• Inflammation contributes to treatment resistance in depression and can be measured with a blood test, C-reactive protein (CRP).


• An elevated CRP predicts a favorable response to certain antidepressants, as well as specific lifestyle interventions.


• Nuedexta’s expanded use in dementia is based on questionable efficacy, but it is safer than many of the psychotropics routinely used in that population. It’s expensive, but there are ways to prescribe a generic equivalent.

Price Drop on L-methylfolate. In our August 2019 issue, we compared two supplements that are used to augment antidepressants: folate (0.5 mg to 10 mg/day) and l-methylfolate (15 mg/day). The clinical data pointed toward l-methylfolate, but the price of this supplement put it out of reach for many patients. We’ve since become aware of a more affordable version of l-methylfolate that’s within the price range of folate. Opti-folate 15 mg is $13/month on Amazon.