoring of labs are an important part of good care for many of our patients, but some find it difficult to get labs done on time. A new technology from clinical laboratory provider OpAns may allow us to perform many of …
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 …
Brain Training for Bipolar
Cognitive problems are the rule rather than the exception for people with bipolar disorder and so the idea of brain training for bipolar is an attractive one. There are a number of commercially available brain training courses. Probably one of the most comprehensive was developed by a company called Posit Science. Its current flagship product is a subscription-based online program …
Nutrition and Diet Update
Nutrition and Diet Update We recently updated the overall guidelines in our healthy diet page to incorporate information from the largest study today looking at diet and its effect on overall mortality. It’s worth summarizing both the strengths and weaknesses of this study which was published in two articles in the Lancet. It is the largest study to date. Nearly 140,000 …