The FDA has approved a new treatment for agitation associated with Alzheimer's disease, marking a significant development in managing behavioral symptoms of dementia.
A study indicates that while dementia prevalence increased among nursing home residents during the pandemic, antipsychotic prescribing rates decreased, highlighting a shift in prescribing patterns for this high-risk population.
The FDA has approved Axsome's Auvelity (dextromethorphan/bupropion) for the treatment of agitation associated with Alzheimer's disease, providing a new pharmacologic option for this behavioral symptom.
The FDA proposed excluding semaglutide and tirzepatide from the compounding list, a regulatory action with significant implications for the availability of GLP-1 obesity and diabetes treatments.
FDA granted approval to Axsome's first non-antipsychotic treatment for agitation associated with Alzheimer's disease, marking a significant shift in pharmacologic management for this behavioral symptom.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from Jan 16 – May 01)
- Consider prescribing lumateperone for patients with schizophrenia who require maintenance therapy and may benefit from its distinct receptor binding profile to prevent relapse.
- Evaluate Auvelity (dextromethorphan/bupropion) as a non-antipsychotic alternative for agitation in Alzheimer's disease to potentially avoid the black box warnings associated with antipsychotics in this population.
- Monitor patients closely for signs of serotonin syndrome when prescribing Auvelity, given its dual mechanism involving dextromethorphan (NMDA antagonist/NRI) and bupropion (NDRI).
- Utilize patient-selected music as a simple, low-cost adjunctive intervention to mitigate transient dissociative or ataxic side effects during intranasal esketamine treatment for treatment-resistant depression.
- Be aware that the development of evenamide for treatment-resistant schizophrenia has been halted due to a patient death, indicating a significant safety concern for this investigational sodium channel blocker.
- Consider the potential off-label repurposing of semaglutide for patients with comorbid alcohol use disorder and obesity, as recent data suggests it may reduce heavy drinking days.
- Explore theta-burst transcranial magnetic stimulation as a non-pharmacologic option for improving social communication and language in autistic children with intellectual disability.
- Exercise caution with sertraline prescriptions by verifying batch integrity and packaging, following recent recalls due to packaging mix-ups that risk unintended serotonergic side effects.
- Recognize that combining cognitive behavioral therapy with psilocybin may offer rapid, significant, and sustained relief of major depression symptoms, supporting integrated treatment approaches.
Diagnosis & Treatment 4
A small proof-of-principle trial suggests MDMA-assisted therapy may be feasible for depression, though the open-label design and pre-treated sample warrant caution.
The FDA has approved Axsome's Auvelity (dextromethorphan/bupropion) as the first non-antipsychotic treatment for agitation associated with Alzheimer's disease, offering a new pharmacologic option for this indication.
Preclinical and early human data suggest minocycline may be effective for panic disorder, showing effects comparable to clonazepam.
A randomized trial published in the BMJ demonstrates that a five-day course of theta-burst transcranial magnetic stimulation significantly improves social communication and language in autistic children with intellectual disability, offering a non-pharmacologic treatment option.
Policy & Regulation 1
The FDA has approved the first non-antipsychotic medication for treating agitation associated with Alzheimer's disease, offering a new prescribing option for this behavioral symptom.
Drug Development 5
MapLight Therapeutics has completed enrollment in two Phase 2 clinical trials evaluating its investigational compounds for schizophrenia and autism spectrum disorder.
The FDA has paused Newron's Phase 3 schizophrenia trial following a patient death, signaling a critical safety signal that may impact the development of this investigational antipsychotic.
A patient death has halted Newron's late-stage clinical trial for a schizophrenia treatment, representing a significant setback in the drug development pipeline for this indication.
This systematic review protocol aims to synthesize human neuroimaging data on dopaminergic dysregulation in opioid use disorder to identify mechanistic targets for novel pharmacotherapies beyond current mu-opioid receptor agonists.
Teva acquired Emalex for $700M to advance its experimental drug for Tourette syndrome, signaling continued investment in neurologic and psychiatric therapeutic pipelines.
Substance Use 2
A small trial suggests semaglutide reduces heavy drinking days in patients with alcohol use disorder and obesity, highlighting a potential repurposing opportunity for GLP-1 agonists in substance use treatment.
Qualitative study reveals that people who use drugs are willing to use higher dose naloxone for opioid overdoses but remain skeptical due to concerns about precipitated withdrawal and pharmaceutical marketing.
Clinical Pearl 3
This case report suggests low-dose mirtazapine as a viable pharmacologic alternative to SSRIs for treating compulsive polydipsia in autistic patients, avoiding the risk of SSRI-induced hyponatremia.
This case report describes the use of patient-selected music as an adjunctive intervention to mitigate transient dissociative and ataxic side effects during intranasal esketamine treatment for treatment-resistant depression, potentially improving tolerability and adherence.
A clinical trial is recruiting to evaluate the efficacy and safety of the dual orexin receptor antagonist daridorexant for treating insomnia in patients with major depressive disorder.
Mechanism of Action 2
This study analyzes intracranial neural activity in three treatment-resistant depression patients to characterize the network effects of combinatorial deep brain stimulation targets, providing mechanistic insights for optimizing surgical parameters.
This study characterizes the acute dose-dependent effects of the psychedelic 2C-B relative to MDMA and psilocybin in healthy volunteers, providing mechanistic insights into psychedelic pharmacology relevant to future psychiatric therapeutic development.
Neuroscience 1
This study identifies the default mode network as a potential neuroimaging biomarker for predicting antidepressant response, offering insights into the neural mechanisms underlying treatment efficacy in depression.
Digital Health 1
This systematic review evaluates intracranial neural biomarkers to guide closed-loop neuromodulation therapies for treatment-resistant psychiatric disorders, highlighting the need to account for disorder-specific symptom time constants.