Lemborexant/Dayvigo is the second in sleep med to join the orexin receptor antagonist family. It’s now on the pharmacy shelves, where it sits beside Suvorexant/Bellsomra, released in 2015. Landry I, Nakai K, Ferry J, et al. Pharmacokinetics, pharmacodynamics, and safety of the dual orexin receptor antagonist lemborexant: Findings from single-dose and...

Your patient is experiencing profound grief after the death of his wife. He can’t afford individual therapy and wonders if a support group can help. Will talking about grief to a room of strangers just trigger him more, or will it help? This metanalysis of 14 randomized controlled trials has...

Evening light is associated with so many health risks ─ cancer, diabetes, heart disease ─ that the AMA has a position statement on it. Psychiatrists may need to pay attention as well. It’s been linked to depression, mania, and poor cognition in epidemiologic studies, and this animal study confirms that. An...

Lithium, atypical antipsychotics, ketamine, thyroid… these consistently rank among the most effective medications for treatment resistant depression, but which is the strongest? Strawbridge R, Carter B, Marwood L, et al. Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis. Br J Psychiatry. 2019;214(1):42‐51. [Link]Published On: 6/24/2020Duration: 2 minutes, 8 secondsTranscript:Lithium, atypical antipsychotics,...

The brain changes that lead to dementia can be seen as early as 25 years before the illness starts. We can’t test for those changes, but who might be at risk? This meta-analysis led by Carol Hudon looked at studies that followed healthy middle aged adults with no cognitive problems...

Don't have a DBT center near you? Dr. Lois Choi-Khan has developed a new form of psychotherapy that may work almost as well. In this interview she shares her top tips from this pragmatic approach called Good Psychiatric Management. Featuring archival audio from the late John Gunderson courtesy of borderlinethefilm.com.Published On: 6/22/20Duration:...

A group of French psychiatrists released two papers this month that looked into how often physicians prescribe benzodiazepines and hypnotics in ways that deviate from the guidelines. The result: 20-30% of these prescriptions deviated, and the rate was even higher in chronic medical and psychiatric disorders: 45-68%. But what I...

This month Dr. Jan Spiker and colleagues from Amserdam published an editorial on how to approach comorbid depression and anxiety. They base their suggestions on two recent meta-analyses that found comorbid symptoms decreased when the more clinically significant disorder was treated. Spijker J, Muntingh A, Batelaan N. Advice for Clinicians on...

Hypothyrodism is fairly common on lithium, affecting about 14-17% of patients. Subclinical hypothyroidism is twice as common, and the risk is greater in the elderly. We know what to do about it ─ start thyroid supplement ─ but what hasn’t been clear is whether we should continue that supplement if...

Negative symptoms are the main cause of disability in schizophrenia, and they’ve long been considered untreatable or barely treatable. This study looked at the antidepressant vortioxetine (Trintellix) for them. Vortioxetine is the only antidepressant that has cognitive benefits that they FDA allowed mention of in the prescribing information. The independently sponsored...