Antidepressants Carlat Reports

Article

A Look at the Latest Antidepressant Meta-Analysis

From The Carlat Psychiatry Report, Neurobiology

Topics: Antidepressants | Neuroscience in Psychiatry

You may have read about the meta-analysis published in Lancet earlier this year on the efficacy evidence for all antidepressants (Cipriani A et al, Lancet 2018;391(10128):1357–1366). It’s a complicated paper, and in this article, we’ll take a closer look at it and give you our take on the bottom line. The authors did a systematic review and met

Research Update

Youth, Antidepressant Medications, and Type 2 Diabetes

From The Carlat Child Psychiatry Report, Psychotropic Risks in Children and Adolescents

Topics: Antidepressants | Child Psychiatry | Psychopharmacology Tips

Review of: Burco M et al, JAMA Pediatrics 2017;171(12):1200–1207 Over the last decade, several published studies have reported an increased risk of type 2 diabetes associated with antidepressant use in adults. But does the same hold true for children and adolescents? This paper is the first population-based study to examine the risk of onset of

Article

An Antidepressant Diet

From The Carlat Psychiatry Report, Neurofeedback

Topics: Antidepressants

There’s a lot of discussion in the medical journals about nutritional psychiatry, which is the concept that certain diets can prevent or treat psychiatric disorders (Marx W et al, Proc Nutr Soc 2017;76(4):427-436). We’ve covered this topic before (see TCPR August 2010, “Alternative Treatments for Depression”), and since then there has been more

Research Update

Aripiprazole Augmentation May Improve Remission Rates in MDD

From The Carlat Psychiatry Report, Retirement

Topics: Antidepressants | Research Updates

Review of: Mohamed S et al, JAMA 2017;318(2):132–145 It seems like an endless debate: When a patient does not respond to the first trial of an antidepressant, what should we do? Switch to something else? Augment with another agent? If the latter, how often should that augmenting agent be an atypical antipsychotic? The VA Augmentation and Switching

Research Update

A Cautionary Consensus on the Use of Ketamine for Depression

From The Carlat Psychiatry Report, Intellectual Disability

Topics: Antidepressants | Depressive Disorder | Research Update

Review of: Sanacora G et al, JAMA Psychiatry 2017;74(4):399–405. doi:10.1001/jamapsychiatry.2017.0080 Ketamine has become increasingly popular as an off-label medication for rapid onset treatment of refractory depression. Recently, the American Psychiatric Association convened a task force to review the data and come up with some recommendations. T

Article

Beginning Antidepressant Treatment: A Recommended Approach

From The Carlat Psychiatry Report, Antidepressants

Topics: Antidepressants | Depressive Disorder | Psychopharmacology Tips

How do you start a new patient on antidepressant treatment? We do this countless times in our practices, and reviewing the topic may feel a bit like returning to residency. However, it’s important to revisit our standard operating procedures from time to time to ensure we’re thinking carefully about our decisions during our busy days. If we turn

Expert Q&A

When First-Line Depression Treatments Don’t Cut It: Newer Antidepressants and Sometimes, Antipsychotics

From The Carlat Psychiatry Report, Antidepressants

Topics: Antidepressants | Depressive Disorder | Psychopharmacology Tips | Registered Articles

TCPR: It’s been about 10 years since we last talked with you about the practical use of antidepressants with so many drugs to choose from. Over the last few years, three new antidepressants have come out: vilazodone (Viibryd), vortioxetine (Trintellix), and levomilnacipran (Fetzima). My sense is that an awful lot of clinicians still haven’t changed

Expert Q&A

When Depression Meds Fail, Transcranial Magnetic Stimulation Might Be Plan B

From The Carlat Psychiatry Report, Antidepressants

Topics: Antidepressants | Depressive Disorder | Psychopharmacology Tips

TCPR: How treatment-resistant does a patient have to be with antidepressants before you should consider trying TMS? Dr. Becker: When TMS initially came out in 2008, it was approved for people who had failed one medication trial. But I’ll tell you, from doing a number of insurance reviews, that health insurers are going to require on average about f

Research Update

Which Are the Most Dangerous Antidepressants?

From The Carlat Psychiatry Report, Personality Disorders

Topics: Antidepressants | Psychopharmacology | Research Updates

Review of: Nelson JC and Spyker DA, Am J Psychiatry 2017;174(5):438–450 Study type: Retrospective cohort We often prescribe antidepressants to patients who are suicidal, and unfortunately, some people use these very medications to try to kill themselves. It’s been known for some time that tricyclic antidepressants are among the most toxic in

From The Carlat Psychiatry Report,

Topics: Antidepressants

From The Carlat Psychiatry Report,

Expert Q&A

Assessing Illness and Medication Treatment in the Perinatal Period

From The Carlat Psychiatry Report, Medication in Pregnancy

Topics: Antidepressants

TCPR: Dr. Vigod, we know that it’s best to avoid medications if we can in pregnant women. But that’s more easily said than done. What’s your approach? Dr. Vigod: I start by assessing the severity of the symptoms and the impact on function. Women usually fall into two categories: those who are not on medication and have become symptomatic, and

Research Update

Atomoxetine Does Not Increase Risk of Suicide Compared to Stimulants

From The Carlat Child Psychiatry Report, Mood Dysregulation in Children and Adolescents

Topics: Antidepressants | Research Updates

From The Carlat Psychiatry Report,

From The Carlat Psychiatry Report,

If you are interested in part-time correctional work, the best place to start is often the local jail—as opposed to a prison. What’s the difference between the two? A jail is a criminal justice facility operated by a city or county. It houses people who are awaiting trial or who have received short sentences, typically one year or less. In c

Article

Psychopharmacology in Jails: An Introduction

From The Carlat Psychiatry Report, Correctional Psychiatry

If you are interested in part-time correctional work, the best place to start is often the local jail—as opposed to a prison. What’s the difference between the two? A jail is a criminal justice facility operated by a city or county. It houses people who are awaiting trial or who have received short sentences, typically one year or less. In contrast,

Expert Q&A

The Experience of Correctional Psychiatry

From The Carlat Psychiatry Report, Correctional Psychiatry

TCPR: Dr. Gariety, please tell us a bit about your background. Dr. Gariety: I’ve been in practice for 23 years, starting out in community mental health, followed by 13 years in the federal bureau of prisons. Currently I work for a large regional medical group in the private sector. TCPR: Tell me a bit more about the correctional setting. D

Article

Four Newer Antidepressants: Should You Use Them?

From The Carlat Psychiatry Report, Antidepressant Roundup

Topics: Antidepressants | Depressive Disorder | Practice Tools and Tips | Psychopharmacology Tips | Seasonal Affective Disorder

Since 2011, 3 new antidepressants have been approved by the FDA, and another (ketamine) has been generating buzz as a potential off-label medication for depression. In this article, we’ll take a step back and review the data on vilazodone (Viibryd), levomilnacipran (Fetzima), vortioxetine (Brintellix), and ketamine. Vilazodone (Viibryd) Vilazodone

Expert Q&A

Thinking Creatively About Treatment-Resistant Depression

From The Carlat Psychiatry Report, Antidepressant Roundup

Topics: Antidepressants | Depressive Disorder | Practice Tools and Tips | Psychopharmacology Tips | Seasonal Affective Disorder

TCPR: The term “treatment-resistant depression” is sort of thrown around a bit. I’m sure that there are various formal or informal definitions of it, but how do you think about it? Dr. Bodkin: The formal definition basically requires 2 failures of distinctly different antidepressants at robust doses for adequate duration. But personally, I thin