A recall of 300,000 bottles of the antidepressant Cymbalta (duloxetine) has been issued, necessitating immediate verification of stock and patient counseling regarding potential quality or safety issues.
This case report describes new-onset visual snow syndrome temporally associated with bupropion initiation and resolution upon discontinuation, highlighting a rare but significant neuropsychiatric adverse effect of this antidepressant.
A long-term follow-up study demonstrates that psilocybin combined with psychotherapy provides sustained antidepressant effects for up to 12 months in patients with treatment-resistant depression.
A study indicates that psilocybin combined with psychotherapy produces sustained antidepressant effects over a 12-month period, highlighting the potential long-term efficacy of this novel psychotropic treatment for depression.
A retrospective cohort study reveals that lithium dispensing remains low in Dutch youth with bipolar disorder despite its first-line status, with a concurrent high rate of prior or concomitant use of SGAs and antidepressants.
Clinical Pearls
Bite-sized clinical takeaways from today's literature (sources from Feb 18 – Jun 18)
- Consider adding a 5-HT3R antagonist like ondansetron to the regimen of patients with schizophrenia who have persistent negative symptoms or cognitive impairment.
- Align lithium dosing schedules with individual circadian rhythms in bipolar disorder patients to potentially enhance efficacy and minimize toxicity.
- Prefer magnetic seizure therapy over electroconvulsive therapy for major depressive disorder when preserving cognitive function is a primary clinical priority.
- Utilize antipsychotic-benzodiazepine combinations rather than haloperidol monotherapy for rapid tranquilization in emergency settings to reduce the risk of extrapyramidal side effects, while monitoring for hypotension.
- Screen for childhood maltreatment history in patients with schizophrenia, as it is a critical predictor of treatment resistance and should guide antipsychotic trial selection.
- Discontinue bupropion if new-onset visual snow syndrome develops, as this rare neuropsychiatric adverse effect may resolve upon withdrawal.
- Verify current stock and counsel patients regarding the recall of Cymbalta (duloxetine) bottles to ensure medication quality and safety.
- Monitor for agitation in dementia patients given the FDA approval of a specific new medication for this indication, offering a targeted pharmacologic option.
- Assess the potential for psilocybin-assisted psychotherapy as a long-term treatment strategy for treatment-resistant depression, noting evidence of sustained efficacy up to 12 months.
Policy & Regulation 2
A common antidepressant has been subject to a recall, necessitating immediate review of current prescriptions and patient monitoring for potential substitution.
The FDA has approved a new medication specifically for the treatment of agitation associated with dementia due to Alzheimer disease.
Clinical Pearl 1
This article proposes integrating chronotherapeutic strategies into lithium treatment for bipolar disorder by aligning dosing with individual circadian rhythms to potentially improve efficacy and reduce toxicity.
Diagnosis & Treatment 3
A meta-analysis indicates that magnetic seizure therapy offers comparable efficacy to electroconvulsive therapy for major depressive disorder with significantly better cognitive safety and tolerability profiles.
This article reviews the use of antipsychotics like pimozide and risperidone for delusional infestation, emphasizing pragmatic engagement strategies and safety monitoring in a psychodermatology context.
A network meta-analysis indicates that antipsychotic-benzodiazepine combinations are superior to haloperidol monotherapy for rapid tranquilization in emergency settings, though they carry a higher risk of hypotension while haloperidol is associated with extrapyramidal side effects.
Journal Article 1
A meta-analysis demonstrates that 5-HT3R antagonists, including setrons and vortioxetine, significantly improve negative symptoms and cognitive impairment in schizophrenia, supporting their potential as adjunctive treatments.
Drug Development 1
A Phase 2 experimental medicine study shows that the novel 5-HT4 receptor agonist PF-04995274 increases hippocampal activity during memory encoding in unmedicated depressed patients, supporting its development as a cognitive-enhancing adjunct for Major Depressive Disorder.
Mechanism of Action 2
A single dose of psilocybin is associated with rapid relief from depressive symptoms, highlighting its potential as a novel pharmacotherapy for depression.
Ketamine increases early NREM slow wave activity in treatment-resistant depression patients, particularly responders, suggesting this sleep modulation is linked to its antidepressant efficacy.