In this webcast about early-stage Alzheimer disease, Drs Burke and Apostolova highlight important conversations to have with patients and their care partners on topics such as diet, exercise, driving, and plans for the later stage of illness.
Patients with psychosis are too often diagnosed with primary schizophrenia when the psychotic symptoms may actually be the manifestation of neurologic, endocrine, or immunologic disease. Learn about alternate diagnoses in this CME journal article.
Tardive dyskinesia must be detected early to minimize the risk of permanence. Do you know how often to screen patients and how to conduct an evaluation? Dr Stephen Saklad provides a refresher in this brief CME activity.
Data are lacking on how best to manage hypertension in patients experiencing alcohol withdrawal. Dr Bojdani and colleagues offer strategies for addressing hypertension in patients detoxifying from alcohol.
Children who have experienced victimization such as maltreatment or violence are at risk for problems that include, but extend beyond, PTSD. To guide assessment and treatment of these youth, the authors of this article propose criteria for a developmental trauma disorder diagnosis and evaluate the psychometrics of a new scale, the DTD-SI.
Could collaborative care be especially beneficial in certain youth with depression? Researchers enrolled patients in a collaborative care treatment model and then looked at program graduation rates in light of baseline scores on depression, anxiety, and substance use assessments. Read this CME selection and see if they were able to identify predictors of remission.
Symptoms of behavioral variant frontotemporal dementia can be identical to those of psychiatric disorders such as major depression, bipolar disorder, and schizophrenia. How can you tell the difference? This study looked at clinical predictors that differentiate patients with bvFTD from patients with primary psychiatric diagnoses.
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.”