All neuropsychological testing and CT exercises were performed at

All neuropsychological testing and CT exercises were performed at the University of Northern British Columbia (UNBC) Brain Research Unit. Informed consent was obtained from individual participants as well as their designated caregiver. All procedures and the collection of data were in accordance with UNBC Research Ethics Board’s policy. Inhibitors,research,lifescience,medical Neuropsychological testing The neuropsychological test battery (Table 2) took less than 90 min to complete. It was constructed to include all major cognitive domains, be a reasonable time period to administer, and ensure a sufficient range of difficulty (floor

and ceiling effects) for participants experiencing cognitive impairments. In addition, the Neuropsychiatric Inventory (Basak Inhibitors,research,lifescience,medical et al. 2008) and the disability assessment for dementia (Cherrier et al. 2001) were also EPZ5676 order included to provide indices for functions of ability. Table 2 Neuropsychological test administered. Cognitive stimulation training Sessions occurred four times per week over a 14-week period, and consisted of approximately two weekly 2-h on-site sessions and two weekly 1-h in-home sessions. On-site testing Inhibitors,research,lifescience,medical at UNBC included: (1) navigation task: participants were provided a standard map of the University and asked to find and return from a marked location on the map. Locations were standardized

so each participant went to the same location during the specified training session. (2) Visuomotor training: (a) a commercially available “Plug and Play” “Pac-Man” game was used for VM training. The

rationale for using Pac-Man is that it requires substantial visually guided ability/control to navigate a virtual environment and it automatically Inhibitors,research,lifescience,medical increases in difficulty as the individual improves in ability. (3) Visuoconstruction procedures: this training required participants to complete three tasks. These tasks included variations Inhibitors,research,lifescience,medical in: block design (WAIS-IV), a correct fold task (Abner et al. 2012), and a mental rotation task (Shepard and Metzler 1988). In-home sessions consisted of workbook activities comprising VS, visuoconstructive, and VM tasks (e.g., “find the differences,” “correct fold tasks,” “mazes,” etc.). Participants were encouraged to engage in these Endonuclease tasks for a minimum of two weekly sessions of 1 h each week for the duration of the study; 100% compliance was achieved, as measured through weekly tracking sheets. Data analysis Neuropsychological tests Neuropsychological analysis was used to characterize participant’s level of cognitive ability at both pre- and posttraining sessions. The role of this analysis is to track changes in cognitive performance in a population that we would expect to have a progressive decline in overall cognition (Zanetti et al. 1995). Thus, a reduction in cognitive performance would be expected to be observed particularly when the population is tracked over a course of 4–5 months.

While no drug-drug interactions with OC have been

While no drug-drug interactions with OC have been reported to date with valproate,

lithium, or the atypical antipsychotics, further study is required in women with bipolar disorder. In summary, there is no systematic controlled data to demonstrate that certain treatments or more effective for men and women. Instead, providers should carefully weigh potential side effects and interactions associated with treatments, and the importance of those risks for individual women. Treatment of bipolar disorder during pregnancy and postpartum Medication use during pregnancy We strongly recommend that clinicians Inhibitors,research,lifescience,medical discuss plans for conception with all women with bipolar disorders who arc of childbearing potential. Recent work suggests that when women with bipolar disorder are provided accurate and balanced information about the potential risks and benefits they face, 37% choose not to pursue pregnancy.50 Prenatal counseling should include discussion of possible risks Inhibitors,research,lifescience,medical of taking medications during pregnancy, risks to the patient, and child of escalating or uncontrolled symptoms of bipolar disorder, and the risk of genetic transmission of bipolar disorder to the child.14 In bipolar women who are pregnant,

the use of medications must, be assessed in terms of adverse fetal or neonatal effects, in PD184352 ic50 addition to the usual concerns for effectiveness, tolcrability, and safety Inhibitors,research,lifescience,medical for the mother. Before pregnancy begins, the patient, family, and clinician should detailed a plan of potential interventions in case of recurrences or exacerbations of mood episodes. For example, deciding if electroconvulsive Inhibitors,research,lifescience,medical therapy, which is relatively safe in pregnancy, would be the first choice if a severe depressive episode occurred. One of the most difficult problems for women with bipolar disorder is the lack of effective nontcratogenic treatments. First-trimester exposure to the traditional Inhibitors,research,lifescience,medical mood stabilizers (lithium, valproate, and carbamazepine) is

