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.
Have you ever wondered if and how often an electrocardiogram should be obtained to monitor the QTc? Have you been unclear about which medical and metabolic conditions and medications can prolong the QTc? If you have, then this case of an elderly man with symptoms referable to multiple organ systems and treatment that involved several agents with QTc-prolonging side effects should prove helpful.
When clinicians use methadone as the standard treatment for opioid-dependent pregnant women, must they be concerned about its effects on the heart of mother and child? Read this study to learn the impact of methadone dose and enantiomer-specific plasma concentrations on maternal and infant QTc.
The authors of this study identify clinical predictors associated with an increased risk of 6 long-term neurodevelopmental outcomes in children with congenital heart disease compared to the general pediatric Medicaid population.
In this systematic review of the literature, the authors investigate the presence of psychiatric comorbidities and quality of life in patients with an implantable cardioverter defibrillator. Research shows that there are prominent signs and symptoms of anxiety and depression in patients with the implantable device.Â
Have you ever wondered if atrial fibrillation, the most common cardiac arrhythmia, predisposes one to cognitive impairment, and, if it does, by what mechanisms? If you have, then this review and discussion of the literature should be useful and assist you when making treatment decisions for your patients with atrial fibrillation.
Low vitamin D levels are common in psychiatric patients, but vitamin D supplementation remains controversial. Review results from a study of the relationship between vitamin D treatment, psychiatric diagnosis, severity of illness, and cardiometabolic risk status in long-term psychiatric inpatients.
Why do some patients fail to seek medical attention for chest pain? Which interventions will overcome patients' denial of clinical realities? Read this case vignette and discussion of a 50-year-old man who denied the significance of acute and intense chest pain.
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.”