Anhedonia, meaning the loss of the normal experience of pleasure in life, can be one of the most troubling symptoms of depression. And also one for which we have relatively few treatments. We know that a small group of dopamine neurons in the ventral tegmentum (limbic system) which project to the prefrontal cortex, among other locations in the brain, are …
Anhedonia Treatment with Ketamine
The treatment of anhedonia and bipolar depression can be very difficult. An article published in Translational Psychiatry in October of 2014 highlights the role of glutametergic transmission in anhedonia and points to the potentially unique efficacy of ketamine in treating this stubborn problem. Anhedonia, the lack (an-) of pleasure (-hedonia), is one of the 2 main symptoms of a major …
Bipolar Education Program
Doctors often do a poor job of educating their patients about their health problems. That is particularly troubling when you are talking about a condition as complicated as bipolar. We have been working on an educational program for this site based on the Barcelona psycho-education program for bipolar, to be called Bipolar 101. The Barcelona program has clearly been shown, …
Bipolar Depression Neurobiology – 2014 ISBD Update
Bipolar depression neurobiology is an area that urgently needs more research. The treatment of a depression that follows an energized (hypomanic or manic) state remains one of the most difficult areas in psychiatry. Mark Frye, Chair of the Department of Psychiatry at the Mayo Clinic, gave a presentation on this topic at the 2014 International Society of Biological Society conference that was …
Bipolar or Unipolar Depression?
Bipolar or unipolar depression: How to distinguish between these two conditions, which can have very different treatment response remains a difficult question without really satisfying answers. As noted in the picture to the right, misdiagnosis is common and can have serious consequences. An article in European Psychiatry adds to the literature pointing to certain features that increase the odds that someone …
Predicting Bipolar Disorder
Predicting bipolar disorder might allow early intervention that could change the course of the condition, or prevent at risk adults or adolescents from developing severe mood swings. But is predicting bipolar disorder a reasonable goal? What is the science behind this effort? The August 2014 issue of Bipolar Disorders (the official journal of the International Society for Bipolar Disorders) has …
Lithium Benefits for Health – NYT Article
Does lithium have benefits for health when it is found at small doses in the water? This is the subject of a recent article in the New York Time (september 13th, 2014). The article captured the attention of many readers of this blog and the companion one I write about mood disorders (moodsurfing.com). It was tantalizingly entitled,”Should We All Take a Bit …
Early Lithium Treatment for Bipolar – Better Outcomes?
Does early lithium treatment for bipolar lead to better outcomes? This is the question that researchers sought to answer by looking at a Danish database of health information. The Danish registry is a set of nearly complete health information on the population of Denmark (hence, studies using this database are more representative of the general population than studies from many …
Genetic Testing Guides Treatment for Bipolar or Depression
We have been using a relatively new assay from a company called Genomind (the Genecept test) in some of our patients with bipolar and/or depression. The test involves a saliva sample which is analyzed for ten gene variants that may be useful in guiding treatment. So far we find that in about half of the patients with treatment resistant depression …
Treatment of Fatigue in Patients with Depression or Bipolar
Treatment of depression in patients with depression or bipolar is often complicated. If medications are prescribed, will they make mood symptoms worse, or have other significant adverse effects? And yet fatigue is common in people with a history of depression (it occurs in up to 10% of the general population and is much more common in women, who have a …