Although psychotherapy is available via the Veterans Health Administration, most veterans diagnosed with posttraumatic stress disorder (PTSD) receive pharmacotherapy. This study evaluated longitudinal prescription practice trends for veterans with PTSD.
In this letter, Dr Hernandez and colleagues reply to a letter from Brigido et al that comments on their recent article on the impact of comorbid posttraumatic stress disorder on outcomes of treatment with repetitive transcranial magnetic stimulation in depressed veterans.
This letter to the editor builds on the findings of a recent article by Hernandez and colleagues on the impact of comorbid posttraumatic stress disorder on outcomes of treatment with repetitive transcranial magnetic stimulation in depressed veterans.
Does suicide risk shortly after discharge from psychiatric hospitalization differ from risk thereafter? This study compared risk factors for suicide in US veterans in the first 90 days after discharge to those during the remainder of the year.
Levels of several fatty acids (FAs) have been linked to suicidal behavior, though research has mainly focused on individual FAs. This study used latent class cluster analysis to identify groupings of FAs that may affect likelihood of suicidal behavior.
Many homeless and unstably housed (HUH) adults have severe mental illness managed with antipsychotic medications. This study examined antipsychotic medication use and correlates of antipsychotic medication prescriptions among HUH versus non-HUH veterans.
Which pharmacologic treatment is most likely to help your patient with PTSD? Only 2 medications are FDA-approved for this condition, although a number of others are in current clinical use. This ASCP Corner article reviews commonly used treatments for PTSD and summarizes the evidence for each.
Opioids and benzodiazepines are commonly coprescribed, but the risk of death associated with this practice is unknown. This study compared mortality among patients coprescribed these agents with those prescribed medications from either or neither class.
Psychiatric disorder has been found to co-occur in sex offenders in civilian populations, but what is the incidence in military service members charged with this type of offense? This study examined the prevalence of psychiatric disorders among service members charged with sexual offenses with the hope of informing strategies to assess, treat, and prevent sexual offenses in the military.
Why do some veterans not utilize VA services? This article examines sociodemographic and military characteristics of US veterans who do and do not utilize VA services as their primary source of health care. The authors examine the relationship between VA utilization and medical and psychosocial characteristics. Read on to find out more.
When choosing among agents for treating PTSD, which one should you pick? Fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine have all shown efficacy. This large retrospective VA study compared the treatments on the basis of PTSD Checklist scores to see if they yielded different outcomes.
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.”