The Myth of New Year’s Resolutions

Every year when New Years rolls around people get a new spurt of ambition to suddenly make themselves better. They make New Year’s resolutions that they’re going to exercise more, drink more water, study more, get that promotion at work…the list goes on and on. But a few weeks later, the vast majority of those people haven’t made any strides toward those goals, and they seem to have lost their motivation to try. Why? Are New Year’s resolutions destined to fail?

Last Year’s Resolutions

Going into 2022, the top resolutions were focused around becoming healthier. On the coattails of the corona virus, that’s not super surprising. The better question, though, is how long do these resolutions last?

Top U.S. New Year's resolutions for 2022

Not super long. After 1 week, about 25% of people give up. And that number continues to drop as time goes on.

Do resolutions really help?

Not all resolutions are a waste of time. Recent statistics show that after 6 months about 46% of people are still holding on to their resolutions and working towards them. Roughly 16% will make it through the whole next year and/or fulfill their original resolution. Imagine if a higher percentage of people could follow through and achieve their goals!

The issue arises when the goals being made are too vague, too hard, or unsustainable over time. Or the person just gets bored with the whole thing. That’s a recipe for disaster! So how can we help make these resolutions stick?

Make SMART resolutions

The acronym SMART can help! And we all know that you’re a smart cookie, so that should be easy to remember 🙂

S- Specific

M- Measurable

A- Achievable

R- Realistic/Relevant

T- Timely

Your goals should be specific. As seen above, the top resolution was “to exercise more”. This might seem SMART, but it could actually be better. A SMART resolution would be “to complete 300 pushups in 90 days”. This resolution is specific in the type of exercise (so there’s no waffling at the gym), it’s measurable by counting the number of pushups done each time exercising is done, it’s (probably) achievable if done in safe increments, it can be broken into realistic segments (maybe 30 pushups a day!, and it’s timely in that it has a deadline (you can’t put it off indefinitely).

Make your 2023 resolutions SMART!

We want to help you stick to your resolutions! Need help coming up with SMART goals? Contact us with any questions you have so we can get you make a plan to tackle 2023 and make it your year! Want to make a goal to study more? Check out our Question Banks and find the best option for you! You’ve got this, and can definitely achieve whatever resolutions you put your mind to!

How does perfectionism affect your life?

Are you a self-diagnosed perfectionist? Or maybe you know someone else who says they are. It may seem like people with a proclivity for perfectionism have a higher degree of finesse or accomplishment. This can be intimidating for those of us that don’t identify with this mindset. It can make you feel like your performance or abilities are less-than in comparison. But did you know the data doesn’t really support this idea?

Dart on a bullseye perfectionism

Perfection is Unattainable (And Unassociated with…)

Yep, you read that right. Try as we might, no one is perfect (duh!). This is obvious, and, particularly in the psychiatric field, it becomes a mantra of sorts that we share with clients and patients as a way to soothe their worries. What’s more, perfectionism isn’t actually associated with academic success of accomplishment.

But wait, you say, I know someone who says they’re a perfectionist and they’re so smart! Sure they are. But a study conducted (back in the 90’s!) on academically gifted students versus typical cohort students found that there was no association between self-perceived perfectionism and academic giftedness (Parker, 1996). Another study by the same author looked only at academically talented students and assessed perfectionism within that group and found a normal distribution of non-perfectionistic type (32.8%), healthy perfectionistic type (41.7%), and dysfunctional perfectionistic type (25.5%), further suggesting perfectionism is not highly associated with academic accomplishment (Parker, 1997).

What Perfectionism IS…

Perfectionism can actually hurt the people that feel this way. Perfectionism is strongly associated with negative symptoms of anxiety, depression, obsessive compulsive inclinations, and distress. This is due to the impossible task of trying to achieve something we – quite literally- cannot. It also can wreck havoc when taking a standardized test that penalizes for missing answers. Instead of taking a best guess and moving on when encountering a difficult question, a perfectionist tends to sit and agonize because they want to be sure. They want to know their answers are just right.

