FM Talk 1065 Podcasts
Time for a Check Up with Dr Kevin Purinta from Altapointe Health
(upbeat music) - This is Midday Mobile with Sean Sullivan on FM Talk 1065. - All right, welcome back to Time for a Checkup on Midday Mobile here on FM Talk 1065. Dr. Kevin Pretena, with Alta Point joining me. Good to see ya, good to meet ya. - Good to meet ya as well, sir. - And this is interesting news out that you have a new treatment for depression. And you hear treatment for depression a lot. You don't hear new treatment for depression a lot, at least from in my world. - Right, right, it's been really 30 years, 40 years since we've had a big breakthrough. - That long, four decades, so what, okay, now you got my attention, what are we talking about? What happened, what is this? - So previously the big breakthrough was kind of the advent of the SSRI's Prozac being the big one in about 85 or so. Recently though, there've been a lot of breakthroughs as far as transcranial magnetic stimulation, Spervato, intranasal ketamine, which Alta Point Health is now providing for patients on a pretty frequent basis here. - Is this a standalone treatment in this conjunction with other things? Where does this come in? - So both of these treatments are gonna be done in conjunction with a standard antidepressant medication, at least one, but generally, a lot of times patients who come to us to get these treatments are on at least one or two medications as is. So it's kind of to add on to in addition to whatever they're taking. - But what about that? - I've heard people talking and number one, I want to talk about like, seasonally, or people you get more people this time of year say, you know, hey, I'm feeling depressed or something like that. It's a seasonal thing. And then beyond that, the medications do people need to change because the body gets used to it. I don't have the right terms, doctor, but you know what I mean? So those two things. - Right, so occasionally you'll see where the medications just lose their effectiveness over time. So that's a thing that happens, right? - Definitely, definitely for a good amount of people, they'll lose effectiveness over a couple years maybe, sometimes for a couple months for people. So these treatments are really indicated for what we call treatment resistant depression. So these are gonna be patients who, maybe they've tried three, four, five different antidepressant medications, and maybe they've been successful for a period of time and maybe they've not at all. But these are gonna be generally patients who have tried multiple medications and found that they've not been entirely helpful. - This is probably great news for patients out there that said maybe this can't be helped and now there's something new. - Right, because probably about a third of patients who suffer from severe depression are gonna find that they don't get much help if any from the traditional medications. So this opens up a lot of evidence. - What percent? - Probably about a third of them. - Wow, that's a whole bunch of Americans out there, a whole bunch of folks locally. - It is, I mean, somewhere between 10, 20% of Americans throughout their lifetime are gonna suffer from major depressive disorder. So if you think of about a third of those patients, that's a lot of people who could benefit from one of these new therapies. - And once again, come back to this, before we finish up, the name of this, if somebody's asking you all for it, is what? - So one of them is transcranial magnetic stimulation, also called TMS, and the other one is Spervato, which is an intranasal medication. - Really? 'Cause you always think, I always gotta be a pill, but you're not putting a pill in my nose. - No, no, so it kinda looks kinda like a bottle of flonase, almost, like you spray it up your nostril, and then you spray it up the other nostril, and then we monitor patients for two hours after they get the medication, just to make sure that they're safe, because these medications can alter blood pressure. - Okay. - But generally they're safe and effective for most people. - How do we navigate, I talked about this time of year, and whatever, but I mean, it's not as bad, I guess, here, as it would be up north, but people, how do they know if they've got depression, or they're feeling depressed? Is there a difference between, I'm feeling depressed doesn't mean you have depression, does it or? - Right, so really when you look at the DSM-5 criteria for major depressive disorder, you've gotta have either true depressed mood, or anhedonia, which is kind of the lack of interest in things, that can be a partial anhedonia, where they don't really feel interested in doing the things they wanna do, or that could be full anhedonia, where they don't want to do anything. You have to have one of those two to be diagnosed with major depression, but you have to have at least five symptoms of depression for two weeks, consistently, to have major depressive disorder. So those symptoms will be depressed mood, anhedonia, difficulty sleeping, excessive feelings of guilt, hopelessness, or worthlessness, reduced energy, reduced concentration, changes in appetite, what we kinda call psychomotor agitation, or psychomotor retardation, where patients maybe move a little bit slower than normal, or maybe feel more irritable than normal. So those symptoms, if you have five of those symptoms for two or more weeks, that would count as a major depressive disorder. - How do you gauge that in somebody like grief? Like somebody loses love on family members, something like that, and so maybe those things you said, you feel that, and you may feel it for weeks, or longer. Are you, has a chemical changed in that person versus somebody who has a disorder with depression? - So you'll see there's kind of a big spectrum of grief, where sometimes people will grieve and it will look exactly like depression. A lot of times people have some of these symptoms, but not all of these symptoms while they're grieving, or they might not have all five of these symptoms that they need consistently. One big thing to kind of differentiate grief from a major depressive disorder is the level of disability that you often see. A lot of times people with major depressive disorder are gonna have their depression be so severe that they're missing time at work, they're neglecting, spending time with people they care about, maybe they're intentionally isolating themselves from friends, from family. A lot of times people who are grieving, and not to downplay how serious grief can be, a lot of times people who are grieving will actually find comfort and solace and spending time with those other people, or they'll say, going to work has helped keep me active and has helped keep my mind off of this, whereas with depression a lot of times, the depression forces them out of those things that they know they'll enjoy. - Wow, that's the best explanation. I've always wondered that. I'm like, you know, is that the same, but it is not exactly the same. But if people have been dealing with this over time, or maybe this is new to them, they need to get in touch with y'all at Altopoyne. - Yes, sir. - Yes, sir. - Yeah, Dr. Padina, tell us how to do that. So we have an access to care line that patients can call, and that phone number is 251-450-2211. And that'll get you in touch with somebody where we can schedule an appointment. What we do here is once you get ahold of somebody on that line and they'll take down your information, they'll schedule a consultation with myself so that I can evaluate you and kind of help determine is one treatment more appropriate than the other. Maybe we need to try more antidepressants because some insurance companies will have different recommendations as far as treatment length, the number of treatments tried. So I'll be able to do that consultation. I also do a pretty thorough medical evaluation to make sure there wouldn't be a contraindication health-wise that people couldn't get one treatment or the other. - Okay, so you gotta look at that before you decide what's right for that patient? - Yes, sir. - Yes, sir. - All right, well, we'll talk more about this going forward. Pleasure meeting you. - Yes, sir. Pleasure meeting you. Thanks, Kevin Patena with UltaPoint, right here on Midday Mobile, and it's time for a checkup. (upbeat music) (upbeat music) (upbeat music)