OCD, when it becomes chronic, rarely can manifest with secondary physical conditions. Here, the authors report the case of a young man who developed hemorrhoids and life-threatening anal bleeding as a result of OCD.
Here, read about a case of atypical Wernicke’s encephalopathy in a woman with avoidant/restrictive food intake disorder presenting with bilateral ophthalmoplegia and normal serum thiamine levels.
Can dehydration lead to psychosis? Read this unique case of brief psychotic episode related to a medical condition, for which dehydration seemed to be the most likely etiology.
Antipsychotics may have immunomodulatory effects that could increase the risk of disseminated infections. This study sought to estimate the effect of antipsychotics on incident bloodstream infections in adults with chronic obstructive pulmonary disease.
Insomnia is often comorbid with psychiatric, medical, and neurologic disorders. Follow along as Dr Rosenberg discusses the bidirectional relationship between insomnia disorder and frequently co-occurring conditions.
Could hypothyroidism and thyroid autoimmunity be linked to depression in adolescents? Read this clinical study of 360 youth with depression and find out.
Although the tetralogy of Fallot (TOF) may be associated with psychiatric disorders, the risk of this association has not been well documented. This nationwide cohort study investigated the long-term risk of psychiatric disorders in TOF patients.
Psyllium is often used to reduce constipation, but could it make a coadministered medication less effective? This report describes an unexpected interaction.
Supportive therapy is a practical and flexible psychosocial intervention that busy practitioners can use to help patients struggling emotionally with a medical illness. Learn more in this CME journal article.
Autoimmune encephalitis (AE) is a highly treatable neurologic condition that can cause psychosis. This study estimated the cost-effectiveness of routine screening for AE compared with clinically targeted screening in first-episode psychosis patients.
Cobalamin deficiency has hematologic, neurologic, and psychiatric sequelae. This report describes a patient with no prior psychiatric history but with past history of total gastrectomy who developed mania.
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