Novel approaches are needed to assist rural primary care physicians in caring for older patients living with depression and pain who are at an elevated suicide risk. Read this article to find out more about the PREDICTOR model.
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.
Serotonin syndrome can be challenging to recognize. Read this report of serotonin syndrome resulting from use of dextromethorphan-based cough medicine in addition to multiple antidepressant and pain medications.
Could valbenazine help your patients who experience antipsychotic-induced abnormal movements? This follow-up analysis of a phase 3 study provides further insights into the efficacy of valbenazine for tardive dyskinesia by extending the analysis to include odds ratios and number-needed-to-treat statistics.
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.
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.
When treating a pregnant woman with SRIs, one area of concern relates to discontinuation symptoms that may occur in the infant. This study explored whether prematurity, SRI exposure, or exposure to maternal mood disorder poses the greatest risk for gastrointestinal, neuromuscular, and CNS-related neonatal discontinuation signs.
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.”