New research suggests that rising estrogen and progesterone levels trigger premenstrual dysphoria symptoms. “Although the mechanisms underlying the mood-destabilizing effects of ovarian steroids in PMDD remain to be better characterized, as does the source of susceptibility to this trigger, our findings provide a new target for interventions,” Peter Schmidt, M.D., chief of the Section on Behavioral Endocrinology at the National …
Protected: Alcohol Use Disorder Guidelines
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Low Dose Atypical Antipsychotics Are Better for Bipolar Depression
An analysis of several studies comparing low and high doses of atypical antipsychotics finds that low dose atypical antipsychotics are better for bipolar depression. In general, the therapeutic effects are the same, but side effects are significantly less with lower doses. The study reviewed the data from seven clinical trials of high and low doses of quetiapine (4 trials), cariprazine, lurasidone, and …
California Healthcare Laws
Over the last five years California has enacted a number of laws and regulations that seek to make the healthcare insurance system fairer, but keeping track of all of these laws is a real challenge. At a recent symposium I ran into a colleague of mine who reminded me of a law that requires insurance companies to continue coverage of …
Stopping Antipsychotics after a First Episode of Psychosis
A recent Spanish study adds to the small literature on the risks of stopping antipsychotic medications following a first episode of psychosis. In this study, discontinuation of antipsychotics after a full functional recovery from a first episode of psychosis (FEP) appeared to be associated with a very high rate of relapse, compared with those who continued to take antipsychotic medications. As the researchers of …
New Staff – Nathaniel Abad
I am very pleased to announce that we have just hired another administrative staff member to help Hershe and Kelli with their work. Nathaniel Abad is joining us. He will be working remotely, primarily on website and information management tasks. Nathaniel Abad graduated from Ateneo de Davao University in 1997 with a Bachelor’s Degree in Biology, a preparatory course for medicine. …
UCSF Psycho-education Group for Bipolar
UCSF Group Psycho-Education for Bipolar Disorder The Adult Psychiatry Clinic at UCSF has released the schedules of their Group Psycho-Education for Bipolar Disorder for January 2016. This activity under the Bipolar Disorder Program of the Department of Psychiatry is aimed at providing a community resource for individuals with bipolar disorder, mental health professionals and psychiatrists. Headed by Dr. Descartes Li, …
Serotonin Reuptake Inhibitors Dose
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 new medication, or should we switch to a different antidepressants? Because …
Google Reviews – How-to [2022]
Some of our patients have asked how they can best express their appreciation for the work we do. One of the best ways is to write a review about Gateway Psychiatric. This is not only gratifying (if honest) but it also helps make us visible when other patients or families are seeking care. We have now updated this post with …
TMS for Tinnitus
About 10 to 15% of adults experience tinnitus, which is the perception of ringing or other phantom sounds in the brain. Of those who experience chronic tinnitus, 20% report that the symptom causes clinically significant distress. Because there is evidence that alterations in the function of the brain, specifically the auditory cortex, may be responsible, in part, for this experience, …