A randomized controlled trial demonstrates that low-frequency rTMS targeting the orbitofrontal cortex improves positive symptoms and attentional alertness in schizophrenia, mediated by dynamic modularity between the OFC and default mode network.
This theoretical paper proposes a mechanistic model for psilocybin-induced neuroplasticity, addressing the paradox between 5-HT2A receptor activation and TrkB signaling, which informs the biological basis of psychedelic-assisted therapy.
A new analysis of BXCL501 demonstrates its efficacy in reducing agitation in patients with bipolar disorder and schizophrenia when administered at home, supporting its clinical utility for acute management.
The VA has launched a new clinical trial for MDMA, and recent data indicates psilocybin's antidepressant effects are both rapid and long-lasting, highlighting ongoing research into novel psychedelic treatments for psychiatric conditions.
This article examines antipsychotic prescribing patterns in Ugandan pediatric epilepsy patients, representing a prescribing-pattern study relevant to psychopharmacology practice.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from May 28 – May 30)
- Consider centanafadine for adult ADHD patients who require non-stimulant options and present with significant executive dysfunction or emotional dysregulation.
- Exercise caution when considering psychedelic-assisted therapies for patients with a history of bipolar disorder, as recent meta-analyses highlight a specific risk of psychedelic-induced hypomania and mania.
- Target the orbitofrontal cortex with low-frequency rTMS to potentially improve positive symptoms and attentional alertness in patients with schizophrenia.
- Use sublingual BXCL501 for the acute management of agitation in patients with bipolar disorder or schizophrenia, particularly in home or outpatient settings.
- Anticipate poorer response to SSRIs and SNRIs in patients with atypical depression, as this subtype appears to be distinct and less responsive to these standard first-line agents.
- Avoid relying on FAAH inhibitors for PTSD treatment at this time, as current Phase II trial data shows no clinical benefit for this indication.
- Prioritize NMDA antagonists with intermediate ion-trapping properties, such as ketamine, for treating major depressive disorder, as these properties are linked to sustained modulation of negative affective biases.
- Review antipsychotic prescribing patterns in pediatric patients with epilepsy, as this population requires careful monitoring of psychopharmacological interactions and side effects.
- Consider valproic acid as an off-label option for managing acute anxiety in complex medical scenarios, such as facilitating mechanical ventilation weaning in patients with Guillain-Barre syndrome.
Diagnosis & Treatment 2
A large Australian study indicates that atypical depression is a distinct subtype with poorer response to SSRIs and SNRIs, suggesting potential implications for prescribing strategies in this population.
This systematic review and meta-analysis evaluates the incidence and risk factors of psychedelic-induced hypomania and mania, providing critical safety data for clinicians considering psychedelic-assisted therapies.
Mechanism of Action 1
Preclinical research suggests that sustained modulation of negative affective biases by NMDA antagonists, particularly those with intermediate ion-trapping properties like ketamine, may predict clinical efficacy in major depressive disorder.
Drug Development 3
Post hoc analyses of the Phase 3 centanafadine trial for adult ADHD demonstrate improvements in executive function and emotional dysregulation, providing additional efficacy data for this non-stimulant treatment option.
Poster data from the 2026 ASCP Annual Meeting presents Phase 3 trial results for COMP360 psilocybin in treatment-resistant depression, offering early evidence on the efficacy of this novel psychedelic therapy.
This review evaluates the pharmacological strategy of inhibiting fatty acid amide hydrolase (FAAH) to enhance anandamide signaling for treating psychiatric disorders, noting that current Phase II trials for FAAH inhibitors have shown modest efficacy in cannabis use disorder but no benefit in PTSD.
Clinical Pearl 1
This case report describes the successful use of valproic acid to treat anxiety-related prolonged mechanical ventilation weaning in a patient with Guillain-Barre syndrome, suggesting a potential off-label utility for valproate in acute anxiety management.