Sad news. Only 1 in 9 patients in ED w/ #opioid use disorder were discharged on a med for it (in US study of half a million):
pubmed.ncbi.nlm.nih.gov/38795424

That includes rescue meds & non-opioids (naltrexone/clonidine).

NP/PAs were 17x more likely to treat it than MDs.

#opioid crisis

Are psychotic symptoms ever normal? ~1 in 50 have hallucinations that are not impairing, not connected to psych d/o

Some high rates below in new study screened 502 resident MDs::
pubmed.ncbi.nlm.nih.gov/38767000

Learn more in today's Wounded Healers podcast:
podcasts.apple.com/us/podcast/wou…

Brain changes from #AgentOrange exposure are similar to those seen in Alzheimer's #dementia , finds new study that tested the #VietnamWar toxin in rats:
pubmed.ncbi.nlm.nih.gov/38306038

#psychiatry #neurology

#LovingKindness #Meditation improved communication, trust, sense of purpose for #doctors in randomized trial from China:
pubmed.ncbi.nlm.nih.gov/38730309

It helped them practice less legalistic, 'defensive' medicine (control group got no intervention)

Try it:
youtube.com/watch?v=OaBboa…

Topiramate (Topamax) and naltrexone reduced heavy drinking days equally in this RCT of #alcohol use disorder (n=147, 8 wks):
pubmed.ncbi.nlm.nih.gov/38706338/

Topiramate surpassed the FDA approved naltrexone in cravings and weight reduction.

#soberliving

Vision Loss, Blindness, and Psychiatric Comorbidity #mentalhealth guilfordjournals.com/doi/10.1521/pd…

Risk for psychosis skyrockets among teens who use cannabis #mentalhealth upi.com/Health_News/20… via @upi

Best meds for psychotic #depression ? In this real world study of 33,000 the ones most likely to prevent future relapses were:
> #Antidepressants : Bupropion, vortioxetine, and venlafaxine
> #Antipsychotics : LAI antipsychotics and clozapine

pubmed.ncbi.nlm.nih.gov/38727044

Art: Anonymous

Histamine: Psychiatry’s Neglected Monoamine #mentalhealth psychiatrictimes.com/view/histamine… via @psychtimes

Welcome to the second episode of Carlat Psychiatry News hosted by Chris Aiken, MD, Psychofarm, and Kellie Newsome, PMHNP! Points of discussion: TMS for Teens; Olanzapine Serum Levels; Old Medication Pairings for Alcohol Use Treatment; and more! youtube.com/watch?v=udWppw…

I agree with comments below that slow titration and #antidepressant withdrawal are important, but one question:

If the relapses in this study are entirely due to a withdrawal syndrome, wouldn’t you expect a higher relapse rate for those on med longer? Instead we see the

Charmi Patel Rao, MD, DFAACAP, writes about How to Refer Patients to Other Providers #mentalhealth thecarlatreport.com/articles/4714-…

New in The Carlat Psychotherapy Report: Structured approaches for Image Rehearsal Therapy (IRT) and the Cognitive-Experiential Dream Model (CEDM) for tackling nightmares. #mentalhealth #sleep thecarlatreport.com/articles/4709-…

Auvelity is a fast acting #antidepressant combo of bupropion+dextromethorphan/DXM. New study will test if DXM augments SSRIs without bupropion:
bmjopen.bmj.com/content/14/4/e…

Dose=30mg/d, paired w/SSRIs that slow DXM metabolism as bupropion does (2D6 block). Risk=serotonin syndrome.

Antipsychotics work well for positive symptoms in schizophrenia but are less effective for negative symptoms. This study tested whether adding an SSRI could improve negative symptoms and allow lower antipsychotic dosing thecarlatreport.com/articles/4700-… #mentalhealth

Subscribe to The Carlat Psychiatry Report and receive a free copy of Psychiatry Practice Boosters, Fourth Edition! #mentalhealth thecarlatreport.com/products/465

Highlights from new review of #probiotics in #depression and #anxiety :
> Multi strain probiotics work better than single strain
> Probiotics work better when taken with prebiotics like inulin and oligosaccharides

Learn how to use them:
moodtreatmentcenter.com/probioticdiet

#psychiatry

In the new issue of The Carlat Psychiatry Report, Chris Aiken, MD interviews Mark L. Ruffalo about psychotherapy in schizophrenia. Other topics include mood switching, sertraline, ketamine, and more! thecarlatreport.com/newsletters/1/…

Clonidine 4-times more effective than placebo at reducing tics (Tourette's) in new RCT of 127 children with #ADHD :
pubmed.ncbi.nlm.nih.gov/38695046

Clonidine treats ADHD & tics, while stimulants can worsen tics. They used patch (1-2 mg/wk), sometimes better tolerated than oral clonidine.

Dr. Awais Aftab takes a look at a study to determine whether administering ketamine during general anesthesia changes its ability to treat depression #mentalhealth thecarlatreport.com/articles/4699-…