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...

The first in our patient guides, this episode was made to share with patients. Follow the key behavioral steps from morning to night as you develop a routine to stabilize the biological clock that drives bipolar moods. Learn how to use dawn simulators and blue light blockers to improve sleep...

The killing of George Floyd has sparked nationwide outrage, but what does it mean for your patients? We found a poignant answer in a 2018 study in the Lancet. Jacob Bor and colleagues poured through a national survey of 100,000 randomly selected adults to find out how police shootings affected mental...