In this webcast about early-stage Alzheimer disease, Drs Burke and Apostolova highlight important conversations to have with patients and their care partners on topics such as diet, exercise, driving, and plans for the later stage of illness.
Case reports suggest a link between obsessive-compulsive disorder (OCD) and dementia, but this association has received little research. The current study investigated dementia risk among OCD patients using a national health insurance research database.
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.
What diagnostic criteria and assessment tools would you use for dementia-related psychosis? What strategies may help when discussing psychosis with patients' family members? Dr Ballard considers these topics in this brief CME activity.
When you treat patients with dementia-related psychosis, do you evaluate the burden on carers, too? If they feel discomfort, fear, or depression, how would you help them? Learn from an expert in this brief CME activity.
Peduncular hallucinosis (PH), an uncommon cause of hallucinations, is typically due to lesions of rostral brainstem or diencephalon. This report describes a case of PH due to right pontine/cerebral peduncle lesion that was treated with risperidone.
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.”