Does this mean those that live for attention to detail and dotting all the i‘s and crossing the t‘s are doomed? Of course not! Everyone has strengths and weaknesses that contribute to what makes them unique. The important thing to see here is that whether or not you like perfectionism, it does not predict your ability to be a competent physician, psychiatrist, student, or worker.

For the perfectionist and non-perfectionist alike, give our question banks a try- FREE- using our Free Trial! Or if you’re ready to take the plunge, check out our Question Banks and find the perfect 😉 fit for you! Or, contact us with any questions you have.

REF: Parker, W. D., & Mills, C. J. (1996). The incidence of perfectionism in gifted students. Gifted Child Quarterly40(4), 194-199.

Parker, W. D. (1997). An empirical typology of perfectionism in academically talented children. American Educational Research Journal34(3), 545-562.

Avoiding Burnout at the End of the Year

We’re almost to the finish line of 2022! This time of year is rife with the possibilities of BURNOUT. Are you starting to feel the creeping feelings of exhaustion, alienation, or reduced performance? Or just feeling like you’re ready to be DONE with this phase? Burnout is common, especially among care providers, but it doesn’t have to take over your Holiday season. We have tips and tricks on how to avoid the end of year burnout so you can finish out strong.

man lying on road with burnout marks

What is burnout and why are we talking about this?

First, what exactly is burnout, and what causes it? This might seem like a silly question. But it’s worth talking about for a second. According to Mayo Clinic, burnout is “…a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity”. In other words, you’ve been doing the same (or similar enough) things for a long time and you’ve reached your capacity to keep doing it at the same performance level.

This is important to talk about because burnout and depression share a lot of similar symptoms. And while you might be experiencing the dragging feeling of typical tiredness, late October through end of February are the months when some folks tend to face the worst symptoms of depression as well. Why? A few reasons are the culprit: Seasonal Affective Disorder (SAD), spurred by the lack of sunshine and being cooped up inside, holidays spent without family or friends (whether due to a death or alienation), or inversely holidays spent WITH family or friends that are not safe to be around can be the top of the list.

Depression and burnout can feel the same, except for a few key differences. Burnout almost always is focused around performance of a task, such as school or a job or even long term care of a loved one. You feel tired, cynical, irritable, emotionally numb, have trouble concentrating or getting going, or gastrointestinal issues. Depression involves all of these, but also low self esteem, hopelessness, and/or suicidal ideation. For your own wellbeing, it’s essential to distinguish between these two things.

If you are experiencing thoughts of harming yourself or others please reach out for help. Call 988 to contact the Suicide and Crisis Lifeline for 24/7 free access to support.

Let’s talk about how to help!

Ok, this is easier said than done (as most things are). You’re experiencing some burnout, whether that is from finals, rotations, school demands, or your current work position. We have some ideas on how to help you get through the next few weeks or months:

  • Get support. This can’t be stressed enough. Grab a cup of coffee with a friend, call your mom/therapist/other trusted person, or commiserate with your cohort. People are social beings and we need to be in community with others to thrive. You will be amazed how much better you’ll feel just by venting for an hour to another person!
  • Journal. A great tool for monitoring your stress and coping levels is by journaling for a few minutes every day. The act of expelling all the negative feelings you have out of yourself is something quick (more or less), easy, and free. It’s also something that can create a sense of autonomy over your stress. Writing things out allows you to evaluate and mull things over in a different way that can lead to more creative solutions or coping!
  • Self-care stress management. Again, easier said than done, but will reap benefits if you implement it. This looks like aerobic exercise, yoga, mindfulness meditation, or a hobby that relaxes you (art, crafting, reading, bubble baths, sitting under a tree…the options are endless!). Carve out the time for YOU and no one else that has nothing to do with any of the things stressing you out.
  • If possible, do something that actively makes your situation better. How? If you’re a student prepping for a board exam or needing help with the school year, give our question banks a try- FREE- using our Free Trial! Or, contact us about our tutoring options!

REF: Depression: What is burnout? Informed Health Online. https://www.informedhealth.org/what-is-burnout.html. Accessed May 13, 2021

Swenson S, Shanafelt T. Mayo Clinic Strategies to Reduce Burnout: 12 Actions to Create the Ideal Workplace. Oxford University Press; 2020.

