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.
Many people with psychiatric disorders use cannabis, but how might this use complicate the clinical picture? This ASCP Corner article looks at the vital information clinicians need to know about assessment and interventions for managing patients with psychiatric disorders who use cannabis.
Myasthenia gravis is a chronic autoimmune disease characterized by neuromuscular transmission dysfunction. Read the case of a patient with myasthenia gravis and comorbid adjustment disorder with mixed anxiety, depression, and insomnia that were effectively treated with cognitive-behavioral therapy.
Combat exposure has been linked to PTSD and other mental health conditions, but is it also linked to physical health conditions? Read this CME article to learn about how mental and physical conditions differ between veterans with and without combat exposure as well as between younger and older veterans with combat exposure.
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.”