Earth Hasassri, MD
@earff
Child, Adolescent, & Adult Psychiatrist. @StanfordMed, @UCSF & @MayoClinicSOM | Neuropsychiatry | opinions are mine & not medical advice
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This is tremendous!
FDA just cleared Neurostar TMS for ages 15-up as antidepressant augmentation. 78% of teens responded to TMS in 1169 real-world cases. 18 controlled trials support #TMS in youth #depression (ages 8-up): pubmed.ncbi.nlm.nih.gov/37211054 #psychiatry #mentalhealth #pediatrics
Just published: The first RCT of esketamine in adolescents, showing positive results in hospitalized #depression with suicidality, n=54 pubmed.ncbi.nlm.nih.gov/37414272/ #ketamine has a few studies in teens [Art Jacob Lawrence, Depression] #psychiatry #clinicaltrials
![chrisaikenmd's tweet image. Just published: The first RCT of esketamine in adolescents, showing positive results in hospitalized #depression with suicidality, n=54
pubmed.ncbi.nlm.nih.gov/37414272/
#ketamine has a few studies in teens
[Art Jacob Lawrence, Depression]
#psychiatry #clinicaltrials](https://pbs.twimg.com/media/F1ZyvLzWcAM34sD.jpg)
New TMS finding: It improved not just depression but also several sleep measures in this randomized controlled trial of 100 subjects. #psychiatry #depression #TMS pubmed.ncbi.nlm.nih.gov/36435397/
For moderate/severe depression, one intervention is more likely to achieve remission with less side effects than medication… Transcranial Magnetic Stimulation (#TMS). It should be considered as a first-line option. psychnews.psychiatryonline.org/doi/10.1176/ap…
No medication works well for the core features of autism: social communication deficits and repetitive/restricted behaviors. However, medications do work for co-morbidities, such as anxiety, depression, OCD, and others.
New analysis of meds in #Autism “Many trials used medications to target core features of autism rather than mental health conditions, but these did not help autistic people... treatment...should follow the evidence available for non-autistic people. ” pubmed.ncbi.nlm.nih.gov/35957523/
The largest study published showed no difference in TMS compared to placebo in adolescent depression (Croarkin et al 2020). That was in a highly treatment resistant population (4 failed trials of antidepressants) whereas this one is a 1st episode of depression. This is promising.
Good news for TMS. One of the largest studies to date validated its safety/efficacy in adolescent depression. TMS is FDA approved for #depression, #OCD, and #smoking cessation, but only in adults. pubmed.ncbi.nlm.nih.gov/35928782/
This is why early studies showing the large effect size of minocycline on depression needs to be replicated in larger, well-controlled studies.
A promising therapy for treatment resistant depression just fell flat in this large RCT from @JAMAPsych ... Minocycline, an anti-inflammatory, neuroprotective antibiotic that had a few small but positive RCTs. pubmed.ncbi.nlm.nih.gov/36103181/
I’ve, unfortunately, seen cannabis-induced psychosis in the hospital too many times in teenagers.
The data on cannabis use in young people (age 12-18) leading to schizophrenia and psychosis later in life even after cessation of cannabis use, are striking, concerning & lend balance to the idea that cannabis is harmless or better b/c it is “safer than alcohol”.
Families frequently find it challenging to navigate the educational options available to their child. When meeting with patients and parents to build a good plan for school, consider these talking points for productive discussion #BackToSchool thecarlatreport.com/the-carlat-chi…
FDA approves #Auvelity (#bupropion and #dextromethorphan),the first new oral MOA #antidepressant approved in 60 years.It is a #NMDA receptor antagonist and worked as quickly as week 1 in improving #depressive symptoms.prn.to/3c9KAsb #nursepractitioner #mh
Nice to see confirmation or vortioxetine’s (Trintellix) cognitive benefits in a study that the manufacturer did not fund. Here it is compared to escitalopram (Lexapro) in #depression. ncbi.nlm.nih.gov/pubmed/35799757
A new review in @Nature Molecular Psychiatry debunks the long-believed but never-proven myth that depression is due to low serotonin. SSRI antidepressants likely work through other effects (+dopamine, protect brain/BDNF, regulate serotonin receptors, etc) nature.com/articles/s4138…
The Mediterranean diet wins again. A 4th trial (AMMEND) showed a large effect size of 1.5 for depression, with previous effect sizes of 1.2 in the groundbreaking SMILES trial and 2.4 in a second trial. To compare, SSRI’s effect size is 0.4 for depression. academic.oup.com/ajcn/advance-a…
Our paper reviewing the most up to date scientific literature on ketamine for adolescent depression came out this month. #ketamine #psychiatry #interventionalpsychiatry
June Issue of the AJP-RJ is out now! Article topics include ketamine for adolescent depression, recurrent catatonia, a review on Modafinil for Long COVID, and so much more. Full issue available via the link in our bio.
Children look to their parents to make them feel safe. All children need to be able to know you are listening to their concerns. Here are some tips for parents/caregivers with talking to their child about the recent mass shooting in Texas. apa.org/topics/gun-vio…
Many of my patients are having anxiety about the conflict in Ukraine. Here's some advice on how to talk to children about this. healthier.stanfordchildrens.org/en/talking-to-…
healthier.stanfordchildrens.org
How to Talk to Children About the Conflict in Ukraine
A Stanford Medicine Children's Health psychiatrist provides advice on how parents can help their kids understand what they see in the news.
Autism rates are increasing, now up to 1 in 44 children (or 2.3%) on the autism spectrum compared to 1 in 54 in 2016. The ratio between male:female is now 3:1 rather than 4:1 meaning more girls with autism are being identified. #autism #AutismAwareness cdc.gov/mmwr/volumes/7…
Is genetic testing to help choose a medication ready for prime time in mental health? The short answer is probably not, especially when you study the general population but the real answer is more nuanced and deserves a conversation with your psychiatrist. #pharmacogenomics
Largest psilocybin study shows those treated with high dose psilocybin were about 4 times as likely to go into remission from their depression than those who had low dose (placebo). This is cautiously promising as we need to learn more about its safety. statnews.com/2021/11/09/lar…
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