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Clinical Update

Are Two Antidepressants Better Than One?

July 3, 2023

Michael Posternak, MD.

Michael Posternak, MD. Psychiatrist in private practice, Boston, MA.

Dr. Posternak has no financial relationships with companies related to this material.

New research calls to question the common practice of antidepressant combinations. Dr. Posternak makes sense of it.

Research Update

Why Do So Many Pediatric Antidepressant Research Trials “Fail”?

April 1, 2023

Pavan Madan, MD

Pavan Madan, MD. Dr. Madan has no financial relationships with companies related to this material.

Placebo response rates in antidepressant trials tend to run high, making it difficult to know whether an active medication has truly beneficial effect. This research update unpacks possible reasons for this phenomenon that give you insight into how to treat your patients using a rational multimodal approach.

SSRIs and Intracerebral Hemorrhage Risk

May 21, 2021

Paul Barkopoulos, MD.

Paul Barkopoulos, MD. Dr. Barkopoulos has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

SSRIs help relieve post-stroke depression but increase the risk of intracerebral hemorrhage. This study gives us tips to reduce this risk.

Can Antidepressants Prolong Survival in Cancer Patients?

May 21, 2021

Paul Barkopoulos, MD.

Paul Barkopoulos, MD. Dr. Barkopoulos has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Antidepressant adherence is linked with increased survival among cancer patients.

EXPERT Q&A

How to Come Off a Psych Med Part 1: Antipsychotics

February 3, 2021

Swapnil Gupta, MD

Swapnil Gupta, MD
Associate professor at Icahn School of Medicine at Mount Sinai. Co-author of Deprescribing in Psychiatry (Oxford, 2019). Dr. Gupta has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

How do you taper off an antipsychotic? Swapnil Gupta gives a practical approach, and discusses dopamine hypersensitivity, a controversial theory that suggests antipsychotic withdrawal can cause dyskinesias, prolactinemia, and rebound psychosis.

How to Select an SSRI

November 12, 2020

Chris Aiken, MD.

Chris Aiken, MD. Editor-in-Chief of TCPR. Practicing psychiatrist, Winston-Salem, NC. Dr. Aiken has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

After digging through 3 decades of research, we can tell you this: There is no such thing as “the best” SSRI. But there are some important differences between them, and this article will show you how to find the right one for your patient.

Mood and Menopause

October 6, 2020

Ruta Nonacs, MD, PhD

Ruta Nonacs, MD, PhD
Ruta Nonacs practices psychiatry at Massachusetts General Hospital’s Perinatal and Reproductive Psychiatry Clinical Research Program. She has published original research on peripartum mood disorders and is the author of A Deeper Shade of Blue: A Woman’s Guide to Recognizing and Treating Depression in Her Childbearing Years (Simon & Schuster). Dr. Nonacs has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Ruta Nonacs names the antidepressants that work best for menopausal depression and when to move to hormonal therapies. And for adolescents and young adults, she tells us which birth control pills are least likely to worsen mood.

Pros and Cons of Using TMS for Kids

August 13, 2020

There’s been some promising research for Transcranial Magnetic Stimulation (TMS), but can it be used for treatment-resistant depression in children and adolescents? Here’s a summary of the pros and cons presented in this 2019 article in The Carlat Child Psychiatry Report. Pros:It seems to work. An open-label trial of TMS for...

Does Prozac Treat Repetitive and Stereotypical Behaviors in Children With Autism?

August 5, 2020

Pavan Madan, MD.

Pavan Madan, MD. Dr. Madan has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Repetitive behaviors are part and parcel of the everyday challenges in autism spectrum disorders. The apparent similarly of these behaviors with obsessive compulsive disorders begs for trials of SSRIs such as fluoxetine (Prozac). But does this strategy work with any clear reliability? This research reviews addresses that question, with interesting results that impact everyday practice.

Optimal Antidepressant Doses in Major Depression

March 9, 2020

Kristen Gardner, PharmD.

Kristen Gardner, PharmD. Dr. Gardner has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

More is not necessarily better in psychopharmacology. Some medications have plateau effect, while others follow a “U-shaped curve,” causing more problems as the dose goes too high. This metaanalysis looked at 77 dose-response trials with antidepressants to quantify their optimal therapeutic window.