Delirious mania is a potentially life-threatening but underrecognized neuropsychiatric syndrome. Here, read about a patient whose symptoms were consistent with nonmalignant delirious mania and were successfully treated with lorazepam and carbamazepine.
Have you ever wondered what is responsible for an altered mental status with agitated behaviors or how to evaluate a patient with such symptoms? If so, then this article illustrating the complexity of diagnosing such a patient should prove useful.
As both delirium and short-term memory impairment can be presenting symptoms in both Wernicke-Korsakoff syndrome and antibody-mediated limbic encephalitis, the potential of misdiagnosis and delayed treatment can occur. Read this interesting case report to find out more.
Although previous studies have demonstrated the efficacy of suvorexant for delirium prevention in limited randomized clinical trial settings, this study aimed to examine the effects of suvorexant on delirium prevention in a real-world setting.
Has the occurrence of delirium been underreported during the COVID-19 pandemic? Here, the authors present the clinical course of an elderly patient with moderate dementia, multiple comorbidities, and COVID-19 characterized by prolonged delirium.
Dementia represents the main risk factor for delirium, though polypharmacy-induced delirium is also common in older individuals. This study explores the role that polypharmacy and the use of specific medications may have in older patients with delirium with or without dementia.
While antipsychotics are often used to treat delirium symptoms such as agitation, hallucinations, paranoia, and sleep disturbances, data on the impact of antipsychotics on ICU delirium are mixed. Thus, this study investigated the effect of early versus late versus no antipsychotic administration on ICU delirium. Read on to find out the results.
To some, burning down your house because of fleas seems reasonable. To the majority of us, the actions of this man signal a bigger problem even before suvorexant is added to the mix. Check out the results when this patient is treated appropriately.
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.”