Studying Tips Broken Down: Set yourself up for success!

Time to get back to studying… wow… it seems like just yesterday the summer was just kicking off!

Now it’s time to head back to school, so naturally, we’ve received some DMs asking “How can I make the most of the upcoming school year?”.

Going back to school can seem like an overwhelming time and it can be, but we’ve put together a few studying tips that should help you excel in your learning.

Our Top Five Tips!

1️⃣ Get Organized…

Get all your study materials together, ensure you know your new schedule, and plan your time properly. Take a look at each class; What do you need? What do you already have?

2️⃣ Be Active In Your Learning.

Don’t just follow your current curriculum. Seek out other experiences and knowledge whether you’re in a group studying, participating in volunteer labs/programs/research groups, and much more. You can gain more knowledge and experience this way!

3️⃣ Study, Study, Study — but with others!

Studying with others can improve your memory recall, provide other points of view, and give you a great trusted group whom you can make memories with outside of just staying. Since you’re all going through the same experiences together it can help ease the stress. You could even utilize various question banks and tools to make the most of the study sessions!

4️⃣ Use Your Time Wisely

Just because others are going out every night doesn’t mean you need to… you can still have a solid social life AND go to school. Write down and prioritize everything you need to do. Ensure you have built a solid routine, and get what you need to do, but also make sure you are taking time to have fun too (which brings us to our next section.)

5️⃣ Take Care Of Your Mental Health!!!

This is last but certainly NOT least. We’ve said it before and we will keep saying it. Take care of yourself and your mental health. You need to ensure you aren’t pushing yourself too far. Find things and activities which help you relax. School is not forever so take everything one step at a time. Use your support group/study group we mentioned in point 3.

Need some additional tips or a tutor? Contact us today!

Who is My Psych Board?

My Psych Board is a board review website created by Dr. Abdel, MD, MBB. CH., founder and CEO of Westlake Brain Health clinic in Cleveland, OH. This program offers access to unique courses and question banks to prepare residents and medical students for the American Board of Psychiatry and Neurology (ABPN) Psychiatry Certification Exam, Psychiatry Resident In-Training Examination, United States Medical Licensing board examination, and Nurse Practitioner examination. Each question bank is specifically tailored to the required difficulty and type of questions expected for the different board exams. New questions are continually being added to the question banks, ensuring the most current and up-to-date information is being made available.

My Psych Board is created by experts in the field and covers all the topics you need to master in order to pass your board-certifying exams. Feedback is given immediately in Practice Mode as questions are answered, including in-depth explanations that accompany each question for both correct and incorrect answer options. Additionally, students have the option of accessing a one-time phone call with Dr. Abdel to discuss their best studying strategies and one-on-one tutoring to help them gain maximum preparation. My Psych Board is customer oriented; we take your feedback seriously and are always looking for ways to improve the user experience! 

Our Top Tips: How to Survive Your Psychiatric Residency!

Our Top Tips - How to Survive Your Psychiatric Residency!

Ok, hear us out for a minute…⁠ Surviving your residency is easier than you think.⁠ ⁠ 

YES, of course, that’s a loaded statement… NO, we aren’t saying it’s not incredibly challenging (because it is…) but we promise you’re overthinking it. You CAN do this. You may have heard horror stories or that it was the worst moment of someone’s life but let’s be real. 

It shouldn’t be.⁠

 Thousands before you have done it and thousands after you will do it too.

How you handle it makes all the difference in what you’ll get out of your residency.⁠ Here are 5 TIPS on how to survive:

#1 HAVE A POSITIVE MINDSET…

Before you begin anything, you should always go in with the correct mindset. If you think things are going to be horrible…then they will be! But if you go in understanding that there will be both highs and lows, you’ll be better prepared to face them.

