Dr Andrade discusses the findings of a meta-analysis and two recent RCTs that indicate fluoxetine may not be a good choice in patients recovering from stroke.
Recent promising data indicate that neuroactive steroids could have a role in treating depression. This article discusses the mechanisms behind potential beneficial effects in premenstrual dysphoric disorder as well.
β-Blocker treatment has long been associated with depression, but is there more to the story than meets the eye? Dr Andrade considers the findings of a recent large meta-analysis—and why the question remains to be settled.
A wide range of psychological outcomes have been observed during the COVID-19 outbreak. Patients often experience the fear of getting sick or dying and feel helpless or stereotyped by others. Read this case report to find out more.
For patients who have PTSD and also have a severe mental illness, can psychotherapies for PTSD still be effective? If so, what component might offer greater efficacy?
Is ECT an effective treatment option for severe and refractory manifestations of somatization disorder? In this review, the authors investigate the efficacy, safety, and tolerability of ECT in somatization disorder.
ECT may be a successful treatment for some cases of tardive dyskinesia. In this review, the authors accumulate all the recent evidence for the efficacy of ECT in treating tardive dyskinesia and make recommendations following data analysis.
Here, read about the case of a patient who met some criteria for depression with seasonal pattern and seasonal affective disorder, but not all, posing a diagnostic dilemma. Could agomelatine be a possible treatment option?
Could increased social cohesion through shared experience mitigate the impact of pandemics on suicide rates? Here, the authors explore the impact of the 1918–1920 influenza pandemic on suicide rates and discuss their findings in the context of COVID-19.
Vilazodone is a novel dual-acting selective serotonin reuptake inhibitor approved for treatment of adult depressive disorders. Here, read about a case of serotonin syndrome in a young woman with suicidal vilazodone overdose with no coingestion.
The pandemic has clearly placed a tremendous strain on health care workers, but how has it affected their ability to function in their daily lives and the likelihood of burnout? This large survey from a New York hospital provides some answers.
The authors of this study assessed the impact of folinic acid supplementation in geriatric inpatients by studying days of clinically needed hospitalization. Read on to find out more about this important topic.
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.”
MY ACCOUNT