{"id":79,"date":"2013-04-21T23:31:59","date_gmt":"2013-04-21T23:31:59","guid":{"rendered":"https:\/\/surgerytoday.com\/education\/?p=79"},"modified":"2013-06-10T06:41:06","modified_gmt":"2013-06-10T06:41:06","slug":"depression","status":"publish","type":"post","link":"https:\/\/surgerytoday.com\/education\/depression\/","title":{"rendered":"Depression"},"content":{"rendered":"<p>1 hour Lecture by Grace Nadolny, MD on 4\/20\/13 in <a href=\"https:\/\/surgerytoday.com\/modesto\/\">Modesto<\/a>, CA, CME provided by Sutter Gould Medical Foundation as part of it&#8217;s Subspecialty Lecture Series. \u00a04 hours total of CME was provided. \u00a0Part of the 4 hours of CME included discussion about <a href=\"http:\/\/www.modestoacupuncture.com\"><strong>back pain<\/strong><\/a> and <strong>ovarian cancer<\/strong>.<\/p>\n<h3>Why this is interesting to me<\/h3>\n<ul>\n<li><span style=\"line-height: 14px;\">I have learned some of this before in my NeuroScience years at Brown University. \u00a0It was good to review.<\/span><\/li>\n<li>I have an acupuncture practice which has a good number of patients with <em>depression<\/em>.<\/li>\n<\/ul>\n<p>Learning points (not all points were made in the lecture, but they were learning points for me):<\/p>\n<h3>Evidence Based medicine supported treatment of depression<\/h3>\n<ul>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">includes the use of methylphenidate, exercise, and sertraline<\/span><\/li>\n<\/ul>\n<h3>Methylphenidate<\/h3>\n<ul>\n<li><span style=\"line-height: 14px;\">Ritalin<\/span><\/li>\n<li>NE and DA reuptake inhibitor. \u00a0(Norepinephrine adn Dopamine)<\/li>\n<li>Psychostimulant<\/li>\n<li>Used for ADHD, Narcolepsy, and Depression<\/li>\n<\/ul>\n<h3>Sertraline<\/h3>\n<ul>\n<li><span style=\"line-height: 14px;\">Also known as Zoloft, Lustral<\/span><\/li>\n<li>SSRI &#8211; selective serotonin reuptake inhibitor<\/li>\n<\/ul>\n<h3>Depression<\/h3>\n<ul>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">Population affected: 20%<\/span><\/li>\n<li>Depression is a state of chronic stress<\/li>\n<li>CV risk<\/li>\n<li>Diabetes risk<\/li>\n<li>Anatomically there is decreased amount of gray matter in the brain. \u00a0Decreased size of \u00a0Cortex and Hippocampus has been found.<\/li>\n<\/ul>\n<div id=\"attachment_86\" style=\"width: 241px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-86\" class=\"size-full wp-image-86 \" style=\"line-height: 1.714285714; font-size: 1rem;\" alt=\"hippocampus\" src=\"https:\/\/surgerytoday.com\/education\/wp-content\/uploads\/2013\/04\/hippocampus.jpg\" width=\"231\" height=\"218\" \/><p id=\"caption-attachment-86\" class=\"wp-caption-text\">hippocampus<\/p><\/div>\n<p>The hippocampus is involved in several functions of the body including:<\/p>\n<ul>\n<li>Consolidation of New Memories<\/li>\n<li>Emotional Responses<\/li>\n<li>Navigation<\/li>\n<li>Spatial Orientation<\/li>\n<\/ul>\n<h3>Current concepts of depression<\/h3>\n<ul>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">glutamatergic theory of depression: exposition to stressful stimuli increases hippocampal glutamatergic neurotransmission and triggers excitotoxic changes.<\/span><\/li>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">Another theory: depression is closly correlated with neuronal atrophy due to a decrease in BDNF (Brain Derived Neurotrophic Factor)<\/span><\/li>\n<li><span style=\"line-height: 1.714285714; font-size: 1rem;\">Monoamine hypothesis is considered old school: \u00a0deficiency in monoaminergic neurotransmission. \u00a0Monoamines being Catecholamines (NE, DA) and Indolamines (5-HT).<\/span><\/li>\n<\/ul>\n<h3>Results of Star*D Trials<\/h3>\n<p>Sequenced Treatment Alternatives to Relieve Depression<\/p>\n<ul>\n<li><span style=\"line-height: 14px;\">Officed based &#8211; what is done after a patient fails first line treatment for depression?<\/span><\/li>\n<li>Level 1 through Level 3 choices in medication to switch to.<\/li>\n<\/ul>\n<h3>After the lecture: \u00a0What about Acupuncture for Depression?<\/h3>\n<p>I asked Dr. Nadolny about what she thought of <a href=\"http:\/\/www.modestoacupuncture.com\">acupuncture<\/a> for depression. \u00a0And she seemed very excited. \u00a0She said that she didn&#8217;t know that acupuncture was readily available in Modesto, CA. \u00a0I do hope to recommend some of my patients to Dr. Grace Nadolny in the future and other psychiatrists too, because I feel that at times combination treatment with acupuncture and excellent psychiatric care would be of greatest benefit.<\/p>\n<p>Disclaimer: \u00a0I am not an expert on the topic of Depression. \u00a0These are notes from a lecture that I took and feel free to use this as a springboard for your own studies.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1 hour Lecture by Grace Nadolny, MD on 4\/20\/13 in Modesto, CA, CME provided by Sutter Gould Medical Foundation as part of it&#8217;s Subspecialty Lecture Series. \u00a04 hours total of CME was provided. \u00a0Part of the 4 hours of CME included discussion about back pain and ovarian cancer. Why this is interesting to me I [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,11],"tags":[46,44,45,43],"class_list":["post-79","post","type-post","status-publish","format-standard","hentry","category-acupuncture","category-neuroscience","tag-acupuncture-2","tag-anatomy","tag-brain","tag-depression"],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/79","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/comments?post=79"}],"version-history":[{"count":10,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/79\/revisions"}],"predecessor-version":[{"id":84,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/posts\/79\/revisions\/84"}],"wp:attachment":[{"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/media?parent=79"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/categories?post=79"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/surgerytoday.com\/education\/wp-json\/wp\/v2\/tags?post=79"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}