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Veterans study cites overdose risk from concurrent opioid, benzodiazepine use
A study examining records from U.S. veterans receiving opioids for pain management between 2004 and 2009 has found an increased risk of death from opioid overdose in patients who took opioids and benzodiazepines concurrently. Risk of death increased at higher daily benzodiazepine doses, study authors reported. Results were published online June 10 in the BMJ. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 21, 2015 Category: Psychiatry Tags: Adverse Events Source Type: research

Enforcement
(Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Tags: From the FDA Source Type: research

Research Roundup
Naltrexone reduces drug craving in methamphetamine‐dependent group Some SSRIs' associations with birth defects not confirmed Meta‐analysis: High‐level evidence lacking in Lewy body dementia treatment Antidepressants combined with NSAIDs increase risk of intracranial bleeding (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Tags: Research Roundup Source Type: research

Adjunctive brexpiprazole effective after inadequate antidepressant response
The novel antipsychotic brexpiprazole improved depression symptoms compared with placebo when used as adjunctive therapy for patients who did not respond adequately to a course of antidepressant treatment, according to two studies that examined a total of three different daily doses of brexpiprazole. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Tags: What's New in Research Source Type: research

Adjunctive raloxifene improves cognition in schizophrenia
The selective estrogen receptor modulator raloxifene significantly improved memory and attention/processing speed relative to placebo in a 13‐week crossover trial that included both men and women with schizophrenia. Raloxifene did not result in a reduction in symptom severity, however. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Tags: What's New in Research Source Type: research

Risk of extrapyramidal reactions with serotonergic antidepressants
Although antidepressants do not possess direct postsynaptic D2 receptor antagonistic activity, case reports in the literature have provided evidence that antidepressant use, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and serotonin/norepinephrine reuptake inhibitors (SNRIs), could be associated with an increased risk of extrapyramidal reactions.1, 2, 3 Recognizing the apparent lack of a clear pharmacological basis of an association between antidepressant use and extrapyramidal reactions such as akathisia, dyskinesia, dystonia, and parkinsonism, a recent review focused on documentin...
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug‐Drug Interactions Source Type: research

SSRI use in pregnancy tied to lower risk of preterm birth
A population‐based cohort study conducted in Finland has found that the risk of preterm birth was lower for pregnant women who received a selective serotonin reuptake inhibitor (SSRI) prescription during pregnancy than for women who had a psychiatric diagnosis but no medication exposure during pregnancy. The children of women receiving SSRIs during pregnancy did have a higher risk of neonatal complications. Study results were published online August 4 in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 20, 2015 Category: Psychiatry Tags: Depression Treatment Source Type: research

High‐quality evidence lacking for cannabinoids in medical treatment
A review and meta‐analysis of studies of cannabinoids for a variety of medical conditions has found that while symptom improvement was common in the studies, it was less likely to see a statistically significant impact of cannabinoid treatment. The highest‐quality evidence seen in the 79 analyzed trials was for use of cannabinoids in the treatment of chronic pain and spasticity. The vast majority of the trials examined cannabinoid drugs and not smoked marijuana, leading the researchers to conclude that more studies of cannabis itself should be conducted. Results of the review and meta‐analysis were published in the J...
Source: The Brown University Psychopharmacology Update - September 23, 2015 Category: Psychiatry Tags: Medical Treatment Source Type: research

Approvals
FDA approves brexpiprazole in schizophrenia and depression treatment FDA approves flibanserin for sexual desire disorder (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Tags: From the FDA Source Type: research

Research Roundup
Review finds rigorous evidence lacking for antidepressants in cancer patients Three antidepressants show efficacy in treating older‐adult population Stimulant improves executive function in study of menopausal women Study highlights metabolite's role in clozapine's effect on memory Supervised heroin injection may work for treatment‐refractory cases (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Tags: Research Roundup Source Type: research

Antipsychotics for children decline, but concerns over prescribing remain
In what is believed to be the first population‐level analysis of antipsychotic prescribing in young people from a nationwide pharmacy claims database, a new study has found that antipsychotic use from 2006–2010 declined in children ages 12 and younger but increased in adolescents and young adults. Among the disturbing findings of the analysis are that only a small minority of young people receive their antipsychotic prescriptions from a child and adolescent psychiatrist, and that most youths receiving these drugs do not have a formal psychiatric diagnosis and have not received psychotherapy in addition to medication. (...
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Tags: What's New in Research Source Type: research

Injectable risperidone shows effectiveness in first‐episode schizophrenia
In findings that conflict with those of other recent studies, a new 12‐month trial has found that long‐acting injectable risperidone was more effective than the oral formulation of the antipsychotic in controlling psychotic symptoms and preventing relapse in patients with recent onset of schizophrenia. The trial differed from other studies in that all patients in the comparison group received oral risperidone, rather than any one of a variety of oral antipsychotics. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Tags: What's New in Research Source Type: research

Serotonin syndrome associated with morphine‐phenelzine interaction
Serotonin syndrome is a potentially serious condition that can, albeit rarely, result in death. It is usually caused by increased serotonin stimulation. The most common pharmacological intervention that results in serotonin syndrome is the concurrent use of a monoamine oxidase inhibitor (MAOI) with either tryptophan, tricyclic antidepressants, or selective serotonin reuptake inhibitors (SSRIs).1 However, some opiates, such as tramadol (Ultram) and meperidine (Demerol), also have weak serotonergic activity and have been reported to precipitate serotonin toxicity with concurrent SSRI administration.2 (Source: The Brown Unive...
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug‐Drug Interactions Source Type: research

Adjunctive ziprasidone improves response in escitalopram‐resistant depression
The atypical antipsychotic ziprasidone had greater antidepressant efficacy compared with placebo when added to escitalopram therapy in individuals with persistent symptoms after 8 weeks of escitalopram alone, a new study has found. Patients receiving ziprasidone plus escitalopram also showed improvement on anxiety measures, according to the study. Results were published online June 18 in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 22, 2015 Category: Psychiatry Tags: Adjunctive Therapy Source Type: research

Infant risk of pulmonary hypertension from maternal antidepressants appears small
A new cohort study examining Medicaid‐insured pregnant women has found a smaller risk of persistent pulmonary hypertension of the newborn (PPHN) from women's late‐term use of antidepressants than what had been seen in earlier research. The latest findings add further context to a topic that has been greatly discussed since the Food and Drug Administration (FDA) in 2006 issued a public health advisory on PPHN risk associated with late exposure to selective serotonin reuptake inhibitors (SSRIs). Study results were published June 2, 2015, in the Journal of the American Medical Association. (Source: The Brown University Ps...
Source: The Brown University Psychopharmacology Update - August 14, 2015 Category: Psychiatry Tags: Antidepressant Treatment Source Type: research