Depression Carlat Reports | Carlat Publishing

Research Update

Oral Contraceptive Users and Depressive Symptoms

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

Topics: adolescents | Depression | Oral Contraceptives | teens

Review of: de Wit AE et al, JAMA Psychiatry 2019;77(1):52–59 Since the dawn of their widespread use in the 1960s, we’ve worried about the impact of oral contraceptives (OCP) on mood. But the research to date has been inconsistent, with studies reporting negative, positive, or no effects on mood. Heterogeneity in study population and design may un

Expert Q&A

Communicating With Patients About Gender

From The Carlat Child Psychiatry Report, Identity & Culture in Children and Adolescents

CCPR: Welcome, Dr. Keuroghlian. Please tell us what you do. Dr. Keuroghlian: At The Fenway Institute, I see transgender and gender-diverse (TGD)* patients in the behavioral health department. We also conduct education, training, technical assistance, and implementation with health systems and programs nationwide. I also direct the Gender Identity Progr

Research Update

Heart Rate Changes Linked to Emotional Dysregulation

From The Carlat Child Psychiatry Report, Autism in Children and Adolescents

Review of: Deutz MH et al, J Am Acad Adolesc Psychiatry 2019;58(6):589–599 Can we use heart rate to assess and track psychopathology? Child psychiatrists associate lower resting heart rate (HR-rest) and heart rate reactivity (HR-reactivity) with externalizing behaviors such as disruptive behaviors and aggression (“under-arousal”) and elevations

Article

Transcranial Magnetic Stimulation (TMS) for Depression in Children and Adolescents

From The Carlat Child Psychiatry Report, Depression in Children and Adolescents

Editor’s note: This article is about the “usual” TMS that we have been hearing about for many years. We are covering trigeminal nerve stimulation (eTNS) separately in this issue in a News of Note as it is far newer with far less clarity about its utility. The search for safer treatment With concerns about both safety and efficacy surrounding a

Expert Q&A

Medications for Depression

From The Carlat Child Psychiatry Report, Depression in Children and Adolescents

CCPR: You recently published an article reviewing the placebo-controlled trials done over the past 10 years on depression in kids (Ignaszewski MJ and Waslick B, J Child Adolesc Psychopharmacol 2018;Epub ahead of print). Can you tell us about your findings? Dr. Ignaszewski: Historically, there’s been a lot of controversy about the effectiveness of a

Expert Q&A

Dr. Jeff Bostic on Treating Pediatric Depression

From The Carlat Psychiatry Report, Antidepressants in Children

Topics: Child Psychiatry | Depression

TCR: Dr. Bostic, what are your clinical and research responsibilities? Dr. Bostic: I work in five different school districts, doing school consultations, helping the mental health and teaching staff deal more effectively with kids. I'm involved with the STAART grant funded by NIMH which is a study of children with autism at 8 sites throughout the count

Expert Q&A

Outpatient Management of Opioid Addiction

From The Carlat Child Psychiatry Report, Substance Use in Children and Adolescents

CCPR: Tell us about your position and what you do. Dr. Gomez-Luna: I directed a short-term adolescent residential program, where I saw a need for identifying and treating kids’ co-occurring conditions. I did another fellowship in addiction psychiatry, then joined studies at Yale on tobacco use and electronic nicotine devices in adolescents. Now I’m

Expert Q&A

Assessing and Treating Cannabis Use Disorder

From The Carlat Child Psychiatry Report, Substance Use in Children and Adolescents

CCPR: Tell us a little bit about your background. Dr. Gobbi: I trained in medicine, psychiatry, and psychotherapy in Rome, Italy, then received a PhD in neuroscience, working in preclinical psychopharmacology. I now work in our mood disorder clinic and ER, and I direct our basic psychopharmacology lab (neurobiological psychiatry unit), including resear

Expert Q&A 2

Opioid Use Disorders and Serious Mental Illness

From The Carlat Addiction Treatment Report, Alternative Treatment in Addiction

CATR: Please tell us about your clinical focus. Dr. Gomez-Luna: My principal role is within an organization called Behavioral Health Care, a behavioral health organization in Connecticut that serves a wide array of populations, from children and adolescents all the way to late adulthood (www.bhcare.org). We provide clinical services to communities for

Expert Q&A

An Antidepressant Diet

From The Carlat Psychiatry Report, Depression

Topics: Antidepressants | Depression | Nutrition | Registered Articles

TCPR: A few years ago, your group conducted the first clinical trial of diet on depression. Where did you get the idea for that? Dr. Jacka: We had a decade of observational evidence linking the quality of people’s diets to their risk for depression. Those findings were pretty consistent across countries, cultures, and age groups: A healthy diet is

Expert Q&A

Getting Uncomfortable with Esketamine

From The Carlat Psychiatry Report, Esketamine

Esketamine (Spravato) was approved for treatment-resistant depression in 2019. In this interview, Dr. Williams (who has no relationship with Janssen Pharmaceuticals, Inc) addresses some lingering doubts that have been raised about the medicine. TCPR: Where does esketamine fit in the list of interventional therapies for depression, like repetitive tra

Article

Antipsychotic Maintenance: How Long is Enough?

