Depression - Articles - Page 15

Optimal Antidepressant Doses in Major Depression

March 9, 2020

Kristen Gardner, PharmD. Dr. Gardner has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

More is not necessarily better in psychopharmacology. Some medications have plateau effect, while others follow a “U-shaped curve,” causing more problems as the dose goes too high. This metaanalysis looked at 77 dose-response trials with antidepressants to quantify their optimal therapeutic window.

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.

How to Use Pramipexole

February 10, 2020

Pramipexole is a selective agonist at the dopamine D3 receptor, which is thought to regulate hedonic drive. It is FDA approved in Parkinson’s disease and restless legs syndrome, and has five randomized controlled trials in depression.

Highlights From This Issue

February 10, 2020

Quick hints on what you’ll find in this issue.

An Answer for Psychotic Depression

February 10, 2020

Randall Moore, MD.

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

Research tells us how to start meds, but rarely when to stop them. This study brings some needed answers on discontinuing antipsychotics after recovery from psychotic depression.

Inflammation and Depression: An Interview with Andrew Miller, MD

February 10, 2020

30-50% of patients with depression have signs of inflammation, and some of those markers may help predict which medication they'll respond to. Andrew Miller, MD, of Emory University is one of the leading researchers in this field, and in this interview he tells us when to suspect inflammation and how...

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.

Antipsychotic Maintenance: How Long is Enough?

January 13, 2020

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of The Carlat Psychiatry Report. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Atypical antipsychotics can work quickly in mood disorders, but their long-term risks give us pause. When is it safe to discontinue them? The answer, it turns out, depends on whether we look to industry-supported or industry-independent trials.

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.

Heart Rate Changes Linked to Emotional Dysregulation

November 21, 2019

Jess Levy, MD

Jess Levy, MD Dr. Levy has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Clinical psychiatry is becoming more attuned to the utility of tracking physiological markers of
regulation and dysregulation. The study clarifies where we are in understanding heart rate as a
clue in diagnosis and management.