Management of resistant depression is challenging, as many patients have tried multiple medications and psychotherapy with no success. This report describes a case of resistant depression successfully treated with an intranasal form of ketamine.
Certain antipsychotics are known to increase weight and the risk for diabetes. Could some medications for diabetes promote not only glycemic control but also weight loss in patients taking antipsychotics? In this CME activity, review the results of a small retrospective study.
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.
Adjunctive atypical antipsychotics can increase antidepressant response in depressed patients, but may cause adverse metabolic effects. This study examines the metabolic effects of adjunctive brexpiprazole in patients with major depressive disorder.
Most agree that a "healthy diet" confers health benefits, but defining "healthy" foods and specific benefits is increasingly confusing. This ASCP Corner article considers the evidence base for dietary interventions purported to have psychopharmacologic properties.
Weight gain is a significant medical problem for psychiatric inpatients. This report outlines the hurdles faced in a previous intervention designed to decrease weight gain in these patients and offers important insight into tackling this issue.
Available data suggest that excess weight and obesity are associated with poorer cognitive functioning and numerous pathophysiologic changes in adults. This post hoc analysis sought to determine whether obesity contributes to worsening of cognition over time in people with bipolar disorder.
How would you help the patient with schizophrenia who believes that suicide is the only way to save his family? What about when he tries to starve himself? Read this case report to see which treatments worked and which didn' t in an effort to treat his negative symptoms.
The literature is replete with interventions to mitigate weight gain in seriously mentally ill patients, but are interventions making a positive impact? This study was undertaken to quantify weight gain in an inpatient setting and to assess whether instituted interventions to reduce weight gain were effective.
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.”