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Meta ‐analysis: Dose of ketamine reduces symptoms of suicidal ideation rapidly
A systematic review of 10 studies has found that a single intravenous dose of ketamine reduced suicidal thoughts within a day in patients with a psychiatric disorder, with the effects of the dose lasting up to one week. The researchers stated that although these results should be considered preliminary, they suggest that ketamine appears promising as a rapid‐acting treatment for patients at acute risk of suicide. Results were published online Oct. 3 in the American Journal of Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - December 21, 2017 Category: Psychiatry Tags: Suicide Prevention Source Type: research

Evidence lacking to support cannabis for treating PTSD, chronic pain
Systematic reviews published online Aug. 15 in the Annals of Internal Medicine concluded that there is insufficient evidence to support the use of cannabis in treating post‐traumatic stress disorder (PTSD) and chronic pain. The review of research on cannabis in pain treatment did find limited evidence suggesting that the drug can relieve neuropathic pain in some patients, but that review also found evidence that cannabis use can generate or exacerbate psychotic or manic symptoms. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - November 20, 2017 Category: Psychiatry Tags: Medical Marijuana Source Type: research

Research Roundup
Omega‐3 supplements improve symptoms in children with ADHD Variable benefit of antidepressants for youths with depressive, anxiety disorders Use of SSRIs not associated with bone density change Both lithium and divalproex effective for bipolar mania in older adults (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - November 19, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research

Neonatal drug withdrawal risk increased by concurrent psychotropic plus opioid treatment versus opioid alone
A cohort study using a national sample from Medicaid records has found that when pregnant women used both a prescription opioid and a psychotropic medication, their newborns were at increased risk of neonatal drug withdrawal when compared with infants who had been exposed only to an opioid. Withdrawal severity also appeared to be greater in the group exposed to both classes of drugs. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - November 19, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Risk of relapse to binge eating disorder lower for lisdexamfetamine compared with placebo
Patients with binge eating disorder (BED) who were randomized to lisdexamfetamine dimesylate after initial response to the drug in an open‐label trial had a significantly lower risk of relapse than patients randomized to placebo, a study has found. Most adverse effects from lisdexamfetamine were mild to moderate in severity and were in line with the drug's safety profile from prior BED studies and from trials in treating attention‐deficit hyperactivity disorder (ADHD), the researchers reported. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - November 19, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Warfarin and SSRIs
Depression frequently occurs in the setting of cardiovascular disease, including atrial fibrillation. Anticoagulants such as warfarin are commonly used in patients with atrial fibrillation in order to prevent the occurrence of stroke, while selective serotonin reuptake inhibitors (SSRIs), the mainstays of antidepressant pharmacology, have been associated with abnormal coagulation and have been reported to cause bleeding. This effect of the SSRIs may be secondary to their impairment of platelet aggregation and/or their inhibitory effects on cytochrome P‐450 enzymes, including those involved in the elimination of warfarin....
Source: The Brown University Psychopharmacology Update - November 19, 2017 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Review of ketamine safety highlights need for analyses of long ‐term effects
Side effects across all categories were more frequently reported with ketamine treatment compared with placebo for depression, a systematic review has found, but few of the studies that were included in the review examined long‐term effects of ketamine dosing. The researchers recommended the initiation of large‐scale trials involving repeated doses of ketamine. Results of the review were published online July 27 in Lancet Psychiatry. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - November 19, 2017 Category: Psychiatry Tags: Adverse Effects Source Type: research

Aripiprazole augmentation of antidepressant improves chance of remission in VA population
A study conducted in the Department of Veterans Affairs (VA) health system has found that for patients with depression unresponsive to antidepressant treatment, augmentation with aripiprazole resulted in a modest increased likelihood of remission when compared with antidepressant switching or augmentation with bupropion. The aripiprazole group was more prone to adverse effects such as weight gain, but other adverse effects were more prominent in the other two patient groups. Study results were published July 11 in JAMA. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Tags: Depression Treatment Source Type: research

Research Roundup
Extended‐release tramadol shows promise for opioid withdrawal Methylphenidate not associated with risk of attempted suicide Self‐harm risk lower with clozapine compared to other antipsychotics Drug in development shows efficacy for negative symptoms of schizophrenia No evidence of intellectual disability risk from antidepressant use during pregnancy (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research

The VMAT2 inhibitors: New hope for an old scourge
A scourge, to be sure, of our own making. I'm referring in the title of this commentary to tardive dyskinesia (TD), one of the most debilitating side effects of the first‐generation antipsychotics (FGAs). Although TD was first recognized as an adverse effect of these drugs in the 1950s, it was decades before our field fully embraced the implications. In no small part, this reflected our reluctance to find fault with a class of drugs that had revolutionized treatment for millions of people. The incidence of TD has declined significantly since the introduction of the second‐generation antipsychotics (SGAs) in the 1990s �...
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Authors: Lawrence H. Price Tags: Editor's Commentary Source Type: research

Two doses of deutetrabenazine show efficacy over placebo in treating tardive dyskinesia
The vesicular monoamine transporter‐2 (VMAT2) inhibitor deutetrabenazine at doses of 24 and 36 mg/day demonstrated efficacy compared with placebo in a 12‐week Phase 3 trial in patients with tardive dyskinesia (TD). The results of this study and another trial were instrumental in the Food and Drug Administration's (FDA's) recent decision to approve deutetrabenazine for the TD indication. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Tags: What's New in Research Source Type: research

Peptic ulcer risk with antidepressants and NSAIDs
Although the selective serotonin reuptake inhibitors (SSRIs) have a very good safety profile, they have been associated with spontaneous bleeding in some patients. The risk could be further increased if patients are taking concurrent nonsteroidal anti‐inflammatory drugs (NSAIDs). Investigators recently conducted a retrospective analysis to evaluate the risk of peptic ulcer disease associated with concomitant use of both classes of drugs, as compared with use of antidepressants alone, as well as to examine the differential risk among the various classes of antidepressants and individual antidepressants. (Source: The Brown...
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Authors: Y. W. Francis Lam Tags: Drug ‐Drug Interactions Source Type: research

Study finds no more than minor increase in mortality risk from benzodiazepines
A retrospective cohort study comparing outcomes for initiators and noninitiators of benzodiazepines has found at most a minor increase of all‐cause mortality associated with initiation. Researchers proposed that residual confounding probably accounts for at least part of the increased risk. Study results were published online July 6 in BMJ. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - October 25, 2017 Category: Psychiatry Tags: Anxiety Treatment Source Type: research

Brain stimulation technique fails to show noninferiority to antidepressant treatment
The noninvasive brain stimulation technique known as transcranial direct‐current stimulation (tDCS) did not demonstrate noninferiority to escitalopram in a 10‐week trial of patients with depression. The study's electrical stimulation group also experienced more adverse events, including onset of mania in two participants. Study results were published June 29 in the New England Journal of Medicine. (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 19, 2017 Category: Psychiatry Tags: Depression Treatment Source Type: research

Research Roundup
No association found between ADHD medication, substance abuse risk Modulator of GABA receptors effective for women with postpartum depression Weekly formulation of buprenorphine stabilizes patients with opioid disorder Clonazepam has favorable results in lowering relapse in panic disorder Review of ADHD treatments shows greater benefit than risk Review of treatment for sex offenders emphasizes limits of available studies (Source: The Brown University Psychopharmacology Update)
Source: The Brown University Psychopharmacology Update - September 19, 2017 Category: Psychiatry Tags: Research Roundup Source Type: research