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.
Here, read the case of a man admitted to the hospital in a manic state 15 years after suffering a traumatic brain injury. He had received several diagnoses over the past 2 years, including different iterations of bipolar disorder. His mania resolved after levodopa-carbidopa, which had been prescribed for an unsubstantiated diagnosis of Parkinson disease, was discontinued.
In this Viewpoint article, Torrey et al call for the National Institute of Mental Health to expand funding for schizophrenia treatment beyond trials that focus on identified biological targets. Specifically, they argue for treatment initiatives directed at normalizing the immune system.
In this Viewpoint article, Dr Joshua Gordon, Director of the NIMH, responds to points raised by Torrey et al regarding the decrease in the number of medication trials for schizophrenia and the funding criteria used by the NIMH for such trials.
Poor treatment adherence masks the true extent of placebo effects in trials of antipsychotics in schizophrenia. Can use of an injectable placebo in double-blind trials of long-acting injectable antipsychotics circumvent issues of adherence and provide a clearer picture of placebo effects? Read this article to find out.
Are you familiar with diagnostic criteria for Parkinson disease psychosis (PDP)? Do you know which psychotic symptoms occur in the majority of patients with PD? Read this CME supplement by 2 experts in the field for an update on PDP symptoms and treatments.
Dopamine dysregulation syndrome (DDS) is a rare complication in patients with Parkinson's disease. Patients with DDS typically take more than the recommended dose of dopamine replacement therapy and subsequently develop hallucinations and impulse control disorders. This report presents the case of an elderly man with Parkinson's disease and DDS who developed psychotic and hypersexual behaviors.
Impulse-control disorders (ICDs) have been noted anecdotally in patients with Parkinson's disease, but what is their true prevalence? To estimate this prevalence, this study compared the frequency of ICDs in elderly Parkinson's disease patients and healthy controls.
Aripiprazole lauroxil, a long-acting injectable antipsychotic, demonstrated safety and efficacy in treating schizophrenia symptoms in a recent RCT. But how does it stack up against other antipsychotics in terms of metabolic profile? Nasrallah and colleagues investigated this question as part of a phase 3 study in schizophrenia patients who were experiencing an acute relapse.
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.”