Dr Roger S. McIntyre highlights 3 important considerations in the differential diagnosis of bipolar disorder and major depressive disorder: age at onset, episode recurrence, and delayed emergence of mania
Learn how to talk with patients who have major depressive disorder about antipsychotic treatment in a way that is clear and balanced and addresses patients’ potential concerns about taking antipsychotic medication
Learn how simplifying a bipolar disorder treatment regimen, with a single agent acting as the “foundation” and others added when needed, may both improve patient morale and be effective for symptom control
Editor in Chief, The Journal of Clinical Psychiatry, introduces the JCP and describes the virtue of being a “good citizen” in your submissions and correspondence and the importance of building relationships by becoming a peer reviewer and eventually an active Editorial Board member.
Editor of the ASCP Corner shares his thoughts, especially for early career psychiatrists, on writing and submitting your manuscript in such a way as to remove fear from the process and increase your chances of acceptance.
Baclofen, a French Exception, Seriously Harms Alcohol Use Disorder Patients Without Benefit
To the Editor: Dr Andrade’s analysis of the Bacloville trial in a recent Clinical and Practical Psychopharmacology column, in which he concluded that “individualized treatment with high-dose baclofen (30-300 mg/d) may be a useful second-line approach in heavy drinkers” and that “baclofen may be particularly useful in patients with liver disease,” deserves comment.1
First, Andrade failed to recall that the first pivotal trial of baclofen, ALPADIR (NCT01738282; 320 patients, as with Bacloville), was negative (see Braillon et al2).
Second, Dr Andrade should have warned readers that Bacloville’s results are most questionable, lacking robustness. Although he cited us,3 he overlooked the evidence we provided indicating that the Bacloville article4 was published without acknowledging major changes to the initial protocol, affecting the primary outcome. Coincidentally (although as skeptics, we do not believe in coincidence), the initial statistical team was changed when data were sold to the French pharmaceutical company applying for the marketing authorization in France. As Ronald H. Coase warned, “If you torture the data long enough, it will confess.”