Polypharmacy is often practiced in schizophrenia, but you have to look hard to find any evidence that it helps. These two large-scale studies lend some empiric support to the practice, but also give us insights into how it could go wrong.

Depression is a risk factor for dementia, but can antidepressants change that risk? Some, like paroxetine (Paxil), have anticholinergic properties that can impair cognition. This study looked at what that means for the risk of dementia.

Lisdexamfetamine (Vyvanse) is an extended release amphetamine-based stimulant that is approved for both ADHD and binge eating disorder (BED).

Clinical evidence is growing regarding an association between hormonal contraception and mood disturbances (Skovlund CW et al, JAMA Psychiatry 2016;73(11):1154–1162), and recently researchers at the University of Copenhagen published a study attempting to correlate hormonal contraceptive use with suicidal thinking and behavior.

Tic disorders, including Tourette’s, often co-occur with ADHD, OCD, and anxiety disorders. Guanfacine is often tried for all of these conditions. Randomized placebo-controlled trials of immediate release guanfacine have been mixed, with one showing 31% improvement in tics but another showing no significant improvement.

It seems like an endless debate: When a patient does not respond to the first trial of an antidepressant, what should we do? Switch to something else? Augment with another agent? If the latter, how often should that augmenting agent be an atypical antipsychotic?

Somatic symptom disorder (formerly known as hypochondriasis) is pretty common, with a prevalence of 5%–7%, and is much more likely to afflict women than men, with a gender ratio of about 10:1. While both psychotherapy and SSRI treatment are helpful, there is limited evidence about the efficacy of combining therapy with medication. A new study sought to remedy this gap.

Some studies have indicated that patients with ADHD may be at an increased risk of suicide. While these studies have shown associations between methylphenidate use and suicide, it is not clear whether the stimulant actually causes suicidality or whether patients taking stimulants are suicidal for other reasons.

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We often prescribe antidepressants to patients who are suicidal, and unfortunately, some people use these very medications to try to kill themselves. It’s been known for some time that tricyclic antidepressants are among the most toxic in overdose, so we embraced the SSRIs and later medications in part because they are considered to be safer. But how safe are they?