I get this question a good deal. I think it’s probably somewhat confusing as to what we do and we offer a lot of procedures and products. Basically we are a two surgeon medical group offering services in Veins, Acupuncture, Plastic Surgery, and General Surgery. That can be quite a lot. But even with that said, it’s somewhat confusing as to what each of these items involves. So I thought I’d make a list which doesn’t include everything, but covers most of what we do:
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’s Subspecialty Lecture Series. 4 hours total of CME was provided. Part of the 4 hours of CME included discussion about back pain and ovarian cancer.
Why this is interesting to me
I have learned some of this before in my NeuroScience years at Brown University. It was good to review.
I have an acupuncture practice which has a good number of patients with depression.
Learning points (not all points were made in the lecture, but they were learning points for me):
Evidence Based medicine supported treatment of depression
includes the use of methylphenidate, exercise, and sertraline
NE and DA reuptake inhibitor. (Norepinephrine adn Dopamine)
Used for ADHD, Narcolepsy, and Depression
Also known as Zoloft, Lustral
SSRI – selective serotonin reuptake inhibitor
Population affected: 20%
Depression is a state of chronic stress
Anatomically there is decreased amount of gray matter in the brain. Decreased size of Cortex and Hippocampus has been found.
The hippocampus is involved in several functions of the body including:
Consolidation of New Memories
Current concepts of depression
glutamatergic theory of depression: exposition to stressful stimuli increases hippocampal glutamatergic neurotransmission and triggers excitotoxic changes.
Another theory: depression is closly correlated with neuronal atrophy due to a decrease in BDNF (Brain Derived Neurotrophic Factor)
Monoamine hypothesis is considered old school: deficiency in monoaminergic neurotransmission. Monoamines being Catecholamines (NE, DA) and Indolamines (5-HT).
Results of Star*D Trials
Sequenced Treatment Alternatives to Relieve Depression
Officed based – what is done after a patient fails first line treatment for depression?
Level 1 through Level 3 choices in medication to switch to.
After the lecture: What about Acupuncture for Depression?
I asked Dr. Nadolny about what she thought of acupuncture for depression. And she seemed very excited. She said that she didn’t know that acupuncture was readily available in Modesto, CA. I 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.
Disclaimer: I am not an expert on the topic of Depression. These are notes from a lecture that I took and feel free to use this as a springboard for your own studies.