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.
Self-isolation measures, while important in curbing the spread and impact of COVID-19, are likely to increase rates of anxiety and depression. Here, a case is presented of COVID-19–related anxiety leading to late-onset psychotic and catatonic depression.
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.
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.
Do you talk with your patients with Parkinson disease about the burden of OFF episodes? Using assessment tools can spur communication. In this CME activity, follow along as 2 experts review the occurrence and identification of OFF time.
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.
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.”