Antipsychotics can be used in the short term to manage dementia-related psychosis, but serious adverse effects can outweigh benefits. Novel antipsychotics or other agents may offer superior efficacy and safety. Explore the evidence in this CME activity.
Episodic ataxia is an autosomal dominant disorder characterized by episodes of ataxia that last hours. Comorbid and psychiatric disorders of atypical presentation have been described in these patients, which may delay diagnosis. Read on to find out more.
Dissociative amnesia is characterized by autobiographical memory loss. Read this case of a woman who was found wandering the streets with no identification. She had autobiographical memory loss and loss of memory for global events.
Patients with multiple sclerosis commonly have neuropsychiatric comorbidity. ECT may be used to treat severe and life-threatening forms of mental illness when other modalities have failed or when a rapid response is required. Read on to find out more.
Psychiatric symptoms in empty sella are uncommon, but empty sella syndrome has been reported to be present along with psychosis. This report presents a case of Wilson’s disease with psychotic presentation and empty sella syndrome in an adolescent.
Here, the authors present a patient with an end-stage neurodegenerative diagnosis, describe the role of palliative care in his management, and discuss the cultural barriers encountered and opportunities offered to the patient and his caregivers.
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.”