associated with an increased risk of fetal malformations.51-53 Given this risk, many women with bipolar disorder choose to discontinue medications during pregnancy and sometimes, while trying to conceive. When this is done abruptly, women are at increased risk for relapse. Viguera et al21 reported recurrence rates following lithium discontinuation in a cohort, of 101 heptaminol pregnant and nonpregnant women. Over the 64-week period following lithium discontinuation, recurrences occurred in 85.7% of the prcgnant/postpartum women and 67.8% of the nonpregnant women. Recurrence rates were less when lithium was discontinued via a gradual taper (15 to 30 days). In some cases, it is preferable to continue the medication while carefully monitoring fetal development with high-resolution ultrasound. Once the high risk associated with first-trimester exposure to certain medications has passed, many women who had discontinued medication then consider restarting pharmacotherapy.

Rather, it was only a very simplified model of social behavior th

Rather, it was only a very simplified model of social behavior that failed to capture other important domains of social interaction, for example, communication through verbal language (Duff et al. 2009), nonverbal language (Brune et al. 2009), facial expressions (Mojzisch et al. 2006), and eye contact (Voncken et al. 2006). Future studies may advance our understanding of the social behaviors of depressed patients by involving Inhibitors,research,lifescience,medical more factors of social interaction. Pairing behavioral with neuroimaging studies in the future could

also help unravel the neural mechanisms underlying the behaviors. Moreover, Fujiwara (2009) have recently shown that people who make altruistic financial contributions to individuals other than family members may be at risk of developing major depression. Inhibitors,research,lifescience,medical Therefore, it is difficult to find more conclude that the depressed patients’ special behavioral pattern

in social decision making is the consequence of their mental disorder. Future longitudinal studies may contribute to addressing the causal relationship between major depression and abnormal choices in social decision making. Conclusion People with depression made fewer deceptive and altruistic decisions relative to their Inhibitors,research,lifescience,medical healthy counterparts. The specific behavioral pattern presented by people with depression was modulated by the task factors, including the risk of deception detection and others’ intentions Inhibitors,research,lifescience,medical (benevolence vs. malevolence). These results contribute to furthering our understanding of the specific pattern of social behavioral changes associated with depression. The findings of this study should prompt further experimentation to identify effective interventions for remediating the social behavioral deficits associated with depression in order to promote a quality social life and rewarding social integration Inhibitors,research,lifescience,medical for people with depression. Acknowledgments This project was supported by the May

Endowed Professorship of HKU.
D-Aspartate (D-Asp) is present at multiple Dichloromethane dehalogenase receptor sites in the Aplysia nervous system (Zhao and Liu 2001), and activates a nonspecific cation channel, impermeable to Ca2+, in Aplysia neurons (Carlson and Fieber 2011). In our prior studies, 25% of buccal S cluster neurons and 48% of pleural ventrocaudal neurons had D-Asp-elicited whole-cell currents but lacked L-glutamate (L-Glu) induced responses (Fieber et al. 2010; Carlson and Fieber 2011). Additionally, D-Asp activated currents independently of the L-GluR agonists AMPA and NMDA (Carlson and Fieber 2012). These observations suggest D-Asp activates a dedicated D-Asp receptor, expanding the view that D-Asp acts as an alternate agonist at NMDAR channels (Olverman et al. 1988; Kiskin et al. 1990; Huang et al. 2005), but the identity of these non-L-Glu channels activated by D-Asp is not known.

93 It is likewise unclear if either measure is a better predictor

93 It is likewise unclear if either measure is a better predictor of risk for subsequent decline.88,91 Structural MRI studies have begun to examine medial temporal lobe volumes as predictors of MCI. An earlier study of highly functioning cognitively normal subjects found baseline measurements of hippocampal size to predict subsequent changes in memory performance and the development of MCI.94 More Inhibitors,research,lifescience,medical contemporary studies have analyzed scans at two or more time points to calculate volumetric rates of learn more change.95-98 These studies confirm that higher rates of atrophy affecting medial temporal

lobe structures can predict longitudinal cognitive decline and the emergence of MCI. Such results also highlight the potential for using structural MRI as outcome measures in pharmacological trials targeting MCI Inhibitors,research,lifescience,medical subjects. At