#2 HAVE A GREAT SUPPORT SYSTEM…

This goes with most things in life. The company you keep will help get you through hard moments. That’s what friends are for. But this support system should also be those around you too! Other residents know what you’re going through, so be sure to include them. It helps so much! ⁠

#3 DON’T NEGLECT YOUR MENTAL AND PHYSICAL HEALTH…

We’ve said this before and we’ll say it again: Take care of your mind AND body! Don’t bottle things up, talk to your support system, and get further help if you need it. It’s a challenging time. Outside of this, being active works WONDERS. Your body will thank you.

#4 IT’S OK TO SAY “I DON’T KNOW” (DO IT MORE!)…

You don’t know everything (that’s why you’re here). Don’t be a “know it all”, it can come back to hurt you. If you’re asked something and you’re really unsure, say that! Saying I don’t know will help you get the answers you need. Don’t feel silly. You’re learning!

#5 IT GETS BETTER…

It will get better!!! The start can be overwhelming and a lot to take in, but use that support system. Once you get in the groove, you’ll start to feel much more relaxed. Give it time. It’s long, draining, and emotional but there are perks. They may not last long but the amount of information and experiences you’ll take away from it, in the end, is all worth it. 

You got this, you can survive… you can thrive! ⁠

Still, feeling overwhelmed?

Contact us and let’s talk through it together.

How To: Create the PERFECT Morning Routine to maximize your success!

Image shows a man with brown hair running through a beautiful forest and mountain rage. The image is "How To: Create the PERFECT Morning Routine to maximize your success!"

Starting off the week on the right foot can completely change how your week plays out! ⁠

This is a KEY part in helping you pass your boards. If you wake up, rush around, and fill your morning with stress it’s most likely that your day will be filled with stress. It can feel like a marathon if you just wake up and jump into the day. That will then hurt your odds of having a successful study session. ⁠

Studies from @Forbes show that waking up earlier than usual has incredible health benefits. They state it gives you ample time to focus on your goals and conquer the day with more energy, mindfulness, and strength.⁠

✨ Here are some helpful tips we’ve complied after doing some additional research!⁠

• Let’s start with the obvious..get a good night’s sleep…you need to be RESTED for your brain to function properly. ⁠
• Avoid the snooze button!⁠
• Instead of snoozing, wake up a few minutes earlier and give yourself enough time to wake up. You can Lay in bed for a few minutes and ease out of bed.⁠
• Write down your thoughts! This could be a to do list for the day, or just general thoughts. Talking about your stressors on paper can also help relieve them.⁠
• Eat something, your brain needs nutrition. Even if it’s something small!⁠
• Do something you enjoy, this could be working out, going for a quick walk, reading a book and so on!⁠
• Drink a full cup of glass of water before you leave the house (or start working/school if you do it remotely from home). ⁠
• Don’t rush! Give yourself enough time. If you know you have to leave by a certain time try and be ready 10-15 minutes before that and make sure you have everything you need.⁠


Did you know we offer a FREE trial for our question banks? Just head over to our website (exams.mypsychboard.com) to get started today risk-free (with no Credit Card required!)

Feeling like you need a bit of extra help?

Contact us OR sign up for our tutoring!

How to make the most of DOWNTIME while in school

Text reads "How to make the most of DOWNTIME while in school!" it shows 2 students walking into a beautiful school and then a desk inside with a green chalk board.

Are you feeling overwhelmed with school or maybe you feel as if you’re not doing enough..?⁠

Here are our top 3 tips on how YOU can make the most of your downtime while in school.. it’s not all books and tests, you can have fun too!⁠

Stay Active!

Exercise is crucial to your mental health, not just physical! Getting up and being active can help by reducing anxiety and depression, improving your mood and self esteem! Studies show it also alleviates social withdrawal and improves your ability to study and learn!

Be Social!

Talk to your fellow students and friends! It will break up the monotony of your classes. Go do something you enjoy, join a club, or just go grab coffee. Being social ALSO has positive effects on your study routines!

Study Study Study!

This should go without saying…make sure you use your time wisely! Although the other topics are essential to your mental health…so is studying!


📲 SHARE this with someone who could use the help! Are you enjoying these tips? Check out our previous post on how you can get the most out of studying. It’s a lifesaver…

Did you know we offer a FREE trial for our question banks? Just head over to our website (exams.mypsychboard.com) to get started today risk-free (with no Credit Card required!)

