In 2005, the FDA issued a health advisory saying that antipsychotics appear to increase the risk of death in elderly patients with dementia. That advisory was based on data from placebo-controlled trials of antipsychotics conducted by industry. Now, a new study based on a completely different, and much larger, dataset, appears to confirm these dangers.

In a provocative study, rates of Ritalin prescriptions in Canada from 1994-2000 were compared with rates of divorce. The study focused on children ages 2-7, and found that in families that stayed intact during the study period, 3.3% of children were prescribed Ritalin.

One of the final major questions that the NIMH-funded CATIE trials promised to answer was whether atypical antipsychotics are better at improving cognition in schizophrenia than conventional agents, as some smaller studies implied.

After reading these articles, you should be able to…

A recent issue of the Journal of Anxiety Disorders (Vol. 21, 2007) focused on the troubling possibility that the PTSD (posttraumatic stress disorder) construct is not nearly as valid as has been assumed. The articles are both fascinating and provocative and are well worth reading.

At least in Britain, it’s official: psychotherapy works better than medication for PTSD. You shouldn’t be too surprised. The last time we covered PTSD (TCPR April 2004) we reviewed the SSRIs and found them to have evidence of only modest efficacy.

Dr. Osser, as an attending psychiatrist at a VA unit in which you evaluate many patients with PTSD, how do you typically approach establishing a valid and reliable diagnosis of PTSD in your patients?

The results of the cognitive therapy component of the NIMH-funded STAR-D trial were finally released. Recall that in STAR-D, about 4,000 depressed patients were initially enrolled and were all given Celexa (citalopram) at an average dose of about 40 mg/day (see TCPR January 2007 for a rundown of STAR-D findings).

Fibromyalgia is usually considered a rheumatologic condition characterized by at least 3 months of widespread pain and the presence of tender points. About two thirds of fibromyalgia patients also suffer from depression, and many such patients eventually find their way to our offices.

Project Match was a large, government-funded research project conducted in the 1990s that showed equivalent benefit of AA, cognitive behavioral therapy, and motivational enhancement therapy in alcoholism. Researchers recently reported on an effort to test brief versions of the Project Match therapies for alcohol abusing patients.