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XAll Individual Users: You may have noticed, we have just launched our new website. We will be adding more features over the upcoming weeks that you will like, so there may be a few hiccups along the way. If this is your first time visiting since our relaunch, please reset your password so you can still access our journals and CME activities that we have been providing for over 80 years. If you have any questions or comments please contact us at webadmin@psychiatrist.com.
Here, read about 2 patients who utilized nonprescription stimulants for analgesia. One smoked methamphetamine for relief of chronic back pain, while another smoked cocaine for relief of eye pain secondary to a workplace injury.
This report describes the use of pramipexole to augment buprenorphine and antidepressant medications in a patient with depression and severe chronic back pain.
Do traumatic experiences contribute to the onset of tension headache? This authors of this study investigate this question and identify the defense styles that are more frequently used by patients with tension headache.
Most people with primary headache disorders, such as migraine, are undiagnosed. Read this PCC Supplement for updated classifications and assessments for patients with headache disorders and to identify and educate patients who are candidates for preventive treatment.
Low sodium can be a death knell if not caught early. Tramadol and some SSRIs can cause hyponatremia. It's not just the elderly who are vulnerable, as in this case of a 52-year-old woman with alcohol use disorder and taking an antidepressant.
In the search for a cause of obsessive-compulsive disorder, 2 theories have predominated: increased activity in the orbitofrontal cortex and low activity in the serotonergic system. Using fMRI and auditory-evoked potentials, this study investigated a possible connection between the two hypotheses.
Corticosteroids and antidepressants are known to induce manic episodes in predisposed individuals. Manic episodes in bipolar patients triggered by tramadol have also been reported. Here, read about a woman with no psychiatric history other than a single depressive episode following a major life event who experienced a manic episode after taking tramadol.
Episodic migraines often lead to medication-overuse headache. Anxiety, mood disorders, and disorders caused by psychoactive substances other than analgesics all have been reported in patients with medication-overuse headache. Could personality traits, anxiety and depressive disorders and headache type be related? Read this article to find out more.
It's been proposed that psychological pain is at the core of the suicidal process, from ideation to attempts. In this meta-analysis, intensity of psychological pain was compared in individuals with and without suicidal ideation and attempts in order to quantify the association between psychological pain and suicide.
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.”