Sleep disturbance is known to contribute to suicidal risk, but gaps in the literature remain, and most research in this area has focused specifically on insomnia. This study draws on data from the National Survey on Drug Use and Health to more fully characterize the relationship of sleep apnea to suicidal thoughts and behaviors.
First-line treatments for bipolar disorder are associated with multisystem side effects, especially weight gain, that predispose patients to obstructive sleep apnea among other complications. This article provides up-to-date information to help you screen for obstructive sleep apnea in patients with bipolar disorder, choose medications for bipolar disorder with consideration of metabolic factors, and initiate treatments that mitigate weight gain.
Acute sleep deprivation is one of the most rapid antidepressant interventions known; however, its benefits are usually short-lived. This meta-analysis synthesizes the existing data on acute sleep deprivation in order to quantify and better understand its effects.
In this study of adolescents exposed to the 2008 Wenchuan earthquake in China, Fan et al investigate the relationships between disturbed sleep and the development of depression and PTSD. The authors also make recommendations for assessing sleep-related symptoms in the wake of natural disasters.
In the US, young adults have historically had lower rates of health coverage than other groups. The dependent coverage provision of the Affordable Care Act extended private health insurance coverage to individuals up to age 26 under their parents' plans. This study looks at the impact of the 2010 expansion on insurance coverage and health outcomes.
Find out what led this veteran to consider suicide when he received a diagnosis of obstructive sleep apnea. See the importance of communication, because even seemingly small or simple things can have big consequences.
Some patients who take hypnotics may engage in abnormal nighttime eating and drinking behaviors when they' re not fully awake. This study sheds light on clinical features of sleep-related eating disorders and the risk factors associated with them.
It can be difficult to treat insomnia in primary care. The authors of this article hope to make the management of sleep problems a little easier. They review the literature on pharmacotherapy for insomnia and present 4 clinical vignettes with corresponding treatment options.
What evidence is there supporting the use of popular agents like diphenhydramine, doxylamine, melatonin, and valerian for occasional disturbed sleep or insomnia? This study investigates the safety and efficacy of these common treatments.
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.”