A randomized clinical trial demonstrates that a single dose of psilocybin reduces cocaine use, with Filament Health holding exclusive rights to the data.
A study on genotype-guided SSRI prescribing yields mixed results, providing nuanced evidence for the clinical utility of pharmacogenomic testing in antidepressant treatment.
This study develops a validated risk model for self-harm in patients with substance use disorders, identifying recent psychotropic medication use as a significant predictor of risk alongside prior self-harm and mental comorbidity.
New Mexico is launching a medical psilocybin program, representing a significant policy shift in the regulation of psychedelic substances for psychiatric treatment.
A clinical trial evaluating the adjunctive use of Ashwagandha with risperidone in schizophrenia patients, representing a study on herbal supplements in psychiatric treatment.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from Oct 29 – May 08)
- Monitor patients starting aripiprazole for signs of impulse control disorders, such as pathological gambling, and educate them on this specific adverse effect.
- Exercise extreme caution and limit duration when prescribing antipsychotics for agitation in dementia due to a significantly increased risk of mortality.
- Consider the patient's sleep architecture when selecting antidepressants; prefer agomelatine or mirtazapine over SSRIs/SNRIs if preserving restorative sleep stages is a priority.
- Utilize Auvelity (dextromethorphan/bupropion) as a pharmacologic option for agitation associated with Alzheimer's disease, noting its recent FDA-approved expanded use.
- Incorporate baseline neutrophil-to-platelet ratio and pre-treatment HAMD scores into clinical judgment to predict poor response to ECT in adolescents with MDD.
- Advocate for precision phenotyping of elevated anxious arousal in PTSD to identify subgroups that may specifically benefit from GABAergic pharmacotherapy.
- Recognize that higher-THC medicinal cannabis products are associated with the majority of psychiatric adverse events and monitor patients closely for psychiatric reactions.
- Discuss with patients that their treatment preference may be a more significant driver of antidepressant success than pharmacogenomic testing results.
- Consider the combination of ketamine and dialectical behavioral therapy for patients with treatment-resistant depression and borderline personality disorder who present with suicidality.
- Evaluate the potential for genotype-guided SSRI prescribing as a strategy to increase remission rates, while acknowledging mixed evidence regarding its routine clinical utility.
Clinical Pearl 4
This article discusses a clinical trial investigating psilocybin for the treatment of cocaine use disorder, highlighting the long-term research efforts by Peter Hendricks.
Clinical evidence suggests that patient preference is a more effective driver of antidepressant treatment success than pharmacogenomic testing, challenging the routine use of PGx in prescribing.
This case report illustrates aripiprazole-induced pathological gambling, reinforcing the need for clinicians to monitor patients for impulse control disorders when prescribing this partial D2/D3 agonist.
A clinical trial is recruiting to evaluate the combination of ketamine hydrochloride and dialectical behavioral therapy for treating suicidality in patients with treatment-resistant depression and borderline personality disorder.
Pharmacogenomics 1
A genotype-guided SSRI prescription strategy significantly increased depression remission rates at six months, highlighting the clinical utility of pharmacogenomics in optimizing antidepressant selection.
Substance Use 1
Monash University research indicates that higher-THC medicinal cannabis products are associated with a majority of adverse events reported to Australia's regulator, with psychiatric disorders being the most common reaction.
Policy & Regulation 2
FDA has approved the expanded use of Auvelity (dextromethorphan/bupropion) to treat agitation associated with Alzheimer's disease, providing a new pharmacologic option for behavioral symptoms in dementia.
Louisiana has passed a bill to establish a state-regulated psychedelic therapy program, marking a significant policy shift for the clinical use of psychedelics in the region.
Diagnosis & Treatment 4
A large meta-analysis confirms that antipsychotic use in dementia patients is associated with a significantly increased mortality risk, reinforcing the need for cautious prescribing and regular medication reviews.
This review suggests that precision phenotyping of elevated anxious arousal in PTSD may identify a subgroup of patients who respond specifically to GABAergic pharmacotherapy, advocating for stratified clinical trials.
Research suggests lithium may reduce impulsive decision-making associated with suicide risk, reinforcing its clinical utility in mood disorders and suicide prevention.
Psychedelic-assisted therapy with psilocybin or LSD yields divergent clinical outcomes, with some patients experiencing therapeutic benefit while others deteriorate, highlighting the need for careful patient selection and monitoring in emerging psychiatric treatments.
Mechanism of Action 5
A study demonstrates that lithium treatment alters brain electrical activity associated with impulsive decision-making in suicide attempt survivors, offering a potential neurophysiological mechanism for its protective effect.
Preclinical or early clinical research indicates psilocybin induces lasting anatomical changes in brain tracts and reduces neural rigidity, offering a mechanistic basis for its therapeutic effects in psychiatric conditions.
This article describes the mechanism of action of psilocybin, specifically its ability to promote neuroplasticity and rebuild synaptic connections, which is relevant to understanding its therapeutic potential in psychiatric conditions.
Preclinical research indicates psilocybin reduces aggression and attack behaviors, providing mechanistic insight into its potential for treating conditions characterized by impulsivity and aggression.
New cellular-level evidence reveals that accelerated TMS restores synaptic connections in IT neurons, offering a mechanistic explanation for its rapid antidepressant effects.
Drug Development 2
The FDA has cleared a clinical trial to evaluate the combination of the investigational drug NRX-101 with robotic-enabled TMS for treating depression and suicidality.
A clinical trial is recruiting participants to evaluate the efficacy, safety, and tolerability of COMP360 (psilocybin) for the treatment of post-traumatic stress disorder.
Podcast Summary 1
This podcast discusses the use of deep brain stimulation and neuromodulation for treating OCD, binge eating disorder, and depression, alongside the neuroscience of compulsive behaviors.
Digital Health 1
A clinical trial is recruiting to evaluate transcranial direct current stimulation (tDCS) as an intervention for Major Depressive Disorder, representing a digital health/neuromodulation treatment approach rather than a pharmacologic one.
Uncategorized 3
Bayer to buy Perfuse for up to $2.45B, bolstering eye drug pipeline
Journal Article 1
This article reports on a randomized, multicenter trial comparing the efficacy and tolerability of seven antipsychotic drugs in acutely ill patients with schizophrenia, providing direct comparative data for prescribing decisions.