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The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits. Read More

Welcoming Our New Editor-in-Chief

We’re pleased to introduce Chris Aiken, MD, as the new editor-in-chief of The Carlat Psychiatry Report. Dr. Aiken is a clinician, researcher, and writer. He is the director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments. Read More

Seven Lifestyle Interventions for Treatment-Resistant Depression

Treatment-resistant depression (TRD) is not untreatable. The challenge is to keep hope alive and the patient engaged in recovery. “You deserve, and can expect, a full recovery,” I’ll often tell patients, “but we’re going to need more than medications to get you there.” I’ll then offer a choice: to either start weekly psychotherapy or make a lifestyle change—or both. Read More

Here’s a common scenario. You have a patient who has tried three or four antidepressants over the years; all have been somewhat effective at least initially, but eventually that effectiveness waned. Read More

A CBT App for Refractory Depression

This study tested a self-guided mobile app in patients with moderate to severe depression who had not responded to at least 1 antidepressant trial. The Japanese app, called Kokoro, used cartoon characters to present concepts from CBT, including self-monitoring, behavioral activation, and cognitive restructuring. Read More

Treatment-Resistant Depression: Some Introductory Tips

Treatment-resistant depression (TRD) has a fairly low barrier of entry. Failure of 2 full antidepressant trials—lasting 6 weeks at a minimally effective dose—is enough to qualify. In this month’s issue of TCPR, we’ll highlight pharmacologic advances that are underutilized and debunk a few that are unlikely to be effective for TRD. Read More

We often come across patients who seem stuck in a repetitive, negative style of thinking that we call rumination. Rumination is often associated with depression or anxiety, and when severe, it can seem akin to psychosis. Read More