Another Black Eye for Prazosin in PTSD?

Topics: Hypnotics | Insomnia | Nightmares | Prazosin | PTSD | Research | Research Update | Sleep | Suicidality

Review of: McCall W et al, J Clin Psychopharmacol 2018;38(6):618–621 Study Type: Randomized single-blind controlled trial (pilot study) Prazosin has become a mainstay in the pharmacologic treatment of PTSD. A selective antagonist of the noradrenergic alpha-1 receptor, it has modest benefits in sleep and nightmares that are supported by around ha

Moderate Alcohol Use Associated With Reduced Risk of Dementia

Topics: Alcohol Use | Dementia | Geriatric Psychiatry | Research Update

Review of: Sabia S et al, BMJ 2018;362:k2927 Type of study: Prospective cohort study Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients. What about the cumulative impact of alcohol over one’s lifet

Amphetamines Stand Out in ADHD

Topics: ADHD | Amphetamines | Research Update

Review of: Cortese S et al, Lancet 208;5:727–738 Type of study: Meta-analysis With so many medications available to treat ADHD, wouldn’t it be nice to know if some are better than others? In this comprehensive meta-analysis, researchers sought to compare the relative efficacy and tolerability of both stimulant (methylphenidate and am

Rapid-Onset Gender Dysphoria in Adolescents and Young Adults

Topics: Child Psychiatry | Gender Dysphoria | Research Update

Review of: Littman L, PLOS ONE 2018;13(8):e0202330 Rapid-onset gender dysphoria (ROGD) is a newly coined but non-standardized characterization of gender dysphoria (GD). In this conceptualization, GD begins abruptly during or after puberty in adolescents or young adults (AYAs) with no prior symptoms of GD. Clusters of GD outbreaks have been noted by p

How Helpful Is Computerized Testing for ADHD?

Topics: ADHD | Child Psychiatry | Research Update | Technology

Review of: Hollis C et al, J Child Psychol Psychiatry 2018;59(12):1298–1308 With busy clinic schedules and the ever-burgeoning load of documentation, computerized diagnostic aids are in more demand than ever. For ADHD, the gold standard is still a clinical assessment with information from parents and teachers, but those reports are difficult to obt

Would Treating Kids With ADHD Help Their Mothers?

Topics: ADHD | Child Psychiatry | Research Update | Working With Families

Review of: Gokcen C et al, J Child Adolesc Psychopharm 2018;28(5):350–353 Parenting a child with ADHD can be challenging. Parents often report feeling stressed, burned out, or depressed while caring for their children with ADHD. When ADHD medications lead to significant improvements in a child’s behavior, can that alleviate symptoms in parents? A

Is Watching ‘13 Reasons Why’ Bad for Teens?

Topics: Research Update

Review of: Zimerman A et al, J Am Acad Child Adolesc Psychiatry 2018;57(8):610–613 13 Reasons Why, a popular Netflix series, stirred controversy when it portrayed the bullying and suicide of a teenager. Although the program increased awareness of these issues, some clinicians argued that it glamorized suicide and would be detrimental to vulnerable

Does Augmenting Varenicline with Bupropion Work Better than Varenicline Alone?

Topics: Bupropion | Research Update | Smoking Cessation | Varenicline

Review Of: Cinciripini PM et al, Addiction 2018;113:1673-1682 We have a good array of smoking cessation treatments to choose from, including nicotine replacement therapy (NRT), bupropion, and varenicline. Varenicline is the most effective monotherapy agent, somewhat better than bupropion and single-product NRT, and comparable to combination NRT. Theo

Switching from Buprenorphine to Extended-Release Naltrexone: Does it Work?

Topics: Buprenorphine | Naltrexone | Opioids | Research Update | Substance Use

Review of: Solli KK et al, Addiction 2018;113(10):1840-1849 Extended-release naltrexone (Vivitrol) has had some good data, yet getting patients on it remains a challenge, because an opioid-free period is required before starting it. Understandably, practitioners get nervous when patients stabilized on buprenorphine ask to be transitioned to extended-

Prazosin for Alcohol Use Disorders

Topics: Research Update

REVIEW OF: Simpson TL et al, Am J Psych 2018; https://doi.org/10.1176/appi.ajp.2018.17080913 TYPE OF STUDY: Randomized, placebo-controlled trial Prazosin is often used as a second-line option for a broad array of psychiatric conditions, including anxiety, insomnia, nightmares, and post-traumatic stress dis­order (PTSD). It is a high blood pressur

How Effective Are Medications for Pediatric Anxiety?

