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

Sleep is free #therapy .

That’s the road Freud took to psychoanalysis, and if your dreams reflect your current stress, at least symbolically, you’ll heal from that stress faster.

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…

1 in 3 people with #bipolar are night owls, and this chronotype indicates a worse prognosis, finds this 2023 study, a confirmation of earlier reports:
pubmed.ncbi.nlm.nih.gov/36622183

#bipolar disorder #depression #psychiatry

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…

DSM-IVs editor Allen Frances is a vocal critic of over diagnosis. Here are the conditions he thinks are underdiagnosed.

Would you add any to the list?

The brain adapts to its environment, including outer space.

In this controlled study there was a decrease in #brain connectivity after a space mission, but it adapted back, normalizing within 8 months of return to earth:
ncbi.nlm.nih.gov/pmc/articles/P…

#neuroscience #nasa

Note: Clozapine and long acting injectables (LAIs) are among the most commonly prescribed #antipsychotics in Sweden, where the study on psychotic depression pictured below was done, see:
tandfonline.com/doi/full/10.10…

I have seen treatment resistant psychotic #depression respond to

Nearly half of patients with treatment resistant #depression take long-term benzos, and this large observational study finds reasons to question that practice:
pubmed.ncbi.nlm.nih.gov/37120004

Benzo use associated with low physical activity and worse cognition #psychiatry

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

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

New episode of Carlat #Psychiatry News covers....
> TMS approved in teens
> Olanzapine serum levels find a niche
> Prazosin-combo for #alcohol use disorder
> How to cross taper #sleep meds
> New findings on #lithium , caffeine, and omega-3's
youtube.com/watch?v=udWppw…

#mentalhealth

63% of people with #depression respond to pramipexole, concludes this metaanalysis in bipolar & unipolar disorder:
ncbi.nlm.nih.gov/pmc/articles/P…

Good safety at 6 months, nausea and somnolence the main side effects.

How to use it in #psychiatry :
thecarlatreport.com/articles/3083-…

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

Don’t stop an #antidepressant within 3 months of recovery, and continue it at least 6 months to minimize risk of relapse, concludes analysis of 36 trials:
pubmed.ncbi.nlm.nih.gov/38733930/

Confirms the findings of earlier studies, that at least 6 mth of #depression recovery is needed

Now that we’ve linked antidepressants to manic switches in #bipolar disorder , this review takes a look at what causes switches into #depression .

Tentatively links them to typical antipsychotics and benzodiazepines:
pubmed.ncbi.nlm.nih.gov/37119556

#bipolar