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Sertraline fails to improve symptoms of depression in kidney disease patients
A 12‐week double‐blind, placebo‐controlled trial has found that the antidepressant sertraline did not result in significant improvement in depressive symptoms in patients with chronic kidney disease not involving dialysis. The study is believed to be the largest randomized trial of a commonly used selective serotonin reuptake inhibitor (SSRI) for treatment of major depression in this chronically ill population, a group that is highly susceptible to developing depression. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - February 9, 2018 Category: Psychiatry Tags: What's New in Research Source Type: research

Atypical antipsychotic ‐associated falls in older adults
Atypical antipsychotics are commonly prescribed for older patients, but their use constitutes an important risk factor associated with falls and resultant hip fracture. A recent analysis of Canadian population‐based claims data showed atypical antipsychotics significantly increased 90‐day risk for falls and various types of fractures. However, research data overall have offered conflicting results. The following study described an emulation analysis with U.S. claims data to evaluate further the risk of falls and fractures in elderly patients receiving atypical antipsychotics. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - February 9, 2018 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Hormonal contraceptive use associated with increased risk of suicidal behavior
Use of hormonal contraceptives was positively associated with an increased risk of suicide attempt and suicide, a prospective cohort study conducted in Denmark has found. The highest risk was present among adolescent women, according to the researchers, and the association between hormonal contraceptive use and a first suicide attempt reached its peak after two months of contraceptive use. Study results were published online Nov. 17, 2017, in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - February 9, 2018 Category: Psychiatry Tags: Adverse Effects Source Type: research

Injectable naltrexone found as effective as buprenorphine in noninferiority trial
A 12‐week trial conducted in Norway has found injectable extended‐release naltrexone to be noninferior to oral buprenorphine‐naloxone on a number of outcomes for opioid‐dependent patients, including treatment retention and opioid‐negative drug tests. These results have significant implications because the study represents one of the first direct comparisons between injectable naltrexone and what has become the standard‐of‐care treatment for opioid dependence in several countries. Study results were published online Oct. 18 in JAMA Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Tags: Addiction Treatment Source Type: research

Research Roundup
FDA data on pimavanserin show favorable risk profile Review finds little evidence of addictive power of gabapentinoids Use of montelukast for asthma linked with neuropsychiatric effects Open‐label trial finds psilocybin improves depressive symptoms Study finds antidepressant adherence varies little between physicians ADHD medication use during pregnancy linked with CNS disorders in infants Two tested doses of valbenazine found safe for tardive dyskinesia (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Tags: Research Roundup Source Type: research

Genetic factors in schizophrenia linked to response to lithium
Patients with bipolar disorder who had a high genetic susceptibility to schizophrenia showed weaker response to lithium, according to a genomewide association study published online Nov. 9, 2017, in JAMA Psychiatry. This research is believed to offer the first evidence that genetic characterization can help guide clinicians' medication treatment decision‐making for patients with bipolar disorder. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Tags: What's New in Research Source Type: research

Data show increase in nonmedical use of stimulants
Data collected from the National Survey on Drug Use and Health indicate that nonmedical use of prescription stimulants was higher in the 2013–2014 period than a decade earlier. More than half of nonmedical users reported that they most recently received the drugs from friends or family members. However, more frequent users and those with a stimulant use disorder were more likely to receive the drugs from a physician, highlighting the role medical professionals can have in curbing stimulant misuse. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Tags: What's New in Research Source Type: research

Anxiety associated with ciprofloxacin
Ciprofloxacin is a commonly prescribed antibiotic from the fluoroquinolone class. In general, fluoroquinolones have a wide therapeutic index with a favorable safety profile. However, use of this class of drugs has been associated with neuropsychiatric adverse effects, with clinical symptoms that include anxiety, depression, and insomnia. The following case report describes an elderly patient experiencing an exacerbation of anxiety after taking ciprofloxacin. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

A pharmacogenetic ‐guided treatment improves depression, anxiety outcomes
A randomized trial has found that patients whose medication treatment for depression or anxiety was guided by a pharmacogenetic test showed higher response and remission rates than patients whose treatment was guided by usual‐care standards. The study offers evidence of the applicability of the pharmacogenetic test, in that physicians in the study's first two weeks made at least one medication change in 81% of the group for whom pharmacogenetic test results were available for review. The study's findings were published online Sept. 23 in the Journal of Psychiatric Research. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - January 9, 2018 Category: Psychiatry Tags: Genetic Testing Source Type: research

Asenapine reduces manic and depressive episodes in maintenance trial for bipolar disorder
The atypical antipsychotic asenapine extended the time to recurrence of any mood episode when compared with placebo in a 26‐week maintenance trial for patients with bipolar disorder, researchers have reported. The results are significant in that many treatments used for bipolar disorder appear to be more effective in controlling manic or depressive symptoms but not both. Study results were published online Sept. 26 in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: Bipolar Disorder Treatment Source Type: research

Drug Safety Communication
(Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: From the FDA Source Type: research

Research Roundup
Psychosocial intervention improves adherence to antidepressants Patients on opioid agonists fare best with psychotherapy for mood symptoms Antidepressant use in pregnancy linked with psychiatric disorders in offspring Suvorexant has preventive effect on delirium in elderly patients Adding lorazepam effective for delirium in patients with advanced cancer (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research

Maternal panic disorder, GAD do not cause pregnancy or birth complications
A cohort study involving pregnant women has concluded that the presence of maternal panic disorder or generalized anxiety disorder (GAD) does not contribute to maternal or neonatal complications such as preterm birth or low birth weight. The study did find that women's use of benzodiazepines or serotonin reuptake inhibitors (SRIs) during pregnancy was associated with some complications of mainly minimal severity. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Methylphenidate improves apathy in veterans with Alzheimer's disease
A 12‐week randomized, placebo‐controlled trial has concluded that methylphenidate improves apathy in community‐dwelling military veterans with Alzheimer's disease. The study also found improvements with methylphenidate relative to placebo on measures of cognition, functional status, depression, and caregiver burden. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Opioids and CNS depressants: Walking the fine line
The U.S. Food and Drug Administration (FDA) is highly respected in the medical community, but it is, after all, a government agency, and not all of its official pronouncements are particularly newsworthy. At The Update, we try to cover the ones that convey new information we believe has the potential to meaningfully impact the practice of our readers or the well‐being of their patients. By those criteria, the Drug Safety Communication summarized in this month's issue (page 8) wouldn't seem to make the cut. It's titled “FDA urges caution about withholding opioid addiction medications from patients taking benzodiazepines...
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Authors: Lawrence H. Price Tags: Editor's Commentary Source Type: research