XAll Individual Users: You 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.
XAll Individual Users: You 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.
In this editorial, Larry Culpepper, MD, PCC Editor in Chief, discusses the 3 pandemics currently affecting patients with mental illness and thanks reviewers for their service in 2020.
Rates of treatment resistance in randomized controlled trials in patients with late-life depression are as high as 77% using SSRIs, yet SSRIs are often used as first-line treatment. This CME article helps to optimize the selection of the next step in treating late-life depression.
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.”