The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 2 CME credits.
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We’re pleased to introduce Chris Aiken, MD, as the new editor-in-chief of The Carlat Psychiatry Report. Dr. Aiken is a clinician, researcher, and writer. He is the 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.
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Treatment-resistant depression (TRD) is not untreatable. The challenge is to keep hope alive and the patient engaged in recovery. “You deserve, and can expect, a full recovery,” I’ll often tell patients, “but we’re going to need more than medications to get you there.” I’ll then offer a choice: to either start weekly psychotherapy or make a lifestyle change—or both.
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Here’s a common scenario. You have a patient who has tried three or four antidepressants over the years; all have been somewhat effective at least initially, but eventually that effectiveness waned.
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This study tested a self-guided mobile app in patients with moderate to severe depression who had not responded to at least 1 antidepressant trial. The Japanese app, called Kokoro, used cartoon characters to present concepts from CBT, including self-monitoring, behavioral activation, and cognitive restructuring.
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Treatment-resistant depression (TRD) has a fairly low barrier of entry. Failure of 2 full antidepressant trials—lasting 6 weeks at a minimally effective dose—is enough to qualify. In this month’s issue of TCPR, we’ll highlight pharmacologic advances that are underutilized and debunk a few that are unlikely to be effective for TRD.
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We often come across patients who seem stuck in a repetitive, negative style of thinking that we call rumination. Rumination is often associated with depression or anxiety, and when severe, it can seem akin to psychosis.
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Here’s a common scenario. You have a patient who has tried three or four antidepressants over the years; all have been somewhat effective at least initially, but eventually that effectiveness waned.
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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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