For decades, the serotonin theory of depression has been the prevailing explanation for the disorder. The theory holds that depression is caused by low levels of serotonin, a neurotransmitter that plays a role in mood regulation. This theory has led to the development of many popular antidepressants, which work by increasing serotonin levels in the brain. However, a new study …
SSRI and Other Antidepressants and Pregnancy – 2020
We have several other posts on this topic which trace the evolution of our thinking about the risks of using antidepressants during pregnancy. Generally, the data continues to support our view that the risks of depression during pregnancy, both in terms of effects on the mother and effects on the child, usually outweigh the risks of antidepressant use. Another large …
Limbic and Prefrontal Connectivity and Treatment Selection for Depression
Boadie Dunlop, M.D., M.S., and Helen Mayberg, M.D., both of Emory University School of Medicine, and colleagues assessed resting-state functional connectivity between the subcallosal cingulate cortex (SCC) and three other brain regions—the dorsal midbrain, the ventrolateral prefrontal cortex and anterior insula, and the ventromedial prefrontal cortex—in 122 patients with depression. The patients were then randomized to 12 weeks of cognitive-behavioral …
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 …
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 …
Genetic Tests for Antidepressants – CNS Dose
About a year ago we reviewed the data on the use of genetic tests for antidepressants as well as other medications and identified three pharmacogenetic panels that seem to have research support: Genecept by Genomind, Genesight, and CNS Dose. Of these three we have been using Genecept and Genesight with some success but now we are happy to add to …
How Long Should You Take Antidepressants
How Long Should You Take Antidepressants – Factors to consider, the importance of first getting well, how long it takes for the brain to heal after depression.
Neuroscience Based Nomenclature
Neuroscience Based Nomenclature is an initiative by a number of prestigious organizations supporting research in neuroscience and psychiatry to change the way that we talk about psychotropic / psychiatric medications. Why this might be useful is illustrated by conversations that are likely familiar to all psychiatrists… A severely depressed patient with bipolar 1 is discussing her need for a change …
Antidepressant Selection Based on Symptom Clusters
Can we do a better job of antidepressant selection based on symptom clusters, analyzed using machine learning techniques? Perhaps so. And if so we will avoid a great deal of unnecessary suffering as people try one medication after another until the find the right medication or combination of medications to treat their depression. That is the premise behind an ambitious …
Antidepressant Response Linked to Norepinephrine Transporter Genotype
A large study of patients treated with venlafaxine found that antidepressant response was linked to the norepinephrine transporter (NET) genotype. The study looked at response in a sample of 350 individuals over the age of 60 with severe depression (MADRS greater than or equal to 15) who were treated with venlafaxine up to a dose of 300 mg a day. …