Chronotherapy for depression may be a very fast and effective treatment for suicidality, according to a preliminary study just published in the Journal of Psychiatric Research. 10 inpatients received what was called “triple chronotherapy” and showed dramatic and rapid reductions in suicidal ideation and depression. Of course this is a very small sample and only one study. But it points …
Antidepressants May Blunt Feelings of Romance
Antidepressants may blunt feelings of romance when taken long-term according to a recent study, but the way this effect shows up may be quite different in men and women. Researchers presented a study at the European College of Neuropsychopharmacology (ECNP) Congress which used a newly developed Sex-Attachment-Love Test (SALT) questionnaire. They looked at almost 200 adults with mild or moderate depression …
TMS Effectiveness
TMS effectiveness is something I have spent a fair amount of time researching. Last year I gave two Grand Rounds presentations on this topic at the University of California, San Francisco and at the California Pacific Medical Center. But despite the compelling evidence that, if you have failed two (or maybe three) antidepressant trials for the treatment of your depression, your …
Genetic Testing for Depression Drugs
Genetic testing for depression drugs is a new approach to selecting medications that may have value, especially in patients with treatment resistant depression. We have been using the Genecept Assay for patients with treatment resistant depression and have found that the results improve our ability to choose effective treatments. Patients who have failed multiple adequate trials of medications are much less likely to …
Therapy or Medication for Depression?
Therapy or medication for depression? Which is more effective? When might you want to consider both treatments? These are among the most frequent questions that we are asked. A recent study published in JAMA Psychiatry provides the best information available about how to make this decision. The study involved 452 patients who received antidepressant medication treatment for depression with or …
TMS Mechanism of Action – Changes in Brain Connectivity?
TMS’s mechanism of action has been unclear. Transcranial magnetic stimulation affects activity locally in the region of the brain that is stimulated, but does that explain how it works? Since it affects local activity in every patient, why does it not work for everyone? A new article in Biological Psychiatry suggests that it may be changes in brain connectivity that …
Exercise and Stress – How Exercise Prevents Depression
Exercise seems to reduce stress. But how does this work? And what about exercise effects on depression? An article in the New York Times summarizes a recent publication in the journal Cell which may explain how exercise prevents depression. A wealth of research shows that regular exercise reduces the risk of depression. A very large study in Britain, for example, suggested that …
Ketamine for Depression – Mechanism of Action
Ketamine for Depression: How does it work? We ran across a useful review of the basic science literature in an interview of David Nichols on the Psych Congress Network. http://www.psychcongress.com/video/ketamine-quick-guide-receptors-19116 Although ketamine blocks the NMDA subtype of glutamate receptors (blocks an excitatory neurotransmitter) the net effect seems to be an increase in excitatory neurotransmission. This image from Nature may help …
TMS Outcomes – Long Term Study
TMS outcomes have seemed favorable for patients with treatment resistant major depression, but what are the long term effects of TMS (transcranial magnetic stimulation)? TMS is a non-invasive technique for stimulating brain activity in parts of the brain that seem to be turned off in depression – the dorsolateral prefrontal cortex. TMS uses magnets to stimulate the brain and the …
Blood Test for Depression
How many times has a new patient in the clinic asked, “isn’t there a blood test for depression?” Always in the past we had to say that there were no reliable tests that could identify depression. There was some evidence that functional brain imaging could do so but the technique was expensive and experimental. In an article published in the …