Geriatric depression often presents with apathy, low energy and motivation, and cognitive decline, so theoretically stimulants are a natural choice. Past studies of combining stimulants with antidepressants have been mainly small open trials, with mostly positive results. But we haven’t seen the kind of rigorous double-blind methodology we’d like. A new study fills that gap.

On July 10, the U.S. Food and Drug Administration (FDA) approved Otsuka and Lundbeck’s Rexulti (brexpiprazole) for schizophrenia and as an add-on to antidepressants for adults with depression. As the name suggests, it’s chemically and structurally related to aripiprazole (Abilify).

After reading these articles, you should be able to…

When we last reviewed neurostimulation devices 3 years ago, we concluded that there was some promise—but more sizzle than beef. Now there are more devices and more data. But is there more beef? Maybe.

Carly Simon swears by it. The daytime show “The Doctors” gave it a glowing review. Ads for it seem to be invading psychiatrists’ Google search results. We’re talking, of course, about the Fisher Wallace Stimulator and the similarly touted Alpha-Stim device. How do these devices work? Are they actually effective? And where do they fit into the rapidly expanding array of neuromodulators?

So let’s say you’ve decided to take the TMS plunge. With three devices currently FDA cleared, you have some decisions to make. The following table brings together some information you might find useful focusing on the Neronetics and Brainsway devices.

Mark George, MD started working on transcranial magnetic stimulation in 1993. In this interview he discusses the history of TMS and the state of trials and treatment options for patients 20 years later.

Dr. Williams discusses the field of interventional psychiatry from a practical standpoint by outlining the philosophy, practice, and case studies where interventional strategies have been effective.

Review of this study regarding the effects of a Mediterranean diet on age-related cognitive decline: Valis-Pedret C et al, JAMA Intern Med 2015. 11.doi:10.1001/jamainternmed.2015.1668. Epub ahead of print.