Dr Howard Schneider
Dr Howard Schneider

Practical, Useful Links for Patients

Anxiety -- Don't just rely on medications.
This article is a technical one, but the summary is easy to read -- it shows that meditation may be as effective as escitalopram (Cipralex brand name in Canada) for controlling anxiety. Many of the patients I see have significant anxiety so it is not always reasonable to stop medication, but don't just rely on the medication -- exercise, meditation, psychotherapy, among others, all help. Also, this study used escitalopram, but many of my patients are on different medications because escitalopram may not be the right medication for you (e.g., its interactions with other medications can be dangerous). Again, don't stop medication without speaking to me (or your physician for other patients) (studies like this one are always overly optimistic -- in the real world the results from meditation may not be as powerful) but consider meditation and other techniques to help with anxiety in addition to the medication.




Boost mood and resiliency during the winter months

Depression rates in 2021 rose to 32.8% of all USA adults according to this link, which of course depends on how a depression is defined. However, more people are struggling with depression now. Below are some useful tips from this easy to read article:

1. Experiment with small goals -- what is appropriate for you
(calling a friend, doing work on a certain aspect of one of your projects, going for a walk...)
2. Try to get a full night of sleep

3. Don't stay isolated -- interact with others

4. Exercise day after day -- do whatever is appropriate for you

5. Do things that you like, that make you happy, every so often




Useful book I use with patients for CBT-I (Cognitive Therapy for Insomnia).

"The Insomnia Answer" -- This book is a bit dated and a bit lengthy to read but it was written for the non-medical reader. The authors are PhD's, i.e., non-drug treatment of insomnia, and experts in the area of sleep science. The paperback version is reasonably priced, plus you can find it at many community libraries.

Link at amazon.ca (note: available at other sources, including for free in libraries):




Schizophrenia -- More evidence to keep your mind active -- Cognitive Remediation 

"Cognitive Remediation Therapy" is different than "CBT / Cognitive Therapy/ Cognitive Behavioral Therapy".

If you have been doing cognitive remediation exercises -- keeping your mind active -- whether to help with the long term effects of schizophrenia or bipolar disorder or another disorder -- there is more evidence that these therapies can help. The link to the article below is a bit technical, but it gives more evidence that these techniques work, and it gives a bit more information about them. (Again, "Cognitive Remediation Therapy" is not the same thing as the popular "Cognitive Therapy/CBT.") I will try to post a good link to Cognitive Remediation Therapy for the non-medical reader in the future.







2022 -- Schizophrenia -- Cognitive Remediation Therapy works over the long term

Dr Buonocore and colleagues in Milano, Italy,  looked at a group of patients diagnosed with schizophrenia ten years after they had received Cognitive Remediation Therapy. They found that 10 years later the cognitive and functional improvements that the therapy initially gave the patients was still preserved. 




Anxiety and Depression  -- Significant Reduction in the Risk of Anxiety and Depression is Associated with Cardiorespiratory Fitness

This association study looked at the baseline cardiorespiratory fitness (calculated, i.e., estimated) in over 30,000 people in Norway and the use (estimated from purchase records) of anxiolytics or antidepressants over the next ten years. (These people were part of another large Norwegian health study.) The more fit someone was, the less likley they ended up using these medications, thus suggesting a lower risk of an anxiety disorder or a depressive disorder.  (This association did not hold for people in the study over 65 years old.) While not proving cause and effect, this study is more evidence suggesting that physical fitness may protect against more serious anxiety or depression.


A good quality review/meta-analysis Feb 2024 showed the same results, concluding that " Exercise is an effective treatment for depression, with walking or jogging, yoga, and strength training more effective than other exercises, particularly when intense. "