Ketamine for analgesia in renal colic

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

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

Consensus and evidence in bipolar disorder: Part I, Consensus

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

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

Olanzapine for Anorexia Nervosa

With the arguable exception of clozapine, olanzapine confers the highest risk of weight gain, obesity, and metabolic adverse effects among the second-generation, atypical neuroleptics. Yet, might that adverse effect become a therapeutic one in persons with anorexia nervosa? So wondered clinical researchers Evelyn Attia and colleagues, of Columbia University (American Journal of Psychiatry 176:6:449-456, 2019), who randomly and … Read the rest