Neuroleptic malignant syndrome (NMS) is a life-threatening condition associated with use of psychotropic medications. This report presents a case of incipient NMS in a patient who developed catatonia during treatment with lorazepam and paliperidone.
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.
The effects of antidepressants and treatment duration on the progression to dementia are currently unclear. This case-control study analyzed the effects of several antidepressants with different treatment durations on the risk of developing dementia.
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.
Patients with dementia often receive antipsychotics in combination with other psychotropic medications. This study compared mortality for antipsychotics combined with benzodiazepines or antidepressants with that for antipsychotic monotherapy.
In this CME journal article, the authors describe a case of new-onset psychosis in a middle-aged woman, review red-flags for a neurodegenerative diagnosis rather than a primary psychotic disorder, and examine the role of genetics.
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.”