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.
Although psychiatric manifestations are one of the most common presentations of pediatric N-methyl-d-aspartate receptor encephalitis, there is a lack of studies that characterize psychiatric aspects of this disorder. This study, which included 21 children, was designed to address this gap. Read on to find out more.
In this Psychotherapy Casebook article, Dr Schuyler continues outlining his strategy for training third-year medical students about issues in palliative care. Read the article to find out how you might incorporate similar training in your own practice.
Could mood-stabilizing medications be increasing patients' risk of developing kidney disease? This large, nested case-control study looks at the degree of risk associated with lithium and valproate treatment in patients aged 66 and older.
In this Psychotherapy Casebook article, Dr Schuyler outlines his strategy for training third-year medical students about issues in palliative care. By emphasizing the psychological role inherent in providing palliative care, his hope is that trainees will be encouraged to provide that part of care to their patients. Read the article to find out more.
Those involved in palliative care suggest that referral should come much earlier in the patient's course, such as at the time of diagnosis of a severe medical illness. Here, the authors present an updated version of a palliative care survey that incorporates an emotional element by allowing patients the opportunity to talk with a knowledgeable mental health professional.
Providers of palliative care suggest that the referral should come at the time of diagnosis of a severe medical illness, rather than later. Join Dr. Schuyler in developing a survey for patients that would indicate the appropriateness of palliative care.
Diagnosis of autoimmune encephalitis is often difficult and frequently delayed given the time taken to rule out more common psychiatric and neurologic conditions. Here, read about a complex case of autoimmune encephalitis with comorbid sinus venous thrombosis.
Asian Americans have among the lowest rates of mental health service utilization of any racial/ethnic group in the United States, and research has identified stigma as an underlying reason for this. A group from Harvard looked at the impact of self-stigma in 190 Chinese immigrants with MDD. Learn about its effect on both depression scores and quality of life.
Palliative care improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses. In this article, the authors, a psychiatrist and a nurse practitioner, share some of the stories they have encountered when treating patients at the end of life.
What would you do if you were diagnosed with cancer? Would you fight and attack it like an enemy? Or would you treat it as a part of yourself that needs to heal? Here, Dr Scott recommends the latter. She explains why waging war against cancer is like fighting a losing battle and, instead, suggests acceptance and starting the journey to return your body to a precancerous state.
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.”