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
This commentary discusses the findings of a recent study by Maccariello et al on the prevalence and predictors of switch to depression in bipolar patients who recently initiated or changed pharmacologic treatment for mania or mixed-mania.
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.
Misophonia is a condition in which repetitive, pattern-based sounds lead to abnormally strong aversive emotional responses and behavioral reactions. This report describes a case of chronic and severe misophonia in a patient with bipolar II disorder.
Bell's mania, also known as delirious mania, is characterized by the overlap of the symptoms of delirium and mania. This case report highlights the importance of proper diagnosis and clinical management.
Serotonin syndrome can be challenging to recognize. Read this report of serotonin syndrome resulting from use of dextromethorphan-based cough medicine in addition to multiple antidepressant and pain medications.
Management of psychiatric illnesses in patients with comorbid medical conditions can be challenging. This report describes the case of a renal transplant patient whose bipolar disorder worsened after taking the immunosuppressant tacrolimus.
Guidelines lay out strategies for maintenance treatment of bipolar I disorder, with an algorithm for pharmacologic and psychosocial interventions. Dr Suppes describes guideline recommendations and situations when you might need to vary from the algorithm.
When should you rely on top-ranked treatment options for acute bipolar mania, and when should you skip down to lower-ranked options? In this brief CME activity, expert Dr Suppes describes guideline recommendations and provides a case illustration.
Patients with severe mental illness tend to have a higher prevalence of metabolic disorders. This review updates the current evidence on the effectiveness of add-on medications to treat weight gain in patients with severe mental illness.
Since 2013, when DSM-5 was published, a third of the patients previously diagnosed with bipolar disorder no longer qualify as having the disorder. So what does this say about those who did meet the stricter DSM-5 criteria?
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.”