The author of this report describes a pragmatic therapeutic approach that can be administered to an adolescent receiving dialectical behavior therapy, who may perceive certain steps in therapy as burdensome and subsequently drop out of treatment.
Optimal intervention for patients experiencing PTSD often includes prolonged follow-up that applies both talk and drug therapies in a supportive environment. This narrative review describes psychotherapeutic and pharmacologic approaches to treat PTSD.
Supportive therapy is a practical and flexible psychosocial intervention that busy practitioners can use to help patients struggling emotionally with a medical illness. Learn more in this CME journal article.
This commentary discusses a recent brief report by Pietrzak et al and lists 3 strategies that health care systems could use to improve mental health support for frontline health care workers during the COVID-19 pandemic.
How many older adults receive electroconvulsive therapy (ECT) for treatment-resistant depression? Among those who receive ECT, how many finish the course? What factors might predict patients' continuation of ECT? Explore these topics in this journal CME activity.
Most evidence concerning suicide prevention strategies comes from either non-experimental epidemiologic designs or randomized controlled trials, but there is a growing call for data from actual clinical practice. Learn the results from when 3 real-world suicide prevention programs were compared.
Telehealth, or treating patients remotely via communications technology, is demonstrably effective and is an appealing option for many reasons, but is it cost-effective? This study of older veterans compared in-person vs telehealth delivery of behavioral activation psychotherapy. Read the article to see what the authors found.
Stress and stress-related disorders such as depression and anxiety can accelerate neurocognitive aging. Could a mindfulness intervention be a way to enhance memory and clinical outcomes in older patients? Read this intriguing article to see what the authors found.
Quetiapine has the greatest evidence of efficacy for bipolar II depression, but it is also associated with metabolic side effects. This study compared psychotherapy plus placebo or plus pharmacotherapy. Read the results to consider whether the side effect burden outweighed an efficacy advantage.
Is adjunctive treatment with repetitive transcranial magnetic stimulation (rTMS) beneficial in medication-resistant OCD? Here, the authors present the case of a patient with medication-resistant OCD who improved significantly following rTMS and describe how they integrated psychotherapy to address his behavioral, cognitive, and family difficulties.
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.”