Various formulations of methylphenidate and amphetamine are approved for the treatment of ADHD. The drug delivery mechanisms of these compounds create unique parameters that differ considerably among the formulations. This CME article is a comprehensive guide for prescribing clinicians.
Raynaud's phenomenon is characterized by episodic spasm or vasoconstriction of the arteries and smaller arterioles of the extremities usually in response to cold or emotional stimuli. Here, read about a 16-year-old boy who developed secondary Raynaud's phenomenon while taking lisdexamfetamine, a medication commonly used in attention-deficit/hyperactivity disorder.
Besides congenital malformation, what other risks might be associated with antiepileptic drugs during pregnancy? In this article, Dr Andrade discusses the results of a recent network meta-analysis evaluating outcomes such as fetal loss and preterm birth associated with use of various antiepiletic agents.
Which antiepileptic drugs present the greatest risks during pregnancy? In this installment of Clinical and Practical Psychopharmacology, Dr Andrade looks at the evidence to determine the drugs associated with the greatest potential danger to the fetus, as well as the ones that seem to pose no added risk.
Anxiety specialists tend to avoid prescribing stimulants due to potential negative effects; however, their use may be justified in patients who cannot tolerate antidepressants or in those whose ADHD symptoms do not respond to such medications. Here, read the case of Ms A, a 31-year-old woman with ADHD whose anxiety symptoms responded to stimulant medication.
While stimulants are the mainstay of ADHD treatment, their use is marred by concerns about substance abuse. This study involvingÂ 37 adults with ADHD looks at whether naltrexone might reduce euphoric effects of these drugs, thereby reducing their abuse potential.
Although some studies suggest that excessive brain opioid activity may affect or even determine the pathogenesis of autism, discrepancies exist between results of individual studies. Read this article to learn if a relationship was found between Î²-endorphin levels, self-injurious behaviors, or pain reactivity in patients with autism.
Even though methylphenidate is the most commonly prescribed medication for ADHD, not all ADHD patients respond to this agent equally. Can sluggish cognitive tempo—sluggishness, sleepiness, and/or "daydreaminess"—affect methylphenidate response? Read this article to find out.
Autism has been linked to higher rates of depression and to suicidality. This study leveraged data from a large insurance database to find out whether the presence of depression is key to the increased suicidality risk, or if this risk is independent of psychiatric comorbidity.
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.”