XYou may have noticed, we have just launched our new website. We will be adding more features over the upcoming weeks that you will like, so there may be a few hiccups along the way. If this is your first time visiting since our relaunch, please reset your password so you can still access our journals and CME activities that we have been providing for over 80 years. If you have any questions or comments please contact us at webadmin@psychiatrist.com.
XYou may have noticed, we have just launched our new website. We will be adding more features over the upcoming weeks that you will like, so there may be a few hiccups along the way. If this is your first time visiting since our relaunch, please reset your password so you can still access our journals and CME activities that we have been providing for over 80 years. If you have any questions or comments please contact us at webadmin@psychiatrist.com.
Assertive community treatment (ACT) teams are an underutilized medical student teaching tool. This article describes the history, evolution, and structure of an ACT program and includes student reviews.
Was the adverse event caused by the drug or by the condition itself? In this installment of his column, Dr Andrade points to the importance of controlling for confounding by indication in observational studies.
Do resident physicians tend to have negative attitudes toward patients with mental illness and substance use disorders? This study explores residents' attitudes and offers solutions to improve them. Read on to find out more.
Do you know what to say if a patient asks about genetic testing for a particular condition? This review from the International Society of Psychiatric Genetics discusses challenges and presents recommendations about the need for informed genetic counseling in psychiatry. Read the article and delve into this increasingly important topic.
Patients increasingly want to use their mobile devices to obtain health content. Could utilization of adaptive text message programs that provide specific health messages based on patient input be an effective way to promote health? Read this informative article to find out more.
Turner syndrome is a genetic disorder in females characterized by partial or complete X chromosome monosomy. These individuals are at increased risk for autism spectrum disorders, ADHD, intellectual disability, and schizophrenia. Read this case of a woman with Turner syndrome who experienced psychotic symptoms. Could she have schizophrenia?
Treatment nonadherence is bipolar disorder ranges from 20% to 60%. Read this article to learn how customized adherence enhancement (CAE)—a brief, bipolar disorder-specific approach that targets individual adherence barriers—compared with an education control in patients with bipolar disorder.
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.
Routine urine drug screening in research trials is an underappreciated risk for trial participants. Here, the authors present a case of lamotrigine cross-reactivity with phencyclidine in a clinical trial in which a positive test result was an exclusion criterion and discuss the implications.
Currently, there are no comprehensive guidelines for sedative-hypnotic use in patients with mental illness. Patients taking sedative-hypnotics are more likely to suffer from adverse drug events, including death, compared to patients not taking sedative-hypnotics. This article describes the effect of a multimodal intervention targeting chronic benzodiazepine and sedative-hypnotic prescriptions in a large behavioral health system.
It's been shown that educating patients about potential adverse effects of a drug can increase the chances that those effects will be experienced. Here, Dr Andrade compares ways in which clinicians can deliver important information about side effects so that placebo-related benefits are enhanced and nocebo-related harm is minimized.
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.”