present, however, it is uncertain whether neuropsychological decline can be more robustly detected over a shorter time interval than structural radiographical change. Functional imaging Functional imaging research in MCI has included studies using positron emission tomography pgx), single Inhibitors,research,lifescience,medical photon emission computed tomography (SPECT), functional magnetic resonance imaging (fMRI), and magnetic resonance spectroscopy (MRS). Positron emission tomography PET studies using the radiotracer 2-deoxy-2[18F]fluoro-D-glucose (18FDG)

have been employed for Inhibitors,research,lifescience,medical over 20 years to study regional rates of glucose utilization in the brain. AD patients tend to exhibit characteristic metabolic reductions in the temporal and parietal association cortices99-101; a distribution that coincides with the neuropathological distribution of AD pathology FDG studies in patients with MCI have demonstrated similar topographic patterns, as well as metabolic reductions in the posterior cingulate gyrus.102-106 Subjects at high genetic risk for AD (due to apolipoprotein E4 [ApoE-4] homozygocity) also exhibit glucose utilization Inhibitors,research,lifescience,medical reductions in regions similar to those that become involved in AD.107 Evidence is conflicting concerning the presence of metabolic reductions within the medial temporal anatomy affected in early AD. Some groups have not found differences,108 while others have reported crotamiton decreased glucose utilization rates affecting the hippocampus and other limbic structures including the mammilary bodies, amygdala, and medial thalamus.109,110 One study found metabolic reductions within the entorhinal cortex to be associated with longitudinal decline to MCI and AD.111 These studies, however, draw their conclusions from small samples and purport to measure structures that challenge the spatial resolving power of the equipment.

However, BNZ is associated with enhancing access to emotional mem

However, BNZ is associated with enhancing access to emotional memories (but not to procedural memory). Actually, until the 1970s, one of the major techniques to treat PTSD was via the “benzodiazepine interview,” which used BNZ (or sodium pentothal) in order to help the individual to go through full re-experience of the event. However,

how does this fit with our line of reasoning that reducing fear memory is beneficial? In a small study, Gelpin et al22 compared at 1-and 6-month follow-up individuals who received Inhibitors,research,lifescience,medical BNZ (clonazepam 2.6 mg/day or alprazolam 2.5 mg/day) with those who did not receive it. Out of the 13 who received BNZ, 9 developed PTSD, as compared with 3 of the 13 controls. These findings were also replicated by Mellman Inhibitors,research,lifescience,medical et al in a small study.23 In a unique animal model, which is based on setting affected (rats) apart from the unaffected,24 administration of alprazolam 1 hour after the exposure was associated with significantly more extreme behavioral response (the behavioral equivalent of PTSD) for the rats who were given alprazolam as compared with those

who got saline.25 Hence, some pilot human data, plus a signal from animal studies suggest that early administration of BNZ might interfere with the Selleckchem MLN8237 normal potent spontaneous recovery. Hypothalamic-pituitary-adrenal axis, PTSD, and BNZ Glucocorticoids were found to reduce Inhibitors,research,lifescience,medical phobic fear in humans.26 Individuals with arachnophobia who were injected with Cortisol 1 hour before exposure reported less fear (as measured on a visual analog scale) as Inhibitors,research,lifescience,medical compared with individuals who got saline. Stress is associated with activation of the hypothalamicpituitary-adrenal (HPA) axis, and consequently with secretion of hydrocortisone. What is the effect of BNZ on this normal, primary cornerstone of the normal response to stress? What is the effect of BNZ on Cortisol? Why does administration of BNZ seem to interfere with the normal recovery process? Administration of BNZ abolishes the expected activation (the normal response) of the HPA axis. Inhibitors,research,lifescience,medical The HPA axis is the main component in the

neuroendocrine response to acute and chronic stress (Figure 4). In response to stress, a chain of reactions Linifanib (ABT-869) stimulates the adrenal cortex to synthesize and release glucocorticoids, in particular Cortisol. These hormones are instrumental in adaptation to stress.27 A main function appears to be in the regulation and containment of the sympathetic and parasympathetic responses to stress (ie, changes in heart rate, blood pressure, respiration), responses that help the body accommodate to an immediate demand. In animal studies, it has been demonstrated that blunted HPA-axis response increased PTSD-like reactions in rats exposed to trauma,28 which strengthens the notion that an intervention aimed at bolstering this natural response with an early intervention immediately after the trauma could help reduce PTSD (Figure 5). Figure 4. The hypothaiamic-pituitary-adrenal axis. Figure 5.

