The treatment of bipolar depression remains challenging. Only two medications are FDA approved for the condition—quetiapine (Seroquel) and olanzapine (Zyprexa)/fluoxetine (Prozac) combination—both of which cause weight gain and sedation, among other side effects.

Despite having been around for 30 years, there is still controversy surrounding the acne drug isotretinoin (Accutane) and its association with psychiatric problems.

These new guidelines were issued jointly by our APA and by the American College of Obstetricians and Gynecologists. In addition to providing a nice summary of the neonatal risks of antidepressant exposure, the paper offers clear, concise, and easy to follow algorithms for the management of depression in three scenarios doctors are likely to encounter.

SSRIs theoretically work by inhibiting the reuptake of serotonin, presumably by blocking the serotonin transporter pump whose job is to clean up excess serotonin in the synapses between neurons.

As we reviewed in the July/August 2009 issue of TCPR (Vol 7, Issue 7), cardiac disease leads to major depression, and, conversely, depression is a risk factor for developing cardiac disease.

SAMe, long a favorite of Italian psychiatrists, has hopped the pond and installed itself as a “natural” remedy for depression in the U.S.

Historically, research into the effectiveness of antidepressants for depressed youths has been unimpressive. The history of SSRI use in children has been fraught with its own series of disappointments and controversies.

We know that for many conditions, both medications and psychotherapy work about equally well. Common sense would dictate that there is some final common pathway of neuropsychiatric change underlying the symptomatic improvements we see. But identifying what is happening in a living human brain is extremely tricky.

The extent to which antidepressants are effective for pediatric depression continues to stir controversy, as discussed in this issue of CCPR.

Suicide remains impossible to predict, though there have been no shortage of retrospective studies attempting to guide us.