This article critiques the design of ADHD clinical trials by arguing that current methodologies fail to capture two critical dosing failure modes, implying limitations in the evidence base for ADHD pharmacotherapy.
This article discusses the off-label prescribing of GLP-1 receptor agonists for persons with mental disorders, focusing on their evidence-based use for metabolic comorbidities rather than direct psychiatric treatment.
GLP-1 receptor agonist prescribing among patients with mood disorders increased five-fold from 2018 to 2023, with the majority of prescriptions initiated by non-psychiatrists, highlighting a growing off-label prescribing trend for mood and metabolic comorbidities.
Psilocybin shows potential to increase abstinence rates in patients with cocaine use disorder, highlighting a novel pharmacological approach to stimulant addiction treatment.
A 52-week open-label extension study of AST-001 in children with ASD demonstrates maintained efficacy and good tolerability among prior responders, providing preliminary long-term safety data for this investigational psychotropic.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from May 17 – Jun 01)
- Monitor closely for homicidal ideation in patients prescribed zonisamide, as this severe psychiatric adverse effect necessitates immediate medication discontinuation.
- Consider AST-001 for children with ASD who have previously responded to treatment, as 52-week data supports maintained efficacy and tolerability.
- Evaluate psilocybin-assisted therapy as a potential intervention for increasing abstinence rates in patients with cocaine use disorder.
- Recognize that GLP-1 receptor agonists are increasingly prescribed off-label for metabolic comorbidities in mood disorders, though they lack evidence for direct psychiatric symptom treatment.
- Be aware that the majority of GLP-1 receptor agonist prescriptions for mood disorders are initiated by non-psychiatrists, requiring collaborative management of metabolic and psychiatric care.
- Critically appraise ADHD pharmacotherapy evidence, keeping in mind that current trial methodologies may fail to capture critical dosing failure modes.
- Stay informed on the FDA's ongoing review of new narcolepsy treatments and the approved clinical trials for psilocybin in PTSD to anticipate future regulatory changes.
- Utilize the long-term safety data from AST-001 studies to counsel families of children with ASD regarding the sustained tolerability of this investigational psychotropic.
Clinical Pearl 1
This case report and literature review documents the first instance of homicidal ideation associated with zonisamide, highlighting a severe psychiatric adverse effect that necessitates medication discontinuation.
Policy & Regulation 1
The FDA is reviewing a new drug application for narcolepsy and has approved a clinical trial for psilocybin in PTSD, highlighting ongoing regulatory and research developments in psychiatric pharmacology.