This would suggest that SULT1E1 may protect peripheral tissues fr

This would suggest that SULT1E1 may protect peripheral tissues from an excess of estrogens. Various SNPs has #BMS-754807 purchase randurls[1|1|,|CHEM1|]# been detected in the human SULT1E1 gene, and some are linked to the recurrence

of hormone-dependent cancer [29]. 4. Enzymes in the Sulfatase Pathway in Estrogen-Associated Cancer Data on the expression of enzymes in the sulfatase pathway in some estrogen-associated cancers are given in the following sections. Generally, the data on the expression of enzymes for the formation of E2 are rather inconsistent. This might be due to the fact that expression of enzymes in the estrogen metabolism and the Inhibitors,research,lifescience,medical concentration of circulating steroids are highly variable even in healthy persons, and they are even more varying in patients with cancer. Therefore, selection of patients with defined clinical parameters is important for studying these pathways. Cancer in a certain organ is not a uniform disease. A specific histological pattern and the molecular

Inhibitors,research,lifescience,medical signature allow division of most hormone-dependent cancers into various subgroups. These are subgroups of Inhibitors,research,lifescience,medical cancer in a certain organ which have a different etiology and will produce a different response to a certain therapeutic regimen. However, even in a defined tumor type, there are great variations in the expression levels of different proteins in different tumor regions. This means that the expression in the tumor center can be completely different from that in one tumor front adjacent to the tumor center or in the front adjacent to the noncancerous tissue. So far, most studies were done in rather heterogeneous collectives of patients with Inhibitors,research,lifescience,medical a certain tumor in an organ. Also, assessment of

target proteins by immunohistochemistry was mostly done on undefined tumor regions. This may explain the often conflicting data on the expression of enzymes and targets in molecular pathways [30]. 4.1. Breast Cancer Breast cancer remains Inhibitors,research,lifescience,medical the leading cause of cancer in woman worldwide. It occurs in both men and women, although male breast cancer is rare (approx. 1% of the rate in women) [30].In 2008, the estimated incidence of breast cancer in woman was 1,384.155 cases, and the mortality was 458.503 cases [31]. Estimated new cases and deaths from breast cancer in women are 226.800 and 39.510 women in the United States in 2012 [30]. More than 70% of breast many cancers express ERs and progesterone receptors, PG-A and PG-B. Therefore, a major concern is whether or not the application of hormone replacement therapy (HRT) would increase the risk of breast cancer in postmenopausal women. According to the 2012 analysis published in the Cochrane Database Syst. Rev., hormone-replacement therapy with estrogens only did not increase the risk of breast cancer in postmenopausal women at a mean age of 60 years, but the combined continuous therapy with estrogens and progesterone-derivates significantly increased the risk for this cancer [32].

2009) In general, the association between DA activity and depres

2009). In general, the association between DA activity and depression (Dunlop and Nemeroff 2007) is based on the fact that the neurotransmitter DA is involved in approach behavior (Schultz 1998) and depression is related to deficits in the approach system selleck compound associated with reduces positive affect (see Shankman and Klein 2003 for a review). To sum up, contrary to empirical findings mentioned above prominent personality theories postulate orthogonality of personality dimensions, but growing empirical evidence indicates a negative correlation between traits of positive and NEM (for an overview see Reuter 2008). Heritability estimates

for personality traits as Inhibitors,research,lifescience,medical well as for psychopathologies are rather high indicating that the genetic background (genotype) of a person accounts substantially for individual differences in behavior and the predisposition to psychiatric disorders. Genetic association Inhibitors,research,lifescience,medical studies provide considerable evidence that DA genes are associated with personality traits and a range of psychiatric phenotypes. For instance, for the well-studied DA candidate genes coding for catechol-O-methyltransferase (COMT) and DRD2, a significant

interaction for the total Behavioral Activation System Inhibitors,research,lifescience,medical (BAS) scale related to PEM and also higher scores on extraversion and PEM for COMT valine (Val) allele carriers have been reported (Reuter and Hennig 2005; Reuter et al. 2006). In line with the “Yin and Yang principle of dopamine” results for the COMT polymorphism showed an association Inhibitors,research,lifescience,medical of the methionine (Met) allele with personality traits primarily related to NEM (Enoch et al. 2003; Eley et al. 2003; Rujescu et al. 2003). Despite this convergent evidence, the proportion of variance accounted

