One of the most exciting initiatives currently in the important area of the treatment of depression is the International Study to Predict Optimized Treatment in Depression (iSPOT-D). This large multi-center initiative is based on a private industry and academic partnership that is designed to both identify best practices in the treatment of depression and also commercialize them. The most recent publication from this …
SSRI Dose Response
It has long been unclear whether higher doses of SSRIs are associated with greater response. What has been clear is that higher doses are associated with significantly increased side effects. In fact previous research, whether individual studies or meta-analyses have failed to find a significant dose response with the result that many have felt that there is a flat dose response …
Vortioxetine for Cognitive Impairment in Depression
Takeda and Lundbeck announced that the Food and Drug Administration (FDA)’s Psychopharmacologic Drug Advisory Committee (PDAC) voted to support the efficacy of vortioxetine (Brintellix) for treating cognitive dysfunction in adults with major depressive disorder (MDD). The advisory committee also reviewed evidence to suggest that cognitive dysfunction in people with major depressive disorder was an appropriate target for treatment. Several recent …
TMS Stimulates Brain Growth
In a recent poster presented at the 2015 Society of Biological Psychiatry meeting Martin Lan and colleagues presented data from the first study of structural changes in the brain following TMS. In the study, 27 patients in an episode of major depression underwent MRIs before and after receiving TMS treatment. Several cortical regions related to cognitive appraisal, the subjective experience of …
New Antidepressant Stimulates Neuron Growth
The results of a clinical trial published in December in Molecular Psychiatry suggest that a new medication (NSI-189) which has been shown to increase the production of cells in the hippocampus and the amygdala in pre-clinical studies may help treat major depression. The results highlight the evidence that has been accumulating that stimulating the production of new cells in the hippocampus (neurogenesis) …
Escitalopram Reduces Inflammation in Depression
Escitalopram reduces inflammation in depression and potentially reduces neurotoxicity according to an article just published in the Journal of Psychiatric Research. A pro-inflammatory tendence has previously been noted in patients with depression, and this seems to be associated strongly with increases in kynurenine (see below for more information on how exercise counteracts this tendency). Kynurenine is the first step in …
Lurasidone for Depression with Mixed Features
Lurasidone (Latuda) May Treat Depression with Mixed Features A recently published clinical trial suggests that lurasidone, which is an atypical antipsychotic with strong evidence for efficacy in treating bipolar depression, may be associated with response in patients who, according to DSM5, do not meet criteria for bipolar disorder, but do have evidence of mixed features. The study points to the importance …
SSRI Doses – Higher May Be Better
SSRI Doses – Optimal Doses May Be Higher than Usual Doses One of the questions that often comes up has to do with the patient who has a partial response to a serotonin antidepressant but who remains depressed. Should we increased the dose about the standard initial dose, should wait and see if there’s further improvement? Should we add a …
Bright Light for Non-Seasonal Depression
Bright light may work for non-seasonal depression. This is the conclusion of a study published in the prestigious psychiatric journal JAMA Psychiatry. Researchers at the University of Toronto and the University of British Columbia in Canada conducted a randomized, double-blind, placebo- and sham-controlled, 8-week trial in adults (aged 19-60 years) with major depression of at least moderate severity. 122 patients were …
TMS Cost Effectiveness
“Is TMS Cost-Effective?” His provocative title of an article just published in psychiatric times which summarizes an Australian pharmaco-economic study. In case you don’t want to read through the rest of this article, here is the summary: “Australian researchers compared the cost-effectiveness of rTMS with pharmacotherapy in treatment-resistant patients with MDD (ie, those who have failed at least 2 courses …