Although DSM-5-TR cautions against diagnosing catatonia and delirium at the same time, real-world patients do not always fit neatly into one category. A prospective quality-improvement study of more than 700 medical inpatients found substantial overlap between the two syndromes, with implications for screening and treatment.

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When an older inpatient develops altered mental status, the answer is not always delirium or dementia—it is often both. In this review we discuss how to distinguish acute from chronic cognitive change, avoid missing hypoactive delirium, use medications judiciously, and set realistic expectations for patients and families.

We’ve long worried about respiratory depression when injectable olanzapine is combined with benzodiazepines. But in a retrospective cohort of nearly 700 ED cases, the combination did not appear to raise major safety concerns, offering some reassurance for severe agitation management.

Metformin is already used to limit antipsychotic-related weight gain in schizophrenia. But two related trials from the same research group suggest it might also modestly improve working memory and verbal learning, raising the question of whether a common metabolic agent could double as a cognitive one.

Soft drinks are implicated in obesity and diabetes. But could they also influence depression—and if so, through what mechanism? A German cohort study of 932 adults points to an unexpected variable in the relationship between dietary habits and mood.