Clozapine is indicated for treatment-resistant schizophrenia (TRS), but many patients do not adequately respond. This study evaluated the combination of long-acting injectable antipsychotics and clozapine in TRS using various outcome measures.
The COVID-19 pandemic is a significant psychological stressor, impacting every facet of life. Here, read the case of a 37-year-old woman who developed mania, which was precipitated by stress related to COVID-19, 17 years after her last episode
First-line treatments for OCD include selective serotonin reuptake inhibitors and cognitive-behavioral therapy. But what do you do when patients do not respond to these or second-line strategies? In this journal CME activity, explore the option of deep brain stimulation.
Women who take mood stabilizers have a greater risk of placenta-mediated pregnancy complications. But are the mood stabilizers themselves responsible for this higher risk? This study explores that question.
Clozapine is essential for the management of treatment-refractory schizophrenia, but its use is often limited by side effects. Read this report of a man who developed dysarthria and delirium after receiving subtherapeutic doses of clozapine.
When treating patients with schizophrenia, achieving stable, long-term remission is an important step toward the goal of functional recovery. This study evaluated the effect of cariprazine on several measures of sustained remission. Read the article to see if the medication outperformed placebo.
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.”