Narcolepsy affects about 1 out of 2000 people, for a prevalence rate of 0.05%. This puts it officially in the category of rare diseases. So why are we asking you to read about such a rare disorder? Partly because there’s a lot of comorbidity between narcolepsy and most psychiatric disorders. And partly because Jazz Pharmaceuticals is placing lots of ads in psychiatric journals urging us to diagnose more narcolepsy so that we’ll use their new drug Xyrem.
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What basic questions should we be asking our patients who complain of sleep problems? We talk to Robert S. Rosenberg, DO, FCCP, to get his insight on sleep disorders, sleep apnea, restless leg syndrome, sleep studies, and benzodiazepines.
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Geriatric depression often presents with apathy, low energy and motivation, and cognitive decline, so theoretically stimulants are a natural choice. Past studies of combining stimulants with antidepressants have been mainly small open trials, with mostly positive results. But we haven’t seen the kind of rigorous double-blind methodology we’d like. A new study fills that gap.
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On July 10, the U.S. Food and Drug Administration (FDA) approved Otsuka and Lundbeck’s Rexulti (brexpiprazole) for schizophrenia and as an add-on to antidepressants for adults with depression. As the name suggests, it’s chemically and structurally related to aripiprazole (Abilify).
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Dr. Aiken is the Editor in Chief of The Carlat Psychiatry Report; director of the Mood Treatment Center in North Carolina, where he maintains a private practice combining medication and therapy along with evidence-based complementary and alternative treatments; and Assistant Professor NYU Langone Department of Psychiatry. He has worked as a research assistant at the NIMH and a sub-investigator on clinical trials, and conducts research on a shoestring budget out of his private practice. Follow him on Twitter and find him on LinkedIn.
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