We have all bumped up against the limits of the current model of antidepressant treatments for depression: the patient who comes in with a laundry list of failed medication trials, or a number of other complaints depicting a portrait of malaise—aches, pains, anhedonia, fatigue, brain fog, digestive woes—that don’t really respond to currently available agents. What if shifting our thinking about underlying causes might hold the answer to treatment of these individuals?
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Too often our literature presents an oversimplified picture driven by some agenda, usually commercial. We prescribers, or, more accurately, “research consumers,” need a more complete and accurate description of what’s actually observed in clinical trials.
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After a dry spell of new antidepressants—the last one to be approved was levomilnacipran (Fetzima), the active enantiomer of milnacipran (Savella) in July 2013—the FDA approved vortioxetine (Brintellix) in September. Vortioxetine is another serotonergic antidepressant. How exactly does it work, and what are its advantages over existing drugs?
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Obesity and metabolic impairments are widespread in both psychiatric and non-psychiatric populations. To make matters worse, weight gain, hyperlipidemia, and diabetes are common side effects of the pharmaceuticals we use to treat psychiatric illness.
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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