There's been a bit of upheaval at the house...all will be well, but in the mean time, I'm trying to blog more and get some more clicks over at Psychology Today. Clicks support the writing and research I do and they are much appreciated! There's a new post up about ketamine, the noncompetitive inhibitor of the NMDA receptor that, in one single IV infusion, can alleviate a suicidal depression in about 30 minutes. However, the magic doesn't last, and depression comes back after a week or two. Still, the mechanism and understanding of this phenomenon is important to figuring out the physiology underlying depression.
For right now, ketamine is being used experimentally in hospitals and also in some "salvage" clinics where folks who've responded poorly to other treatments pay for to get a short break from depression. Other NMDA receptor antagonists might be useful drug targets for experimentation...but to be honest glutamate has been the holy grail neurotransmitter for several psychiatric disorders (schizophrenia, major depressive disorder, and bipolar disorder among them) for the past 20 years, and I've not seen anything come of it, or anything new in the drug pipeline that has panned out.
The supplement NAC utilizes the glutamate pathway via a somewhat convoluted mechanism. I've seen it work for obsessive thoughts, hair pulling (but never for picking behaviors in general) and, interestingly, bipolar depression when every other treatment has already been tried. There's only one study for bipolar depression, but the trichotillomania efficacy is solid and NAC should be part of the clinical arsenal for that symptom.
First off there is a brand new post over at Psychology Today. A new case study was recently published about the use of ketone esters, a supplement that raises blood ketones to levels in humans found only with prolonged fasting. A man with early onset dementia, formerly treated with a ketogenic diet, had lasting improvement on 20 months of ketone esters. Interesting stuff.
On the homefront I've been following the Ebola epidemic closely, partially because I have an amateur interest in emerging tropical diseases (I read all those virus hunter books from the 90s), and partially because I went to medical school in Dallas, so I know some of the folks on the front lines, both living in the neighborhoods of the infected and working in the hospitals there.
From what I know, the threat of Ebola (as the virus is now) seems minimal to the general public in the developed world, but it seems abundantly clear after this weekend that ordinary contact precautions (usually gloves, gown, booties, and masks/face shield) in hospitals will not protect the health care workers who are face to face with all those bodily fluids teeming with virus at the sickest stages of the disease. The higher level body suits and meticulous training in PPE (personal protective equipment) found at specialty units and hospitals will be required until everyone gets up to speed.
At the same time, Paul Whiteley tweeted a note from the Lancet with interesting observations about asymptomatic Ebola infections, perhaps quietly immunizing people without causing risk of infections in others.
There's also a terrific Frontline on the Ebola outbreak with all sorts of information about the virus and the experimental drug ZMapp which seems effective (though in very short supply, as in used up for now I think).
The first new post over at Psychology Today is about the big, recently released study shedding some real insight as to how schizophrenia is inherited and what might cause the diseases. It's a game-changer (the findings, not the blog post, though the post was picked as a Psych Today "Essential Read" and "Top Post" for the week).
The short answer is...it's possible, but it's probably not causing your irritable bowel symptoms. That's pretty much the FODMAPs if you respond well to a gluten-free diet.
I'm spending a lot of my free time working on a couple of science fiction manuscripts in a far future after most of the population has been wiped out by gluten (kidding! They are wiped out by something else, but I'll have to publish the book for you to find out, probably).
In the mean time, there's a lot of action about gearing up for next year's conferences. I kept a relatively low profile this year, but I've put in a proposal for the American Psychiatric Association Annual Meeting in Toronto, I'm considering PaleoFx in Austin 2015...and I've also been invited to AHS New Zealand, and can't wait to go.