Amphetamines raise the risk of #opioid #overdose death.

So it's alarming that ~1 million amphetamines were prescribed on discharge from the ED, often with opioids:
pubmed.ncbi.nlm.nih.gov/36738570

Rising rates likely reflect the scarcity of outpatient #psychiatry resources

Update on #ketamine
1. Large, rapid effect in #depression
2. Mixed results in #PTSD
3. Preliminary trials in #alcohol , #opioid , #cocaine use
4. Toxicity (liver/bladder/cognition) with high-dose recreational use

From review by Owen Muir et al:
pubmed.ncbi.nlm.nih.gov/38518272

New use for fluoxetine (Prozac).

It treated refractory bed-wetting in children in this RCT, but the benefit declined over time (in primary monosymptomatic nocturnal enuresis):
pubmed.ncbi.nlm.nih.gov/36043350

Need to weigh against risks of antidep in children

#psychiatry #Pediatrics

1st lumateperone (Caplyta) RCT in major #depression :
> Aug #antidepressants , medium effect size (0.6)
> 6 wks, 485 pts, 1-2 failed med trials
> Fatigue, dry mouth, tremor main side effects

Data unpublished, summary here:
ir.intracellulartherapies.com/news-releases/…

2nd trial anticipated in summer.

Modafinil (Provigil) s not an energy pill.

It has failed in many trials of medical #fatigue , including this new, large phase-III trial in cancer-fatigue:
ncbi.nlm.nih.gov/pmc/articles/P…

Also failed in RCTs of antipsychotic-related fatigue

#psychiatry #medicine

What if people waited 4 wks instead of the usual 1 wk to quit #nicotine after starting verenicline (Chantix)?

A lot of theory supports this idea, but this large trial failed to find any lasting benefit with the delayed-quit approach:
ncbi.nlm.nih.gov/pmc/articles/P…

#quitsmoking

Review lists saffron's results from small, randomized trials:
> Beat placebo in #depression , cognition, insomnia
> Equaled standard meds in #anxiety , #ADHD , #OCD
> Well tolerated
pubmed.ncbi.nlm.nih.gov/38424688

Recommended products (surprisingly, low cost):
moodtreatmentcenter.com/products

A green #tea extract (l-theanine) reduced biological measures of #stress in this study of 120 volunteers:
jstage.jst.go.jp/article/jnsv/6…

Learn how to use l-theanine:
moodtreatmentcenter.com/products

Or just drink #Matcha :
psychiatrictimes.com/view/cognitive…

#mentalhealth

Antipsychotics are often used for #delirium , but you have to look hard to find evidence that they work.

You won’t find it in this analysis of olanzapine (Zyprexa):
pubmed.ncbi.nlm.nih.gov/36845642

#psychiatry #antipsychotic #medicine

Fascinating that psychiatrists (KOLs) in Europe are promoting Silexan (lavender extract) for #anxiety heavily. In the US it is over the counter and largely unknown

My take: Bias on both sides. Stick to the evidence. And let’s keep learning from the international community

Silexan (lavender extract approved for anxiety in Europe) is more effective than SSRIs in head-to-head trials & worked better for more severe #anxiety in new analysis of 5 RCTs:
pubmed.ncbi.nlm.nih.gov/38425206

Podcast:
thecarlatreport.com/blogs/2-the-ca…

How to use:
moodtreatmentcenter.com/products

The first placebo-trial of low-dose #lithium for cognitive impairment came out 12 years ago, and this study followed up on 59% of the cohort:
ncbi.nlm.nih.gov/pmc/articles/P…

Benefits were sustained, even after stopping lithium.
#memory #psychiatry #neurology

First case of ketamine tolerance from Mayo Clinic:
pubmed.ncbi.nlm.nih.gov/38597410

To stay well, the patient required increasing frequency of #ketamine , until it no longer worked after 5 years.

#depression #psychiatry

Two psych meds held promise for #COVID : lithium and fluvoxamine, an #SSRI antidepressant. So far, the data favors #lithium :
ncbi.nlm.nih.gov/pmc/articles/P…

but not the SSRI:
pubmed.ncbi.nlm.nih.gov/37002592

#psychiatry

Update on #MDMA :
1. Large effect in #PTSD assisted therapy (full remission in 61-71%)
2. Preliminary trials in #autism , social #anxiety , #alcohol use disorder
3. All trials from the same company (Lykos/MAPS)

From a review by Owen Scottt Muir, MD, DFAACAP et al:
pubmed.ncbi.nlm.nih.gov/38518271

Clonidine treats ADHD, but does it help cognition in #schizophrenia ? A new, small RCT suggests yes, as do a series of studies with the similar med guanfacine:
sciencedirect.com/science/articl…

Clonidine also helps psychogenic polydipsia, common in psychosis