Topics: Anxiety | Research Update

Review of: Strawn JR et al, J Am Acad Child Adolesc Psychiatry 2018;57(4):235–244.e2 Antidepressants are part of the first-line treatment for severe childhood anxiety disorders when removal of stressors and psychotherapy are not enough, but are all antidepressants created equal in this situation? A recent meta-analysis shows that antidepressants

Cannabidiol for Schizophrenia

Topics: Cannabidiol | Research Update | Schizophrenia

Review of: McGuire P et al, Am J Psychiatry 2017;175(315). doi:10.1176/appi.ajp.2017.17030325 Type of study: Double-blind, randomized controlled trial Traditional antipsychotic medications leave much to be desired. Their therapeutic response rate for schizophrenia is low, and their side effects are troubling and lead to high rates of noncompliance

Is Ketamine Just Another Opiate?

Topics: Antidepressants | Depression | Ketamine | Opioids | Research Update

Review of: Williams NR et al, Am J Psychiatry 2018;175:1–11 Type of study: Double-blind, placebo-controlled, crossover study Ketamine’s rapid antidepressant effects have now been demonstrated in over two dozen double-blind, placebo-controlled trials, but how it works is less clear. For many years, NMDA receptor antagonism was thought responsib

Suicide Rates in College Students

Topics: Research Update

Review Of: Mortier P, J Am Acad Child Adolesc Psychiatry 2018;57(4):263–27 Adolescence is a time of high risk for suicidal thoughts and behaviors (STB), and rates are rising. In those ages 15–29, suicide is the second leading cause of death globally (http://www.who.int/mental_health/prevention/suicide/suicideprevent/en). A recent article publishe

More Evidence of Lives Saved by Medications for Opioid Use Disorder

Topics: Opioids | Registered Articles | Research Update

REVIEW OF: Larochelle MR et al, Ann Intern Med 2018;169(3):137–145 We are in the middle of an opioid crisis in the US, with many lives lost daily to opioid-related deaths. Pharmacotherapy with methadone, buprenorphine, or naltrexone represents an important tool for clinicians during this crisis. But just how good are these medications in saving liv

Probiotics for Bipolar Disorder

Topics: Bipolar Disorder | Research Update

Review of: Dickerson F et al, Bipolar Disord 2018. doi:10.1111/bdi.12652 [Epub ahead of print] Type of study: Randomized double-blind placebo-controlled trial Probiotics, the so-called “good” bacteria in the gut flora, have become popular as a natural treatment for various disorders. They are taken as capsules or through food sources like yogu

Does TMS Really Work in Depression?

Topics: Depressive Disorder | Free Articles | Research Update

Review of: Yesavage et al, JAMA Psychiatry 2018;75(9):884–893 Type of study: Randomized, sham-controlled trial Repetitive transcranial magnetic stimulation (rTMS) has been FDA-approved for treatment-resistant depression (TRD) since 2008. This non-invasive therapy uses an electromagnetic coil to stimulate electrical activity in the frontal cortex

Is Cannabis Bad for Cognition?

Topics: Free Articles | Research Update | Substance Abuse

Review of: Cobb SJ et al, JAMA Psychiatry 2018;75(6):585–595 Our patients typically tell us that, according to the internet, weed is perfectly safe and does not affect their ability to think or function. Thirty states and the District of Columbia have laws legalizing cannabis, supporting the notion that people have begun to think of marijuana as re

Is Clozapine the Next Step After a Single Failed Antipsychotic Trial?

Topics: Antipsychotics | Research Update

Review of: Khan RS et al, Lancet Psychiatry, published online 8/13/2018 Type of study: Sequential trial with open-label and randomized, double-blind comparison phases Clozapine is often used as a last resort in schizophrenia, even though practice guidelines recommend a trial of this medication after failing 2 antipsychotics. The current study set

Opioids Not Superior to Other Medicines for Some Chronic Pain

Topics: Addiction | Free Articles | Research Update | Substance Abuse

REVIEW OF: Krebs EE et al, JAMA 2018;319(9):872–882 Rising rates of opioid overdose deaths have sounded alarm bells over opioid prescribing practices for chronic pain. Unfortunately, and despite the absence of quality data on their risks vs benefits, long-term opioid management has remained a common approach to managing chronic musculoskeletal pain