Ketamine for Depression: How does it work? We ran across a useful review of the basic science literature in an interview of David Nichols on the Psych Congress Network. http://www.psychcongress.com/video/ketamine-quick-guide-receptors-19116 Although ketamine blocks the NMDA subtype of glutamate receptors (blocks an excitatory neurotransmitter) the net effect seems to be an increase in excitatory neurotransmission. This image from Nature may help …
TMS Outcomes – Long Term Study
TMS outcomes have seemed favorable for patients with treatment resistant major depression, but what are the long term effects of TMS (transcranial magnetic stimulation)? TMS is a non-invasive technique for stimulating brain activity in parts of the brain that seem to be turned off in depression – the dorsolateral prefrontal cortex. TMS uses magnets to stimulate the brain and the …
Blood Test for Depression
How many times has a new patient in the clinic asked, “isn’t there a blood test for depression?” Always in the past we had to say that there were no reliable tests that could identify depression. There was some evidence that functional brain imaging could do so but the technique was expensive and experimental. In an article published in the …
TMS Improves Memory
TMS improves memory. According to a study published in the Aug. 29 issue of the journal Science, “electrically stimulating a portion of the brain that coordinates the way the mind works can enhance memory and improve learning.” The researchers used Transcranial Magnetic Stimulation (TMS) to indirectly stimulate activity in the hippocampus, a key part of the brain involved in the storage …
Treatment of Fatigue in Patients with Depression or Bipolar
Treatment of depression in patients with depression or bipolar is often complicated. If medications are prescribed, will they make mood symptoms worse, or have other significant adverse effects? And yet fatigue is common in people with a history of depression (it occurs in up to 10% of the general population and is much more common in women, who have a …
Low Frequency Magnetic Stimulation is Rapid Antidepressant
There is a lot of interest in an article that just appeared in Biological Psychiatry about a new magnetic stimulation technique that may be associated with rapid antidepressant effects in both unipolar and bipolar depression. Researchers at McLean Hospital were studying Low Frequency Magnetic Stimulation as a way of imaging the brains of bipolar patients and discovered that many of …
Depression Costs US 200 Billion Dollars Per Year
A meta-analysis of more than 60 clinical studies covering almost 60,000 adult patients estimates that the total cost in the United States of the treatment of patients with depression is in the range of $188 billion to $200 billion. Roughly a third of all costs ($64 billion) are related to people with treatment-resistant depression, who represent only a fraction of all cases. The article, “A Review of the Clinical, Economic, …
Biomarker for Suicidality
A just published study by Jerry Guintivano, et al, in the July issue of the American Journal of Psychiatry reports having identified a gene that seemed to predict suicide. The study used one population to identify the risk association and then confirmed it prospectively in a second population. Zachary Kaminsky, Ph.D., an assistant professor of psychiatry and behavioral sciences at …
TMS Not Effective for Depressed Patients with Anhedonia
TMS is a revolutionary treatment for major depression that is being significantly underutilized, but it is also a very expensive treatment that does not work for many patients with treatment resistant depression. One of the major issues impeding the use of TMS is the difficulty identifying patients who are likely to respond to treatment. In an earlier blog post we …
Simple Test May Predict Which Antidepressant Will Work
A simple laboratory test may predict which antidepressant will work best. This is the result of a study reported in the American Journal of Psychiatry by a team of Canadian and European researchers. The study was part of larger research program (Genome-Based Therapeutic Drugs for Depression – an effort to find biomarkers to guide medication selection) and it identified C-reactive …