Category Archives: Controversies

Flawed consensus statement for tardive dyskinesia

Intended as a statement of consensus to inform a standard of care in persons with tardive dyskinesia, this report, by authors of record Stanley Caroff, Les Citrome, and colleagues, published last spring in the Journal of Clinical Psychiatry (2020, March-April (81(2): 19cs12983), is presented as an investigational study, but it is not designed to test a null hypothesis, nor does … Read the rest

Pregabalin and gabapentin side effects differ

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“Gabapentinoid” differences hidden in plain view

The exposition of this epidemiologic survey of “gabapentinoids,” by an elite research collaboration that includes groups at the University of Oxford and Sweden’s Karolinska Institute (Yasmina Molero and colleagues, British Medical Journal 365: 12147, 2019 (published online on June 12, 2019)), seems to have hidden in plain view what may prove critical differences … Read the rest

An opioid adjunct for treatment-resistant depression

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

Confirmation bias and esketamine approval

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

Partial Tolerance to Methylphenidate in ADHD?

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