Feeling like you need a bit of extra help?

Contact us OR sign up for our tutoring!

Q&A: Pharmaceutical Specifications, Treatment Resistant Depression, and Intervention

PHARMACEUTICAL SPECIFICATIONS FOR DEPRESSION

Will SSRI and SNRI side effects go away with time?

SRIs and SNRIs are safer and better tolerated than other classes of antidepressants. Side effects are typically mild and they often go away after using the medication for a few days. Common side effects during the initiation of treatment that typically go away with time include gastrointestinal disturbance, headache, decreased appetite, and initial weight loss. Symptoms that sometimes go away with time include insomnia, vivid dreams, and emotional blunting. Other symptoms, if present, are likely to not resolve on their own which include sexual dysfunction (decreased libido or arousal, anorgasmia, and delayed ejaculation in men), restlessness/akasthisia, and weight gain. There is no consistent weight gain in short-term RCTs (4-12 weeks), but retrospective cohorts indicate they may cause modest gains of up to 1kg on average after 1 year.

What antidepressants are safe in liver disease?

Antidepressant drugs can cause drug-induced liver injury. Although data on antidepressant-induced liver injury are scarce, 0.5%−3% of patients treated with antidepressants may develop asymptomatic mild elevation of serum aminotransferase levels. All antidepressants can induce hepatotoxicity, especially in elderly patients and those with polypharmacy. Liver damage is in most cases idiosyncratic and unpredictable, and it is generally unrelated to drug dosage. The antidepressants associated with greater risks of hepatotoxicity are iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, tianeptine, and agomelatine. The antidepressants that seem to have the least potential for hepatotoxicity are citalopram, escitalopram, paroxetine, and fluvoxamine.

What antidepressants are safe in kidney disease?

Comorbidity rates of depression in patients with renal disease are high, making the use of antidepressants in renal disease common. SSRIs are generally preferred in this population and medications should be started a low doses and titrated slowly. Among the SNRIs venlafaxine may be used, however the require dose adjustments and duloxetine should be avoided in severe renal impairment. Bupropion should be avoided in patients with chronic renal failure and on dialysis since the active metabolite (hydroxybupropion) is not dialyzable and plasma levels are increased in patients with even mild renal impairment thus increasing the risk for seizures and other adverse side effects. TCAs should be decreased by 50% in geriatric patients with moderate to severe renal dysfunction.

What other conditions are antidepressants used for?

The use of antidepressant medications are not limited to depressive disorders. There is evidence for a variety of indications. Some of these include:

  • Obsessive compulsive disorder: SSRIs (in high doses), TCAs (clomipramine)
  • Panic disorder: SSRIs, TCAs, MAOIs
  • Eating disorders: SSRIs (in high doses), TCAs
  • Social anxiety disorder (social phobia): SSRIs, SNRIs, MAOIs
  • Generalized anxiety disorder: SSRIs, SNRIs (venlafaxine), TCAs
  • Posttraumatic stress disorder: SSRIs
  • Irritable bowel syndrome: SSRIs, TCAs
  • Enuresis: TCAs (imipramine)
  • Neuropathic pain: TCAs (amitriptyline and nortriptyline), SNRIs
  • Chronic pain: SNRIs, TCAs
  • Fibromyalgia: SNRIs
  • Migraine headaches: TCAs (amitriptyline)
  • Smoking cessation: Bupropion
  • Premenstrual dysphoric disorder: SSRIs
  • Insomnia: Mirtazapine, trazodone, TCAs (doxepin)

TREATMENT RESISTANT DEPRESSION

What is the definition of treatment-resistant depression?

Treatment-resistant depression (TRD) is most commonly defined as a failure of treatment response or remission with two or more treatment attempts of adequate dose and duration. Unfortunately, there is not a clear consensus about this definition. Specifically, what is an adequate response? 50% reduction in symptoms? Complete resolution of symptoms? Also, what are the specifics regarding the adequacy of both dose and duration of treatment? 

