Research has shown that heavy cannabis use is associated with new-onset psychosis, so a study exploring the drug’s use as a treatment for schizophrenia is surprising, to say the least.

Evaluating a first episode of psychosis in college students is challenging—it’s not clear from the outset if the episode will represent a one-time occurrence or the start of a lifelong illness. The differential diagnosis is large and includes depression with psychotic features, bipolar disorder, a primary psychotic disorder like schizophrenia or schizoaffective disorder, drug-induced psychosis, and transient psychotic episodes.

If a kid without psychosis says Freddy Krueger’s in the closet and his parents assure him that no one is in there, he will eventually settle down and fall asleep. A psychotic child will not be able to fall asleep and will persist in his belief no matter how much reassurance he receives. Another important clue is if the child has these fears during the day or at school.

The post-test for this issue is available for one year after the publication date to subscribers only. By successfully completing the test you will be awarded a certificate for 1 CME credit.

The use of antipsychotics during pregnancy has doubled over the past decade, and there have been ongoing concerns about the risk of congenital malformations. In the May issue of TCPR, we reviewed a pregnancy registry study showing no significant association between atypical antipsychotic use and major malformation.

Atypical antipsychotics are commonly used to reduce irritability and agitation in children with autism spectrum disorder (ASD). Although effective, these medications lead to weight gain and other metabolic problems. Strategies like tailored diet plans and exercise can help, but they are often not enough. If not interrupted early, for many, continued weight gain will lead to diabetes, hypertension, and heart disease later in life.

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Excessive salivation is a common and troubling adverse effect of clozapine therapy, occurring in about 30% of patients. Recently, Israeli researchers evaluated another potential treatment, metoclopramide (Reglan), which is a drug for nausea and other gastrointestinal problems. Since metoclopramide commonly causes dry mouth, the authors of this paper reasoned that it might work for clozapine-induced hypersalivation.

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