for by a single polymorphism is rather low. Complex phenotypes of high heritability such as personality traits are influenced by the interplay of many Inhibitors,research,lifescience,medical different genes (Reif and Lesch 2003), resulting in a wide variance of individual behavioral dispositions. In order to investigate the role of the DA system for personality, we have to keep in mind that DA genes interact to determine the efficacy of the DA system by influencing the expression and distribution of the gene products within Cediranib (AZD2171) the brain. In particular, DA activity depends on synthesis rates, catabolism, and receptor density but also on further enzymes and proteins regulating DA neurotransmission (see Opmeer et al. for an overview). Numerous polymorphisms in the corresponding genes can have major influence on DA metabolism and neurotransmission. A vast body of evidence from studies in humans as well as animals illustrates the pivotal role of COMT and the dopamine transporter (DAT1) in DA neurotransmission.

PD symptoms reportedly occur in over 50% of all elderly patients

PD symptoms reportedly occur in over 50% of all elderly patients receiving these agents and the cumulative annual incidence of TD in middle-aged and elderly patients is over 25%.56 The likelihood of reversing this potentially debilitating condition XAV-939 clinical trial diminishes with age. Other adverse effects of these agents that are often intolerable in the older population include orthostatic hypotension and anticholinergic effects. Orthostasis is estimated

to occur in 5% to 30% of geriatric patients and is a major contributing factor to the occurrence of falls.57 The Inhibitors,research,lifescience,medical elderly are also more prone to the consequences of falls, such as bone fractures, injuries, and dependency. Low-potency antipsychotics and clozapine are more likely to cause significant drops in orthostatic blood pressure. Anticholinergic effects in the elderly may cause side effects, such as constipation, dry mouth, urinary retention, and cognitive impairment. The elderly are especially sensitive to these effects and the Inhibitors,research,lifescience,medical use of laxatives or stool softeners is already

particularly high in nursing homes. Cognitive impairments may lead to decreased independence, and a more rapid decline in cognitive functioning may occur in the elderly treated with antipsychotics than in the younger adult population. Clozapine has been used successfully in the elderly Inhibitors,research,lifescience,medical population at lower doses than adult patients. Mean dosages range from 50 to 300 mg/day with a much slower rate of titration. Inhibitors,research,lifescience,medical This may be a good choice for treating psychotic elderly patients with preexisting

PD, because of its lower affinity for D2 receptors in the striatum. Clinically, however, it is a poorly tolerated antipsychotic in geriatric patients and should Inhibitors,research,lifescience,medical be used with caution. The risk for agranulocytosis appears to be about 4% in the elderly population with older women being at highest risk.58 The risk for seizure activity is increased in the elderly59 and sedation is one of the major reasons for discontinuation.60 Clozapine therapy should be initiated at 12.5 to 25 mg/day given in two divided doses, titrating by increments of 12.5 Cell press mg over 5 to 7 days. Controlled studies examining the efficacy of clozapine in the elderly specifically for patients with schizophrenia are rare. Howanitz and colleagues61 studied clozapine (maximum 300 mg/day) compared with chlorpromazine (maximum 600 mg/day) in a 12-week, double-blind fashion in patients with chronic schizophrenia. Patients on clozapine tended to do better than the chlorpromazine group, although this did not reach significance, probably due to the sample size.62 Tachycardia and weight gain were problematic for clozapine-treated patients, while those treated with chlorpromazine were highly sedated. Clozapine should be used as a last resort in geriatric patients with schizophrenia and at least one trial of an SGA should be made first.

However, recent studies utilizing current standard chemotherapy

However, recent studies utilizing current standard chemotherapy with or without biologic

agents have reported a median overall survival of 10-15 months in patients with colorectal peritoneal carcinomatosis (5,6). These VX-689 supplier results underscore the decreased efficacy of systemic treatment in the setting of PC, when feasible CRS and HIPEC should be considered as the standard treatment for patients with colorectal cancer peritoneal carcinomatosis. As described in the review article cytoreductive surgery Inhibitors,research,lifescience,medical is a major surgical procedure with significant morbidity. However, in appropriately selected patients the risk-benefit ratio favors an aggressive treatment approach. Extent of peritoneal dissemination, measured as peritoneal cancer index (PCI) and the completeness of cytoreduction Inhibitors,research,lifescience,medical have been indisputably shown to be major predictors of outcome (7). Patient selection is a challenging task, as the risk-benefit ratio is influenced by multiple factors. In addition, the ability to accurately estimate the extent of peritoneal Inhibitors,research,lifescience,medical dissemination and predicting the chances of complete cytoreduction is far from perfect. Esquivel and Pelz have proposed a peritoneal surface disease severity (PSDS) scoring system based on symptoms, extent of disease

