Do you know how to manage tardive dyskinesia symptoms? In this Case and Comment activity, consider the case of John, a 25-year-old project manager diagnosed with bipolar disorder who has begun exhibiting symptoms of uncontrollable movement.
Only 30% to 60% of patients with treatment-resistant schizophrenia benefit from clozapine monotherapy. Does augmentation with mood stabilizers/antiepileptics improve the chances of success? This meta-analysis of 22 randomized controlled trials was performed to answer that question.
With the advent of second-generation antipsychotics, hopes were high that tardive dyskinesia would all but disappear as a side effect. However, it persists. In this meta-analysis, Carbon et al analyze 41 studies to determine how prevalent tardive dyskinesia still is during treatment with first-generation and/or second-generation antipsychotics.
Meige syndrome is a focal oral facial dystonia involving symmetrical blepharospasm and oromandibular dystonia. The typical symptom of the disorder is difficulty keeping the eyelids open. This report highlights the case of a 64-year-old woman who presented with Meige syndrome. Could paliperidone have caused her symptoms?
Have you ever wondered whether the presence of myoclonus helped to create or narrow your differential diagnosis? Have you ever been uncertain about whether or how to treat focal or diffuse myoclonus? If you have, then this case vignette and discussion should prove useful.
Covert dyskinesia is a masked form of tardive dyskinesia that emerges only after antipsychotic drugs are withdrawn or reduced in dosage. Here, read the case of a 53-year-old man who experienced covert dyskinesia after cessation of aripiprazole.
Read about the case of a 64-year-old man who experienced myoclonus, a rare and easily missed side effect of midazolam. The myoclonus resolved once the patient was off of the midazolam for 1 day and had his magnesium level corrected.
See how a 5-year-old boy with Tourette's disorder benefited from the components of Comprehensive Behavior Intervention for Tics (CBIT), a manualized behavioral treatment based on habit reversal training.
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.”