What are some of the challenges you face in overcoming adherence issues and providing patient-centered care for people living with schizophrenia? Drs Harvey and Kane offer evidence and clinical experience on these topics in this journal CME activity.
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.
Yawning is an unusual side effect of antidepressant medications. Here, read the case of a patient who developed yawning with every antidepressant she was prescribed, resulting in discontinuation of the medication.
This study examined the use of injectable paliperidone palmitate in Black/African American patients with schizophrenia and prior criminal justice system involvement. Read it to see if treatment failures were reduced with paliperidone vs oral medications.
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.”