and histology to stratify patients with colon cancer peritoneal carcinomatosis into different prognostic groups that may aid in patient selection for different treatment (8). The risk-benefit ratio for CRS and HIPEC not only depends on the ability to achieve complete cytoreduction but on the biologic aggressiveness of the tumor, Inhibitors,research,lifescience,medical which is heavily weighed into the PSDS score.

Multi-institutional prospective validation studies are required to assess the clinical utility of the PSDS scoring system. Finally, the importance of measurement of health related quality of life (HRQoL) cannot be overemphasized in patients undergoing CRS and HIPEC. The authors have provided a comprehensive Inhibitors,research,lifescience,medical review of the available scoring systems and the data for QoL. Most studies report a decrease in the quality of life up to six months after CRS and HIPEC, with improvement in majority of patients at one year. This should be taken into consideration while counseling patients about the outcomes of CRS and HIPEC. In summary, management of patients with peritoneal carcinomatosis is complex and requires CYTH4 a multidisciplinary approach. Proper patient selection for CRS and HIPEC based on favorable risk-benefit ratio is of utmost importance. Management should focus on both cancer-specific outcomes and quality of life. Acknowledgements Disclosure: The author declares no conflict of interest.
Fifty one patients received 57 stents because of oesophageal cancer. Mean survival after stent placement was 141 days. No case of perforation occurred. In nine cases (17%) clogging with food occurred. Tumour overgrowth was noted in four cases.

This remarkable and immediate antidepressant modality has been re

This remarkable and immediate antidepressant modality has been recognized for 30 years, but is little used in everyday clinical practice. Perhaps it is the paradox of taking sleep away from the depressive insomniac that has a negative connotation for both patient and psychiatrist (“wake therapy” would be a more positive alternative name). Perhaps it is also the short-term nature of the response

that has hindered its use, though the magnitude of the clinical changes brought about by sleep deprivation still remain highly intriguing and may provide clues for understanding the pathophysiology of depression. Sleep deprivation Inhibitors,research,lifescience,medical is the paradigm par excellence for depression research: rapid, nonpharmacological, and short lasting. It may be the nonpharmacological Inhibitors,research,lifescience,medical nature of sleep deprivation (it cannot be patented) that has contributed to its status as an “orphan drug.”67 It is surprising that no pharmaceutical company has focused on this model to search for that much-needed rapid-acting antidepressant.8 This lack may be remedied in the future; new research reveals that, whereas Inhibitors,research,lifescience,medical sleep induces very few genes, wakefulness increases expression of several groups of genes,68 and here comparisons with

the effects of antidepressant drug treatment may narrow down the candidates. Some committed proponents of sleep deprivation have recognized its clinical usefulness to initiate rapid improvement, particularly in Inhibitors,research,lifescience,medical the most signaling pathway severely depressed

patients in whom time is of the essence. Sleep deprivation is effective in all diagnostic subgroups of depression. The problem is the relapse after recovery sleep, and new strategies have sought treatments to prevent this. Response appears to be well maintained by treatment with lithium, antidepressants (in particular SSRIs), or the 5-HT1A receptor antagonist pindolol, Inhibitors,research,lifescience,medical as well as nonpharmacological adjuvants such as repetitive transcranial magnetic stimulation (rTMS),69 light therapy, or phase advance of the sleep-wake cycle, or various combinations thereof (see, for example, reference 36 and 70, reviewed in reference 8; Table I). Light therapy Light therapy can be considered to be the most successful clinical application of circadian Cell press rhythm concepts in psychiatry to date. Light is the treatment of choice for SAD.71 The quality of recent SAD studies has been exemplary, and the response rate is well above placebo (in fact, superior to analogous trials with antidepressant drugs).72 The success of this nonpharmacological treatment has been astonishing, but it has taken rather long for light therapy to be accepted by establishment psychiatry,72 and trials of other indications are still in the research phase. Its very success in SAD has limited use in other forms of depression (characterized as “it’s a chronobiological treatment for a chronobiological subset of depressive patients”).