Mechanically ventilated ICU patients experience fear, anxiety, and loneliness. This report highlights 3 COVID-19-positive ICU patients with tracheostomy to show the importance of early and consistent use of benzodiazepines for anxiety management.
How do psychological factors contribute to the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS)? Read this case of a patient who completely responded to rTMS in relapse periods, even with a single session.
This analysis of data from 2 clinical trials examined the effect of benzodiazepines on outcomes in older patients with generalized anxiety disorder or major depressive disorder, including the likelihood of dropout, adherence, and treatment response.
Excessive and inappropriate emotional expressions may be exhibited months after a patient's stroke. Traditional SSRIs may help for a while, but as brain stem lesions progress, drugs that target other receptors may be necessary to treat chronic PSEI.
Although depression guidelines discourage monotherapy with benzodiazepines, patients with depression continue to receive benzodiazepine monotherapy. This study evaluates the prevalence and predictors of benzodiazepine in depressed patients.
Anxiety complaints are common among older adults, especially those with chronic illnesses. This narrative review describes the characteristics of common anxiety disorders among older people and provides treatment guidelines.
When you treat youth with anxiety disorders, are your decisions evidence-based? This meta-analysis examined efficacy and tolerability of agents studied for pediatric anxiety in double-blind, placebo-controlled trials. Read the article to learn which medication class fared best.
Benzodiazepines are used widely for anxiety and insomnia, but what proportion of users are misusing them? This analysis of National Surveys on Drug Use and Health data considers correlates of different levels of benzodiazepine use and the motivations for misuse, with the goal of identifying those who may be at risk.
Many patients with panic disorder have short-term response to psychotherapy, but subsequent relapse can occur. Read this article to learn if treatment gains achieved with 3 different psychotherapies were maintained after 6 months and 1 year.
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.”