Risk Evaluation and Mitigation Strategy (REMS) Programs

Topics: Depression | Depressive Disorder | Esketamine | Pharmacology | Treatment-Resistant Depression

Certain psychiatric treatments require both the healthcare provider and patient to enroll in a Risk Evaluation and Mitigation Strategy (REMS) program before they are administered. Below are links to enroll: Brexanolone (Zulresso) http://www.zulressorems.com/ Buprenorphine-based therapies (Suboxone, Subutex) https://www.samhsa.gov/medication-assi

Brexanolone (Zulresso) for Postpartum Depression

Topics: Depression | Depressive Disorder | Pharmacology | Postpartum Depression | Pregnancy

On March 19, 2019, the FDA approved brexanolone (Zulresso), the first medication for postpartum depression (PPD). Delivered by intravenous injection, brexanolone is an analogue of the hormone allopregnanolone. Allopregnanolone levels fall abruptly after childbirth, which is thought to contribute to PPD by destabilizing GABAA receptors. We covered brexa

Lithium in Geriatric Depression

Topics: Depression | Depressive Disorder | Geriatric Psychiatry | Lithium | Psychopharmacology | Treatment-Resistant Depression

REVIEW OF: Buspavanich P et al, J ­Affect Disord 2019;251:136–140 TYPE OF STUDY: Prospective, non-randomized controlled trial Augmentation with lithium has long been established as an effective strategy for refractory depression, but how does it fare in geriatric patients? There is a dearth of evidence on lithium in the geriatric population, which

An Opioid Combo Falls Short in Depression

Topics: Depression | News of Note

Opioids have a bad name these days. But let’s not forget that they were once consid­ered a first-line treatment for depression before the discovery of MAOIs and tricy­clics in the 1950s. That history has been revived recently by buprenorphine, a par­tial opioid agonist that was fast-tracked by the FDA for treatment-resistant depression. Buprenorphi

Wellbutrin Augmentation: When Does It Work?

Topics: Depression | Treatment-Resistant Depression | Wellbutrin

Each month, Editor-in-Chief Chris Aiken, MD, gives advice on a different practice challenge. Dear Dr. Aiken: In the July/August 2018 issue, you wrote that ­bupropion (Wellbutrin) augmentation does not work in ­treatment-resistant depression (TRD). So why do we see it work so often in practice? Dr. Aiken: When all of the studies are averaged tog

Is Ketamine Just Another Opiate?

Topics: Antidepressants | Depression | Ketamine | Opioids | Research Update

Review of: Williams NR et al, Am J Psychiatry 2018;175:1–11 Type of study: Double-blind, placebo-controlled, crossover study Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsib

Bullying and Suicidality: Some Practical Tips

Topics: Bullying | Depression | Free Articles | Suicidality

What can you do when one of your patients reports being bullied? Research has shown that being bullied increases the risk of depression, anxiety, and suicidality in children. In this article, we’ll give you some tips for how to ask about bullying, how to assess its impact, and how to help your patients and their families deal with the problem. How

Benefits of Alpha-Stim

Topics: Depression

TCPR: Dr. Massoumi, you are one of the most nationally prominent psychiatrists teaching about complementary and alternative medicine (CAM) treatments. We’re happy that you could help us with this special issue of TCPR. When did you get interested in this topic and why? Dr. Massoumi: I come from a long line of doctors in my family, and I always felt

Statins and SSRIs Together Lead to Better Outcomes in Depression

Topics: Depression | Research Update

Review of: Köhler O, Gasse C, Petersen L, et al. The effect of concomitant treatment with SSRIs and statins: a population-based study. American Journal of Psychiatry 2016;173(8):807–815. Study Type: Naturalistic cohort study Is depression a disorder of inflammation? This intriguing hypothesis has been floating around in the literature over the

Citalopram Safety Warning Has Serious Consequences for VA Patients

Topics: Depression | Research Update

Subject: (Rector T et al, Am J Psychiatry, 2016; ahead of publication) Short Description: In the summer of 2011, the Food and Drug Administration (FDA) reported that post-marketing surveillance showed that patients taking greater than 40 mg/day of citalopram were at greater risk of QT prolongation. The agency advised doctors not to prescribe doses