From The Carlat Psychiatry Report, Esketamine

Your 58-year-old patient started risperidone to augment lithium 2 years ago. It got her out of a severe mania, and she has stayed well since then. Now she’s worried about long-term risks and wondering if it’s time to come off. Augmentation with an atypical antipsychotic may offer rapid relief from mania and depression, but antipsychotics’ potenti

Research Update

TMS: Deeper is not Better

From The Carlat Psychiatry Report, Esketamine

REVIEW OF: Filipcic I et al, J Psychiatr Res 2019;114:113–119 TYPE OF STUDY: Randomized single-blind controlled trial Seven transcranial magnetic stimulation (TMS) devices are FDA approved for depression, but only one—the Brainsway—is distinctly different from the others. Brainsway uses a patented H1 coil that penetrates deeper into the cortex t

Clinical Update

Trazodone: The Forgotten Antidepressant

From The Carlat Psychiatry Report, Telepsychiatry

If your practice is anything like mine, trazodone is your go-to hypnotic. As an antidepressant, it’s an afterthought, dismissed as ineffective or intolerable since its release in 1981. Four decades and over 200 clinical trials later, it’s a good time to see if we’ve missed any opportunities in this forgotten antidepressant. How trazodone worksTra

Expert Q&A

Thyroid Augmentation in Bipolar Disorder

From The Carlat Psychiatry Report, Thyroid and Mental Illness

TCPR: When do you use thyroid augmentation in bipolar disorder?Dr. Kelly: It may be useful for treatment-resistant bipolar depression, and I emphasize treatment-resistant because that is where the empiric support lies. Now, the evidence is not rock-solid, but when it comes to treatment-resistant bipolar depression we don’t have much else to draw on ex

Clinical Update

Antidepressants: When Dosage Matters

From The Carlat Psychiatry Report, Thyroid and Mental Illness

Topics: Antidepressants | Depression | SSRIs

When it comes to dosing antidepressants, it’s often assumed that more is better. While this is true for a few meds, most second-generation antidepressants don’t clearly work better at higher doses. In this article, I’ll review the evidence on antidepressant dose-response relationships and the optimal dose ranges for some antidepressants. First-ge

Expert Q&A

Mental Illness and Flourishing

From The Carlat Psychiatry Report, Living With Mental Illness

Topics: Depression | Mood | Personality Disorders | Psychotherapy

TCPR: You and other psychiatrists at Johns Hopkins have a way of viewing mental illness that differs from the biopsychosocial model. Tell us about that. Dr. Chisolm: We use a model called “perspectives of psychiatry” that was developed by Paul McHugh and Phillip Slavney in the 1970s. It’s really a framework that considers the origin of patients�

Research Update

Oral Zuranolone for Postpartum Depression

From The Carlat Psychiatry Report, Living With Mental Illness

Topics: Depression | Postpartum Depression | Randomized controlled trial | steroids | Women’s Issues in Psychiatry

REVIEW OF: Deligiannidis KM et al, JAMA Psychiatry 2021;78(9):951–959 STUDY TYPE: Randomized controlled trial DSM-5 defines postpartum depression (PPD) as any major depressive episode that begins during pregnancy or within four weeks after giving birth. Traditional antidepressants have long been used during this period, but only small studies suppor

Clinical Update

Light Therapy: Good for What Ails You?

From The Carlat Psychiatry Report, Mood Disorders

Topics: | | | | | | | | | | | | | | | | | ADHD Alternative treatments Antidepressant Augmentation Bipolar Depression Bulimia Nervosa Complementary treatments Complimentary Medicine Depression Depressive Disorder Light and Dark Therapy Light therapy Lightbox PTSD Seasonal Affective Disorder Sexual Dysfunction Sleep Sleep Disorders Traumatic Brain Injury (TBI)

There are several lifestyle changes with broad health benefits that we often encourage in our patients. Exercise, a healthy diet, sleep hygiene, and supportive social connections are near the top of the list, and bright daytime light might be worth adding. Light therapy is a standard treatment for seasonal affective disorder, and in this article we’ll

Research Update

Psilocybin vs Escitalopram for Depression

From The Carlat Psychiatry Report, Overdiagnosis

REVIEW OF: Carhart-Harris R et al, New Engl J Med 2021;384(15):1402–1411 STUDY TYPE: Randomized controlled trial Psilocybin is, among other things, a serotonin 2A agonist responsible for the psychedelic properties of magic mushrooms. Back in 1960, Sandoz (now Novartis) began marketing psilocybin to enhance the effects of psychotherapy, but produ