Recent Posts

DSM-5 and eating disorders:What’s new

The DSM-5 remains the best approach to categorizes mental disorders, even though it has serious limitations, like no real psychobiological underpinning for any its conditions and arbitrary lines between normal and abnormal.   The research is hampered by incoherence, as the definition ( i.e. the inclusion criteria) of who is considered a subject is quite inconsistent […]
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Neuroprogression of Psychiatric disease

The idea of staging and progression of mental diseases borrows from cancer models describing the natural course of illness.  The psychiatric stages differ with a stage 0 which denotes asymptomatic, genetic vulnerability, and moves through typically 4 stages to full disease.  I have written about bipolar stages in other posts.  In this one, I offer […]
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Perimenopausal Depression Guidelines Released | Psychiatric News

https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2018.10a15?utm_campaign=email&utm_source=etoc&utm_medium=textlink&utm_content=news& Interestingly, the two pearls I learned were: 1. Best evidence among antidepressants for Pristiq, desvenlafaxine. 2. It is acceptable to use HRT for menopausal symptoms 3. CBT for depression is very important

SSRIs–Game Changer study

Well, here is the study of the year for me.  link This study is a game changer.  A recent study is turning upside down the theory of how SSRIs treat depression, with startling implications.  It turns out that serotonin (which is increased by SSRIs, of course) interacts with the Serotonin Receptor across the lifespan to modulate […]
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Association of Stress-Related Disorders With Subsequent Autoimmune Disease. – PubMed – NCBI

https://www.ncbi.nlm.nih.gov/pubmed/29922828?dopt=Abstract Bottom Line: if you are severely traumatized, particularly in your youth under 33, the chances that you develop an autoimmune disorder are 36% higher than not. This was determined by a large Scandanavian 10-year study. Interesting, taking an SSRI for a year after the onset of PTSD significantly LOWERED the risk of an autoimmune […]
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FAST and RAPID: Acronyms to prevent brain damage in stroke and psychosis | MDedge Psychiatry

https://www.mdedge.com/psychiatry/article/171147/schizophrenia-other-psychotic-disorders/fast-and-rapid-acronyms-prevent/page/0/1# The most passionate exhortation by an expert to use injectable antipsychotics after the first psychotic episode in the youth. Powerful and convincing J

Thyroid May Hold the Cognitive Key | Psychiatric Times

http://www.psychiatrictimes.com/geriatric-psychiatry/thyroid-may-hold-cognitive-key?rememberme=1&elq_mid=2773&elq_cid=176288 Basically, treating dementia with donezepil (a cholinesterase inhibitor) used to be a 50-50 proposition, but now this Taiwanese study showed that having higher T4 levels before treatment predicted response to the drug. This suggests a relationship between thyroid function (and cortisol BTW) and neurodegeneration/dementia. Other studies link dementia to number of general anesthesias and […]
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Association of Cannabis Use With Adolescent Psychotic Symptoms | Adolescent Medicine | JAMA Psychiatry | JAMA Network

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2681642?utm_source=facebook&utm_medium=social_jamapsyc&utm_campaign=article_alert&utm_content=automated Basically, no child is completely safe from cannabis-induced psychosis. The old thought that some kids are more vulnerable that others seems to no longer apply. It’s dose and duration. Good to know Wiggers

Latest Study comparing Antidepressants–UPDATE

Trial link. Cipriani updates her last major review of all head to head trials between antidepressants to give us a new line up of best ones to use for either efficacy or tolerability. There is not clear winner, but there are some losers. The new line up: Best choices: agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and […]
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List of meds that cause depression

https://int.nyt.com/data/documenthelper/34-medications-potential-depression/1daa5542d3a2dd905a94/optimized/full.pdf#page=1 full.pdf