Over the past couple of decades, psychiatry has adopted a number of anticonvulsants that effectively treat psychiatric conditions. The “kindling hypothesis” has provided a rationale for their increasing use, but what is the evidence behind this theory, and is it actually applicable for psychiatric practice?

In a ruling certain to make psychiatrists and their patients happy, the DEA has finally said that doctors may give patients 90 days worth of prescriptions for schedule II controlled substances, which includes stimulants and narcotics.

In a multi-center study conducted in Great Britain and Australia, 86 adults with mental retardation (IQ < 75) and aggressive behavior were randomized to double-blind treatment with Risperdal (mean dose, 1.8 mg/day), Haldol (mean dose, 2.9 mg/day), or placebo. The primary outcome was score on the modified overt aggression scale (MOAS) at 4 weeks.

The North American Prodrome Longitudinal Study is a consortium of 8 academic centers (all but one in the U.S.) seeking to develop predictors of the development of psychosis in young patients who present with prodromal symptoms.

The FDA has issued a warning that Asian patients with a specific human leukocyte antigen (HLA) are at increased risk of developing life-threatening Stevens Johnson syndrome rash, and should be tested for this antigen before initiating treatment.

Dr. Ghaemi, Lamictal (lamotrigine) has become a very popular medication in psychiatry, but there remains some confusion about when to use it. What is its official FDA-approved indication?

After reading these articles, you should be able to…

The last time we took a close look at transcranial magnetic stimulation (TMS) was three years ago (TCPR, Jan 2005), and we concluded that it had promise as a treatment for major depression. In that article, we reported that the company making the device, Neuronetics, would apply for FDA approval as early as Fall of 2005, and that we could be passing magnetic coils over our patients’ heads as early as 2006.

Many psychiatrists are already hearing from patients about “this new technique” of using EEG to predict whether a given antidepressant will work. How good is this technology? Is it even remotely ready for prime time?

VNS (vagus nerve stimulation) was initially developed and approved for treatment-refractory epilepsy. Cyberonics conducted one sham-controlled study for treatment-resistant depression, and while this double-blind study showed no statistical benefit over placebo, an open-label extension showed enough benefit to impress someone at the FDA.