Clozapine is indicated for treatment-resistant schizophrenia (TRS), but many patients do not adequately respond. This study evaluated the combination of long-acting injectable antipsychotics and clozapine in TRS using various outcome measures.
Stress-induced changes in pharmacokinetics can alter plasma levels of drugs like clozapine. This brief report describes the case of a man with schizoaffective disorder who showed sustained elevation in clozapine levels 3 days after discontinuation.
In this journal CME activity, find experts' recommendations for reducing schizophrenia relapse, such as adopting a patient-centered approach, selecting medications based on current evidence, and implementing psychosocial interventions.
In addition to psychosis, depressive symptoms can occur in patients with anti-NMDAR encephalopathy (ANMDARE). ANMDARE should be considered in patients presenting with psychotic or atypical depressive illnesses. Early recognition of ANMDARE could lead to better management of this potentially life-threatening autoimmune disorder.
A 39-year-old man with schizophrenia develops paranoia about his neighbors and COVID-19 and then injures himself by applying cleaning products to his body. Read this case to see how the pandemic intersected with mental illness to cause physical harm.
The COVID-19 pandemic has caused various manifestations of psychosis to surface in otherwise healthy individuals. This case series describes paranoid delusions about COVID-19 resulting in the patients' first inpatient psychiatric hospitalizations.
Autism and early onset schizophrenia are often comorbid, but clinicians may fail to recognize one or the other disorder because of overlapping symptoms. This case report highlights the importance of early diagnosis and management of these disorders.
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.”