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?

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 responsible, but other NMDA antagonists have not worked well in depression.

Dr. Massoumi is one of the most nationally prominent psychiatrists teaching about complementary and alternative medicine (CAM) treatments. In this Expert Q&A she discussses cranial electrotherapy stimulation (CES), with a focus on Alpha-Stim.

Is depression a disorder of inflammation? This intriguing hypothesis has been floating around in the literature over the past few years. Thus far, the findings are suggestive but not definitive. For instance, one marker of inflammation, C-reactive protein, was found to be higher in people with psychological distress and depression.

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. Shortly thereafter, the Department of Veterans Affairs (VA) alerted its providers to this warning. VA researchers recently published a study detailing the results of this warning on patients.

In July 2013, the FDA approved the SNRI Fetzima (levomilnacipran) for major depressive disorder (MDD) in adults (Forest Laboratories, Inc). The efficacy of Fetzima at doses 40 mg to 120 mg once daily was established in three, eight-week, randomized, double-blind, placebo-controlled studies in adults diagnosed MDD.

Dr. Bostic, what are your clinical and research responsibilities?