The brain changes that lead to dementia can be seen as early as 25 years before the illness starts. We can’t test for those changes, but who might be at risk? This meta-analysis led by Carol Hudon looked at studies that followed healthy middle aged adults with no cognitive problems...

Don't have a DBT center near you? Dr. Lois Choi-Khan has developed a new form of psychotherapy that may work almost as well. In this interview she shares her top tips from this pragmatic approach called Good Psychiatric Management. Featuring archival audio from the late John Gunderson courtesy of borderlinethefilm.com.Published On: 6/22/20Duration:...

A group of French psychiatrists released two papers this month that looked into how often physicians prescribe benzodiazepines and hypnotics in ways that deviate from the guidelines. The result: 20-30% of these prescriptions deviated, and the rate was even higher in chronic medical and psychiatric disorders: 45-68%. But what I...

This month Dr. Jan Spiker and colleagues from Amserdam published an editorial on how to approach comorbid depression and anxiety. They base their suggestions on two recent meta-analyses that found comorbid symptoms decreased when the more clinically significant disorder was treated. Spijker J, Muntingh A, Batelaan N. Advice for Clinicians on...

Hypothyrodism is fairly common on lithium, affecting about 14-17% of patients. Subclinical hypothyroidism is twice as common, and the risk is greater in the elderly. We know what to do about it ─ start thyroid supplement ─ but what hasn’t been clear is whether we should continue that supplement if...

Negative symptoms are the main cause of disability in schizophrenia, and they’ve long been considered untreatable or barely treatable. This study looked at the antidepressant vortioxetine (Trintellix) for them. Vortioxetine is the only antidepressant that has cognitive benefits that they FDA allowed mention of in the prescribing information. The independently sponsored...

These 10 questions can identify borderline personality disorder with almost as much precision as a lengthy structured interview. Plus the word of the day: Hysterical Psychosis.Published On: 6/14/20Duration: 19 minutesArticle Referenced: "A Pragmatic Approach to Borderline Personality Disorder," The Carlat Psychiatry Report, June 2020Transcript:Welcome to the Carlat Psychiatry Podcast, keeping psychiatry honest since 2003.

1 out of 3 zolpidem ─ Ambien ─ tablets are dispensed to older adults, but how safe and effective is it in the elderly? This review by Flavio Machado and colleagues pulled together 32 studies – half of which were randomized placebo-controlled trials ─ to look for answers. Study referenced: Machado FV, Louzada LL, Cross NE, Camargos...

1 out of 3 zolpidem ─ Ambien ─ tablets are dispensed to older adults, but how safe and effective is it in the elderly? This review by Flavio Machado and colleagues pulled together 32 studies – half of which were randomized placebo-controlled trials ─ to look for answers. Study referenced: Machado FV, Louzada LL, Cross NE, Camargos...

Topiramate may have failed as an antimanic treatment, but it has small positive trials in impulse control disorders like bulimia, gambling, cocaine/amphetamine abuse, OCD, irritability. This study tested it out in Sleep-related eating disorder. Winkelman JW, Wipper B, Purks J, Mei L, Schoerning L. Topiramate reduces nocturnal eating in sleep-related...