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 1 CME credit.
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There is a need for rapid treatment in postpartum depression, as each month of this potentially severe condition can take a toll on infant development. That is why brexanolone (Zulresso), which was recently fast-tracked for approval by the FDA, is causing such a splash.
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Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsible, but other NMDA antagonists have not worked well in depression.
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In this pilot study, investigators evaluated the benefits of cannabidiol (CBD), which is one of the two main active components of marijuana (the other being THC), for the treatment of schizophrenia.
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Dear Dr. Aiken: In the July/August 2018 issue, you wrote that bupropion (Wellbutrin) augmentation does not work in treatment-resistant depression (TRD). So why do we see it work so often in practice?
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Deprescribing refers to lowering or stopping medications that might be causing harm or no longer providing benefit. It’s done in a planned, collaborative, and supervised way rather than simply the patient stopping the medications independently.
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Your patient comes in with a new medication on his list: CBD oil. He started taking it for anxiety and wants to know if it’s safe. You hedge, explaining that there is limited information available on unregulated products, but the patient is persistent. He says CBD oil is available as a prescription, and wonders if you could write one for it.
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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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