When patients present for treatment of anxiety or mood disorders, do you consider whether there is also an untreated substance use disorder? Check out these data on disorder prevalence and treatment rates.
Opioid withdrawal can lead to abnormal cardiac function. This case report illustrates use of the naloxone challenge test in a patient with cardiac comorbidities who received naltrexone LAI for opioid use disorder.
As of March 2019, "medical marijuana" has been approved in 33 states; however, these products are not FDA-regulated. This article summarizes the evidence for marijuana in psychiatric indications, as well as risks, side effects, and drug interactions.
Are foreign-born Mexican Americans and non-Hispanic whites at higher risk for substance use and psychiatric disorders compared to their US-born counterparts? Read this article to find out more about this important topic.
Although possible connections between mental illness and crime often attract national attention, there are currently no estimates of the relationship between DSM-5 psychiatric disorders and crime among US adults. This study aims to reduce that knowledge gap—read this article to see if connections were found.
This case report describes the symptom progression of a 24-year-old man who used high doses of crystal methamphetamine for 10 days and then developed superior vena cava syndrome as well as persistent psychotic symptoms in the ensuing months. The authors then discuss a possible link between the physical and psychiatric symptoms.
Are heavy drinkers more likely to die by suicide at a particular time of the day? This study used a large database to examine circadian peaks and nadirs in suicides. Read the article to see if the time of day of the suicidal act differed in heavy drinkers versus individuals who were not alcohol-dependent.
Urine drug screens are often followed by confirmatory gas chromatography/mass spectrometry (GC/MS) tests. Periodically, GC/MS tests can have false-positive results. Read this case of a man with a past history of opioid use disorder, currently in remission, who tested positive for methamphetamine.
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.”