Treatment-resistant-depression - Articles - Page 2

Genetic Testing: What You Need to Know in 2021

June 29, 2021

John Nurnberger, MD, PhD

Vice Chair for Preclinical Research, Department of Psychiatry, Indiana University, Indianapolis, IN. Dr. Nurnberger has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Is genetic testing ready for clinical practice? It depends on which test we’re talking about. In this interview John Nurnberger details the tests to pay attention to on a genetic panel and describes how to use whole exome sequencing (WES) to identify genetic causes of autism and intellectual disability.

Pros and Cons of Using TMS for Kids

August 13, 2020

There’s been some promising research for Transcranial Magnetic Stimulation (TMS), but can it be used for treatment-resistant depression in children and adolescents? Here’s a summary of the pros and cons presented in this 2019 article in The Carlat Child Psychiatry Report. Pros:It seems to work. An open-label trial of TMS for...

When Further Medication Trials Seem Futile

June 10, 2020

Joseph Goldberg, MD

Joseph Goldberg, MD

Dr. Goldberg is a clinical professor of psychiatry at the Mount Sinai School of Medicine and maintains a private practice focused on mood disorders. He has published three psychiatric textbooks and is completing a fourth on psychopharmacology. Dr. Goldberg has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Joe Goldberg believes we do a disservice by shuffling patients through medication trials that have little chance of working. He shares techniques to engage patients, motivate change, combat demoralization, as well as his top pharmacologic strategies for highly resistant depression.

EXPERT Q&A

Inflammatory Biomarkers in Depression

February 10, 2020

Andrew H. Miller, MD

Andrew H. Miller, MD

William P. Timmie Professor of Psychiatry and Behavioral Sciences, Emory University, GA Dr. Miller has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Andrew Miller, Vice Chair of Psychiatry Research at Emory University, translates two decades research on inflammation and depression into practical terms, including a low-cost biomarker that may guide antidepressant selection.

Getting Uncomfortable with Esketamine

January 13, 2020

Nolan Williams, MD

Nolan Williams, MD

Director of the Brain Stimulation Lab and Interventional Psychiatry Clinical Research Program; Assistant Professor of Psychiatry at Stanford University, CA. Dr. Williams has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

The FDA approval of esketamine (Spravalto) left some unanswered questions, including suicide, addiction, withdrawal, neurotoxicity, and bladder inflammation. Nolan Williams addresses those risks and looks at where esketamine fits among other options like TMS and ECT. Dr. Williams directs the Interventional Psychiatry Clinical Research Program and Brain Stimulation Lab at Stanford University.

TMS: Deeper is not Better

January 13, 2020

Edmund S. Higgins, MD.

Edmund S. Higgins, MD. Dr. Higgins has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Two devices are available for transcranial magnetic stimulation (TMS). Neurostar came first with the figure-8 coil, which is now off-patent, while Brainsway’s H-coil which claims to reach deeper into the cerebral cortex. See how they compare in the first head-to-head controlled trial, undertaken without industry support.

Anti-Inflammatories as Antidepressants?

October 3, 2019

Edmund S. Higgins, MD.

Edmund Higgins, MD Dr. Higgins has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

A host of anti-inflammatory medicines are effective in treatment-resistant depression, particularly celecoxib.

Mirtazapine Augmentation: Running Low on Rocket Fuel

August 30, 2019

Thomas Jordan, MD and Chris Aiken, MD.

Thomas Jordan, MD and Chris Aiken, MD. Dr. Jordan and Dr. Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dubbed “California Rocket Fuel” by Stephen Stahl, the combination of venlafaxine and mirtazapine seemed to hit all the right receptors. The hype may have gotten a little ahead of the evidence on this one, however, as three new studies reveal.

l-Methylfolate for Depression: Costly Mistake or Good Thinking?

August 1, 2019

Folic acid and l-methylfolate are two versions of the same vitamin. Both are popular for antidepressant augmentation, but one is a expensive prescription. We compared them side-by-side and found that one has a slight advantage.

Esketamine Gets FDA Approval

July 3, 2019

Michael Posternak, MD. Psychiatrist in private practice, Boston, MA. Dr. Posternak has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

On March 5, 2019, the FDA approved esketamine (Spravato) nasal spray as add-on therapy to traditional antidepressant medications for treatment-resistant depression (TRD). In this article, I will describe the events that led to esketamine’s development, review the data submitted to the FDA, and discuss what the future might hold for esketamine.