Reflections on Psychiatry & Psychology

Researchers found that amyloid plaques in Alzheimer’s brains trap lithium, creating early lithium deficiency that may contribute to disease onset. In mice, low lithium worsened plaques and memory loss, while low-dose lithium orotate improved them. Human studies are still needed.

Does naltrexone block ketamine’s antidepressant effects? Stanford research shows opioid receptor blockade dampens ketamine’s mood and antisuicidal benefits. Point Loma Clinic in San Diego explains what this means for your treatment plan.

Psychedelic psychiatry is moving from fringe research to mainstream clinical practice. An overview of psilocybin, MDMA, and ketamine — including benefits, risks, and what the evidence supports.

If multiple antidepressants haven't worked for you, you're not alone and you're not out of options. Why Antidepressants Fail: Lessons from the STAR*D Study Treatment-resistant depression (TRD) is a complex challenge in mental health, characterized by patients' inadequate response to standard antidepressant therapies. The landmark STAR*D study, which extensively evaluated treatment strategies for depression, revealed that a significant percentage of individuals do not respond

Stress and bipolar disorder (BD) interact bidirectionally. Stress, particularly in early life, appears to have lasting effects and marks for early onset of BD, although the exact mechanism is poorly understood. The relationship of stress to the onset of the disorder and its course has implications for treatment and management — and perhaps even prevention.

Zurzuvae, the first FDA-approved oral pill for postpartum depression, is taken for 14 days and can reduce symptoms within days. Costing about $15,900, access may be limited despite its rapid action compared with traditional antidepressants.

Methylfolate, the active form of folate (B9), supports serotonin and dopamine production and may help depression, especially in people with MTHFR variants or treatment-resistant cases. It can cause GI upset or insomnia and should be used cautiously, especially with SSRIs, under medical supervision.

There are several exciting developments in the field of antidepressants, with various drugs currently in the pipeline. still in various stages of development. Clinical trials are ongoing to evaluate their safety, effectiveness, and potential side effects.

A 2022 study confirmed brain zaps as real antidepressant-withdrawal symptoms. Restarting or slowly tapering meds may help. Most improve over time, but some suffer for years. Despite this, psychiatry has shown little response.

Dextromethorphan (DXM), found in cough meds, acts like mild ketamine. Combined with bupropion to slow its breakdown, it works quickly for depression. This combo was FDA-approved in 2022 as Auvelity.

Years of trial-and-error approach can be averted by this relatively new tool in mental health assessment. The psychiatrist will be able to devise an effective treatment, without side effects.

Cravings for drugs or alcohol are controlled by a variety of brain chemicals, including norepinephrine, dopamine, and glutamate.  Many people describe their cravings as coming out of nowhere, as if these chemicals pop into their brains and create a cravings spontaneously. These chemicals and the manifestations of cravings are actually triggered by stimuli from external environmental cues and internal mood states, particularly anxiety, irritability, and dysphoria.  Environment

Pharma has saved millions but is driven by profit. New drugs are priced high to recoup R&D costs; when patents expire, generics get cheaper. Companies often use tactics to extend profits beyond patent life.

Joe was in his mid-fifties, an accomplished attorney who has been suffering from recurrent depression since his early adulthood. The depression was difficult to treat; many different medications have been tried, including mood stabilizers (medications for bipolar disorder), but those were prescribed such a long time ago that Joe had  a hard time remembering how he was feeling when they were prescribed. All he knew that for at least the last ten years he was only depressed, so

Suicide is the 10th leading US death. Predicting it is hard; only clozapine, lithium, and ketamine reduce risk. Genetics, stress, and access to means all contribute.

Drug labels can mislead: meds are named for first uses, but act by mechanism. Topiramate (Topamax) began as seizure and migraine treatment, yet is also used off-label for mood stabilization or weight loss, among others.

“Brain zaps” are shock-like sensations during antidepressant withdrawal, especially with short–half-life SSRIs like Effexor or Paxil. Poorly studied, often abrupt-stop related; tapering helps only somewhat.