Psychiatric News (9/6) reported, “Along with aripiprazole and risperidone, olanzapine and perphenazine should be considered first-line antipsychotics for patients with schizophrenia, according to a clinical perspective.” According to Psychiatric News, “given its demonstrated effects on hostility, the researchers believe olanzapine is a preferred first-line choice for patients for whom aggression may be a concern, with clozapine as a second-line medication.” The perspective was published in Schizophrenia.

Related Links:

— “Researchers Propose Olanzapine and Perphenazine as First-Line Schizophrenia Treatments, Psychiatric News, September 6, 2024

HealthDay (9/5, Thompson ) reports “ketamine is becoming a popular depression drug, but” physicians are not “keeping in mind the danger it can pose to a pregnancy, a new study warns.” Ketamine may “be very harmful to a developing fetus and should not be used during pregnancy, researchers said.” However, “only 20% of ketamine clinics require a pregnancy test at least once prior to or during treatment, according to” study results. Additionally, “only 26% of clinics discuss the potential need for contraception with” patients using ketamine, “and fewer than 15% specifically recommend or require contraception use during ketamine treatment, researchers found.” The findings were published in the Journal of Clinical Psychiatry.

Related Links:

— “Ketamine Can Fight Depression, But Pregnant Women Face Risks,”
Dennis Thompson, HealthDay, September 5, 2024

Psychiatric News (9/5) reports, “About 4% of individuals with a neuropsychiatric disorder had a serious adverse event – including worsening depression, suicidal behavior, psychosis, or convulsions – after being given a ‘classic’ psychedelic as part of a research study, according to a meta-analysis that spanned some 75 years.” The research “identified no such adverse events among healthy participants; at the same time, tracking of such events should be improved, the study researchers wrote.” The findings were published in JAMA Psychiatry.

Related Links:

— “Study Finds Roughly 4% Of Individuals With Neuropsychiatric Disorder Have Serious Adverse Event After Being Given Psychedelic As Part Of Research, Psychiatric News , September 5, 2024

Healio (9/5, Mahoney) reports, “High-dose psilocybin showed the potential to treat depressive symptoms, although the effect size appeared small and comparable to that of escitalopram, according to results of a network meta-analysis.” The researchers “performed a sensitivity analysis that included only patients with major depressive disorder and found that the relative effects of escitalopram, ayahuasca and high-dose psilocybin had better responses than placebo in antidepressant trials.” The findings were published in The BMJ.

Related Links:

— “High-dose psilocybin may help treat depressive symptoms, with small effect size,”Moira Mahoney, Healio, September 5, 2024

MedPage Today (9/4, DePeau-Wilson ) reports, “Having a medical condition was associated with an increased risk of suicide in a dose-response-like manner, such that the higher the burden of disability, the higher the risk of suicide, according to an observational study in Denmark.” An analysis of over “6.6 million people found that nine medical condition categories including 31 specific conditions were associated with a statistically significant increased risk of suicide, with the exception of endocrine disorders.” Researchers found “the associations were most pronounced for gastrointestinal conditions… cancers…and hematological conditions.” The findings were published in JAMA Psychiatry. “ Individuals with mental disorder requiring psychiatric hospital treatment appear to be at such elevated risk of suicide that additional disability associated with medical conditions has little impact in this regard.”

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— MedPage Today (requires login and subscription)

MedPage Today (9/3, Monaco ) reports, “Two new studies published in JAMA Internal Medicine do not support a previously reported association between GLP-1 receptor agonists and a signal for suicidal ideation.” In one “analysis of nearly 300,000 new users of a GLP-1 agonist or SGLT2 inhibitor in Sweden and Denmark, primarily for diabetes, rates of suicide death over 2.5 years were not significantly different between groups, reaching 0.23 and 0.18 events per 1,000 person-years, respectively.” In the second study, researchers “pooled data from several of the STEP trials that supported semaglutide’s (Wegovy) weight-loss indication.” The “analysis showed that in STEP 1, 2, and 3, depression scores on the Patient Health Questionnaire-9 were lower at study end for patients on a 2.4-mg dose of semaglutide versus placebo recipients.”

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— MedPage Today (requires login and subscription)

Psychiatric News (9/3) reports “cannabis use disorder and frequent cannabis use are linked to greater absenteeism at work, a study” found. Study “participants who used cannabis in the past month had a mean 1.47 days of missed work because of illness or injury, compared with 0.95 days for those who never used cannabis.” The findings were published in the American Journal of Preventive Medicine.

Related Links:

— “Cannabis Use Linked to Absenteeism at Work, Psychiatric News, September 3, 2024

The New York Times (9/1, Silver-Greenberg , Thomas) reported “Acadia Healthcare is one of America’s largest chains of psychiatric hospitals,” and “since the pandemic exacerbated a national mental health crisis, the company’s revenue has soared.” However, “a New York Times investigation found that some of that success was built on a disturbing practice: Acadia has lured patients into its facilities and held them against their will, even when detaining them was not medically necessary.” According to records, “in at least 12 of the 19 states where Acadia operates psychiatric hospitals, dozens of patients, employees and police officers have alerted the authorities that the company was detaining people in ways that violated the law.” In a number of “cases, judges have intervened to force Acadia to release patients.”

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— “The New York Times (requires login and subscription)

Psychiatric News (8/30) reported, “A systematic analysis of brain imaging data from nearly 500 individuals suggests that a prevailing neurological hypothesis of autism spectrum disorder (ASD) – theorizing that people with ASD have poorer neural connections in certain brain regions relative to those without ASD – may not be accurate.” The researchers said, “It is important to note that we do not conclude that amygdala [connectivity] is generally typical in autism. Instead, we conclude that the evidence for atypical [connectivity] of the amygdala in autism is weak at best, and unreliable.” The findings were published in the American Journal of Psychiatry.

Related Links:

— “Study Uncovers No Strong Evidence That Autism Is Linked With Poor Amygdala Connectivity, Psychiatric News, August 30, 2024

Pharmacy Times (8/29, Halpern) reports, “Essential trials supporting the approvals of FDA breakthrough therapy-designated drugs often used surrogate markers as primary end points – even when not approved through the accelerated approval pathway – and often lacked post-marketing studies to confirm a drug’s clinical benefit, according to the results of a study.” These discoveries “could lead to uncertainties and confusion for both clinicians and patients surrounding the use of breakthrough therapy-designated drugs and suggest that the requiring of post-marketing studies – regardless of approval pathway – could heighten certainty that key stakeholders have in the expected clinical benefit.” The findings were published in JAMA Network Open.

Related Links:

— “Frequent Use of Surrogate Markers Could Create Uncertainty for Breakthrough-Designated Drugs,”Luke Halpern, Pharmacy Times , August 29, 2024