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

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

NeuroStar’s Latest TMS System: 19 Minutes Is the New 40

Topics: Depressive Disorder

NeuroStar just announced that the FDA has cleared an updated version of its TMS system. Called the NeuroStar Advanced Therapy System, its primary claim to fame is that patients can receive a full TMS treatment in only 19 minutes, as opposed to the 40 minutes required with NeuroStar’s original system. How was NeuroStar able to slim down the treatmen

High-Dose Citalopram and Escitalopram: Undeserved Bad Rap?

Topics: Depressive Disorder | Psychopharmacology Tips | Research Updates

Review of: Ray WA et al, High-dose citalopram and escitalopram and the risk of out-of-hospital death. J Clin Psychiatry 2016. doi:10.4088/JCP.15m10324 Study type: Retrospective cohort study Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatment for depression; however, our confidence in their safety took a hit when

Switching Antidepressants May Be No Better Than Staying the Course

Topics: Depressive Disorder | Practice Tools and Tips | Research Update

Review of: Bschor T, Kern H, Henssler J, Baethge C. Switching the antidepressant after nonresponse in adults with major depression: A systemic literature search and meta-analysis. J Clin Psychiatry 2016. doi:10.4088/JCP.16r10749. [Epub ahead of print] Study type: Meta-analysis Clinical trials have shown that the response rate of major depression t

Statins and SSRIs Together Lead to Better Outcomes in Depression

Topics: Depressive Disorder | Research Updates

Benefits of Alpha-Stim

Topics: Brain Devices | Depressive Disorder | Natural Medications | Practice Tools and Tips

Whole-Body Hyperthermia for Depression: Effective or Too Early to Tell?

Topics: Depressive Disorder | Research Updates

Whole-Body Hyperthermia for Depression: Effective or Too Early to Tell?

Topics: Depressive Disorder | Research Update

Review of: Janssen CW, Lowry CA, Mehl MR, et al. Whole-body hyperthermia for the treatment of major depressive disorder: a randomized clinical trial. JAMA Psychiatry 2016;73(8):789-795:ahead of print. Study type: Randomized double-blind sham-controlled trial Saunas and hot tubs are pleasant and “therapeutic” for most of us, so it may be no sur

Treating Complicated Grief: Grief-Focused Psychotherapy Is More Effective Than Citalopram

Topics: Depressive Disorder | DSM | Psychopharmacology Tips | Research Updates

Treating Complicated Grief: Grief-Focused Psychotherapy Is More Effective Than Citalopram

Topics: Depressive Disorder | DSM | Psychopharmacology Tips | Research Update

Review of: Shear M et al, JAMA Psychiatry, 2016;73:685–694; Study type: Randomized placebo-controlled trial Complicated grief (CG) is a relatively common response in those who have suffered the loss of a loved one. In DSM-5, it is listed in the section on conditions for further study, and it is called “persistent complex bereavement disorder.”

Buprenorphine for Suicidality? Maybe

Topics: Addiction | Depressive Disorder

Buprenorphine for Suicidality? Maybe

Topics: Addiction | Depressive Disorder | Research Update

Subject: (Yovell Y et al, Am J Psychiatry 2016;173:491–498) Short Description: When patients become severely suicidal, we have few good treatment options. These include close monitoring (often in a locked unit), intensive psychotherapy, antidepressants (which, while effective, take weeks to work), a variety of medications to treat symptoms such a

Psychedelic Mushrooms May Help Treatment Resistant Depression

Topics: Depressive Disorder | Research Updates

Does Light Therapy Work for Non-Seasonal Depression?

Topics: Depressive Disorder | Seasonal Affective Disorder

Four Newer Antidepressants: Should You Use Them?

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

Getting Bullied as a Kid: Not Good for Your Mental Health

Topics: Child Psychiatry | Cognitive Behavioral Therapy | Depressive Disorder | PTSD

Thinking Creatively About Treatment-Resistant Depression

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

Does Light Therapy Work for Non-Seasonal Depression?

Topics: Depressive Disorder | Research Update | Seasonal Affective Disorder

(Lam R et al, JAMA Psychiatry 2016;73(1):56-63) Many studies have shown that light therapy works for seasonal affective disorder, but does it work for non-seasonal major depression? That’s less clear. Systematic reviews have yielded inconclusive results, in part because prior studies have had methodological weaknesses. A new study with a robust des

Diagnosing Depression in Children and Adolescents

Topics: Child Psychiatry | Depressive Disorder | Free Articles

Today, the idea that adolescents and children, even young children, can have a major depressive disorder is widely accepted, but that was not always the case. Debates about the age at which “true” depression could manifest itself were widespread in child and adolescent psychiatry through the late 70s and into the early 80s (Pataki CS and Carlson GA,

Antidepressants and Suicidal Ideation in Young People: A Practical Approach

Topics: Antidepressants | Child Psychiatry | Depressive Disorder

Many of you will remember that in October of 2004, the FDA announced to drug companies that they should add black-box warnings about the risk of suicidal behavior in children and adolescents started on antidepressants. This was based on an analysis of placebo-controlled, randomized trials (a total of 24 trials involving over 4,400 patients) showing that