While not a consensus, the most commonly used definition in research studies regarding response are the following :

  • No response: Improvement <25 percent.
  • Partial response: Improvement 25 to 49 percent.
  • Response: Improvement ≥50 percent but less than the threshold for remission.
  • Remission: Rating scale scores within the normal range.

What are augmentation options if antidepressant medications fail to show an adequate response?

Some patients may not achieve an adequate treatment response after a full trial of SSRI or SNRI at therapeutic doses. If there is no response then switching to another medication in the same class or a different class should be considered. If there is some response than maximizing dose or augmentation strategies should be considered. There are a number of medications that have been trialed for treatment resistant depression. We will list some of the more common augmentation strategies below:

  • Buproprion: included in the STAR*D trial and typically well-tolerated from a side effect perspective. Can also help with SSRI induced sexual side effects, smoking cessation, and weight loss.
  • Mirtazapine: effective antidepressant and improves appetite and sleep. Be aware of weight gain and sedation.
  • Lithium: well supported in the literature and is recommended by the NICE guidelines.
  • Second-generation antipsychotics (SGAs): particularly aripiprazole, quetiapine, olanzapine, and risperidone (2nd choice) have shown to be effective.
  • Buspirone: supported by STAR*D trial. High doses are usually required and poorly tolerated due to dizziness at high doses.
  • Lamotrigine: reasonably well researched and possibly the best tolerated augmentation strategy. Appropriate dosing is unclear and requires slow titration due to risk of Steven Johnson’s Syndrome.
  • T3 (Triiodothyronine): augmentation has some research support but also has negative studies.
  • TCAs or MAOIs can be used as augmentation or to replace the primary antidepressant (SSRI/SNRI). Often considered later in the treatment algorithm due to significant side effects, food restrictions, and higher lethality in overdose.

INTERVENTION TECHNIQUES FOR TREATMENT RESISTANT DEPRESSION

What interventional techniques are available for treatment resistant depression?

Electroconvulsive Therapy (ECT)

  • Formerly known as shock therapy.
  • Involves a brief electrical stimulation (generalized seizure) of the brain while the patient is under general anesthesia.
  • Most effective and rapid treatment in severe depression, psychotic depression, depression with catatonia, and treatment refractory depression.
  • There are no absolute contraindications to ECT, however several relative contraindications exist including recent myocardial infarction or stroke, increased intracranial pressure, retinal detachment, and unstable dentition.
  • Standard practice in the U.S. is to give treatments three times per week.
  • Most symptoms improve substantially in 6-12 treatments, however there is no absolute standard number of treatments.
  • Certain medications that affect the seizure threshold should be held prior to ECT including benzodiazepines, valproate, lamotrigine, gabapentin, carbamezapine, and lithium.
  • ECT can cause acute confusion, anterograde and retrograde amnesia. These are typically the most feared side effects from patients. Many patients do experience some adverse cognitive effects, however objecting indicates that impairment is generally short lived (weeks). ECT does not appear to be associated with an increased risk of dementia.

Transcranial Magnetic Stimulation (TMS)

  • Machine that produces weak repetitive electric currents in the brain tissue by rapidly changing magnetic fields.
  • Numerous small-scale studies have demonstrated efficacy in the treatment of major depression; however, studies show less efficacy than for ECT.
  • TMS works by passing a weak alternating electrical current through a metal coil placed against the scalp. This produces rapidly changing magnetic fields. These magnetic signals pass through the skull and induce electric currents that depolarize neurons in a specific area of the surface of the cortex and associated neural circuits. The mechanism of antidepressant effects is not completely understood.
  • FDA approved for major depressive disorder, migraine headaches, and obsessive-compulsive disorder. There is also growing evidence for anxiety disorders and PTSD.
  • Treatment typically occurs every weekday for 4 to 6 six weeks or a total of 20-30 treatments. Each session lasts around 30-40 minutes.
  • Relative contraindications of TMS include implanted metallic hardware or electrical devices and unstable general medical disorders. Patients with epilepsy or increased risks of seizures can be considered for low frequency TMS if benefits outweigh the risks.

