A study suggests that aripiprazole augmentation may be an effective strategy for treating major depression in older adults. The article has generated a lot of interest because of evidence suggesting that late life major depression may be different from major depression in early adulthood. Cognitive impairment, including memory troubles and trouble with planning and decision making (executive function), seems to …
Cognitive Behavioral Analysis System of Psychotherapy
I have just posted another page on the site devoted to orienting patients to types of psychotherapy that we may recommend for them. This most recent page talks about Cognitive Behavioral Analysis System of Psychotherapy, an approach to the treatment of patients with chronic depression that many people have benefitted from during the course of their treatment at Gateway Psychiatric. …
Ketamine for Depression Update
Probably the most exciting development in psychopharmacology in years is the discovery of the dramatic effects of ketamine on depression. However, a recent report from the American Psychiatric Association (APA) Task Force on Novel Biomarkers and Treatments highlights not only the reason for the excitement about ketamine but also the significant areas of uncertainty that make it not yet ready to …
Bipolar Depression Treatment
Dr. Peter Forster and Dr. Kelsey Schraufnagel gave a very well attended presentation for an international audience of participants hosted by the International Bipolar Foundation on June 24th. Listeners from India, Taiwan, France, Ireland and all over the United States received an update on the state of the art in the treatment of bipolar depression. Doctor Forster updated the audience about medication …
ABCB1 Gene Predicts Antidepressant Response
An article that will soon appear in the American Journal of Psychiatry suggests that it may be possible to predict who will respond to different antidepressants using a genetic test. The study looked at whether by testing for specific genetic variants of a protein involved in transporting drugs and other potentially toxic substances into and out of cells and across the blood …
Stimulants and Geriatric Depression
Stimulants and Geriatric Depression May be Underused. A well designed study showed that adding methylphenidate (Ritalin and others) to citalopram (Celexa) improve the likelihood of complete remission from depression in older patients. In general older depressed patients are more likely to have some cognitive impairment and are less likely to respond to antidepressants. A number of reports suggests that adding stimulants to antidepressants can …
Methylfolate and Depression
Depression and Methylfolate The role of methylfolate in the treatment of patients with depression has once again been highlighted by an article published in the American Journal of Psychiatry in 2016. After successfully treating treatment resistant depression in a patient deficient in cerebrospinal fluid (CSF) tetrahydrobiopterin (necessary for biosynthesis of several neurotransmitters) with sapropterin (a synthetic form of tetrahydrobiopterin’s active isomer), …
NMDA Receptor and Depression
A new drug that stimulates the glycine site of NMDA receptors had rapid antidepressant effects in the just released results of a phase II clinical trial. The drug substantially reduced depression symptoms, with no severe side effects. The NMDA receptor has 2 sites that are involved in its activation. One site is stimulated by glutamate or aspartate. Another site is stimulated by glycine. For …
Bipolar Depression
The recent presentation that I gave at UCSF on this topic allowed me to review all of the controlled clinical trials related to the treatment of bipolar depression. In a follow-up post I plan on talking about some of the exciting new developments that suggest that we will soon, and to some extent do already, have some very promising approaches …
Bipolar Depression Update
On Thursday at noon Dr. Peter Forster, our clinical director, will be giving a presentation to the UCSF Department of Psychiatry Mood Disorder Grand Rounds on the topic of “Bipolar Depression: An Update.” He will be reviewing the recent literature on new treatment options and will summarize some of the talk findings in a future blog post.