Besides apprising us of the height at which FDA currently sets the bar for approval of new drugs in psychiatry, the recent approval of the s-enantiomer of ketamine for treatment-resistant depression provides grist for conjecture about what may be an increasing resemblance between criteria for approval of prescription drugs, which traditionally have required compelling evidence (before approval) of both safety … Read the rest
More recently discussed as a drug that induces a mood-state change devolving to a longer-term augmentive antidepressant effect in persons with erstwhile treatment-resistant depression, ketamine has analgesic effects for acute and chronic pain that have been documented plenteously over nearly two decades in both children and adults. A recent study by Iranian clinical researchers (A. Forouzan and colleages, Review of … Read the rest
This review, published on line by the FDA reviewers who voted (without unanimity) to approve esketamine for treatment-resistant depression (Jean Kim and colleagues, New England Journal of Medicine, published on line, ahead of print, on July 4, 2019), illustrates potential adversity that may devolve from confirmation bias with good intentions. We do not know whether the authors submitted it … Read the rest
CP: Eleven professional associations over the last two decades have published guidelines for the treatment of bipolar disorder (G.B. Parker and colleagues, Acta Psychiatrica Scandinavica 135(6):515-526, 2017; Editor), and of the many recommendations therein, only two have achieved consensus, and neither pertains to the treatment of bipolar depression. One recommends treating mania with antimanic agents, and the … Read the rest
Little is known about long-term outcome of persons diagnosed with and treated for attention deficit/hyperactivity disorder (ADHD) in childhood or adolescence.
That approximately half of the children and adolescents who begin stimulant pharmacotherapy are no longer receiving it ten years later broaches a possibility that ADHD may represent a self-limited anomaly of neurodevelopment—a normal variant that some youth “out-grow.” … Read the rest