Intranasal Ketamine

  • Ketamine is technically considered a dissociative anesthetic, however has been discovered to be helpful in treatment resistant depression. It is an NMDA glutamate antagonist and also affects brain growth factors and opioid receptors, suggesting a possible mechanism for its antidepressant properties.
  • Unlike many of our treatment options (antidepressant medications, psychotherapy, TMS) esketamine nasal spray has the unique benefit of a rapid onset of action to reduce suicidality or other serious acute symptoms of depression.
  • The recommended frequency of intranasal esketamine for acute suicidal ideation or behavior in adults with unipolar major depression is twice weekly for four weeks. After four weeks of treatment with esketamine, its benefit should be evaluated to determine the need for ongoing treatment.
  • Side effects may include increased blood pressure, perceptual disturbances, or dissociative / out of body experiences.

Vagus Nerve Stimulation (VNS)

  • Surgical treatment involving the implantation of a medical device that sends electrical impulses to the brain via the vagus nerve.
  • Has been used for epilepsy since 1997 and for refractory major depression since 2005.

Deep Brain Stimulation (DBS)

  • Surgical treatment involving the implantation of a medical device that sends electrical impulses to specific parts of the brain.
  • Originally used in treatment refractory neurologic conditions such as Parkinson’s disease, dystonia, and tremor.
  • Now used in treatment refractory major depression.

REFERENCES

1. Hasin DS, Sarvet AL, Meyers JL, et al. Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States. JAMA Psychiatry. 2018;75(4):336–346. doi:10.1001/jamapsychiatry.2017.4602

2. National Institute for Health and Care Excellence. (2009). Depression in adults: recognition and management. Retrieved from https://www.nice.org.uk/guidance/cg90/chapter/Recommendations

3. Cuijpers, P., Andersson, G., Donker, T., & van Straten, A. (2011). Psychological treatment of depression: results of a series of meta-analyses. Nordic journal of psychiatry, 65(6), 354–364. https://doi.org/10.3109/08039488.2011.596570

4. Blumenthal SR, Castro VM, Clements CC, et al. An Electronic Health Records Study of Long-Term Weight Gain Following Antidepressant Use. JAMA Psychiatry. 2014;71(8):889–896. doi:10.1001/jamapsychiatry.2014.414

5. Voican, C. S., Corruble, E., Naveau., and Perlemuter, G. (2014). Antidepressant-Induced Liver Injury: A Review for Clinicians. The American Journal of Psychiatry. https://doi.org/10.1176/appi.ajp.2013.13050709

6. Ward, S. W., Reach, W. J., &amp; Thomas, C. (2016). When to adjust the dosing of psychotropics in patients with renal impairment. Current Psychiatry, 15(8), 60–66.

7. Puckett, J. A., Beach, S. R., &amp; Taylor, J. B. (2020). Pocket psychiatry. Wolters Kluwer.

8. Gaynes BN, Asher G, Gartlehner G, Hoffman V, Green J, Boland J, Lux L, Weber RP, Randolph C, Bann C, Coker-Schwimmer E, Viswanathan M, Lohr KN. Definition of Treatment-Resistant Depression in the Medicare Population. Technology Assessment Program. Project ID: PSYT0816. (Prepared by RTI–UNC Evidence-Based Practice Center under Contract No. HHSA290201500011I_HHSA29032006T). Rockville, MD: Agency for Healthcare Research and Quality. February 2018. http://www.ahrq.gov/clinic/epcix.htm.

9. Taylor, D., Barnes, T. R. E., Young, A. H. (2018). Depression. The Maudsley Prescribing Guidelines in Psychiatry (13th ed., pp. 208–212). Wiley Blackwell.

10. Williams, N. R., Taylor, J. J., Kerns, S., Short, E. B., Kantor, E. M., & George, M. S. (2014). Interventional psychiatry: why now?. The Journal of clinical psychiatry, 75(8), 895–897. https://doi.org/10.4088/JCP.13l08745

11. United States Food and Drug Administration approved labelling. https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/211243s004lbl.pdf (Accessed on August 10, 2020).