Research Update

Research Update

Prescribing Patterns for Children With Anxiety Disorders

Topics: adolescents | Anxiety | Child Psychiatry | children | Medication | prescribing patterns | Research Update | teens | treatment pediatric

Review of: Bushnell GA et al, J Clin Psychiatry 2018;79(1):pii:16m11415 Anxiety disorders are some of the most common conditions we encounter in children and adolescents, and clinicians employ a variety of medications to treat them. This study examined prescribing patterns for the initial treatment of pediatric anxiety. Researchers analyzed a larg

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Research Update

Steroid-Induced Psychosis in the ­Pediatric Population

Topics: adolescents | Child Psychiatry | children | pediatric | Psychosis | Research Update | steroids | teens

Review of: Hodgins GE et al, J Child Adolesc Psychopharmacol 2018;28(5):354–359 Childhood psychosis is a rare disorder, and accurate diagnosis is crucial. Recently, clinicians at the University of Miami Miller School of Medicine reported a case of steroid-induced psychosis in a pediatric patient. In the case report, a 12-year-old Haitian girl wa

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Research Update

Risk of Psychosis With Stimulants in ADHD Patients

Topics: ADHD | adolescents | amphetamine | Child Psychiatry | children | Medication | methylphenidate | pediatric | Psychosis | Research Update | stimulant | teens

Review of: Moran LV et al, N Engl J Med 2019;380(12):1128–1138 In 2007, the FDA required stimulant manufacturers to warn of possible psychosis with stimulants. But what is the real incidence? This study set out to find and discern if there is a difference between methylphenidate and amphetamine classes of medications. Drawing from two large comm

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Research Update

Melatonin for Insomnia in Patients With Autism

Topics: Autism | Child Psychiatry | Research Update | Sleep Disorders

Review of: Maras A et al, J Child Adolesc Psychopharmacol 2018;28(10):699–710 Treating sleep problems in youth with autism spectrum disorder (ASD) is tricky at best. One promising treatment is pediatric prolonged-release melatonin ­(PedPRM) sold under the name Slenyto. In 2017, a randomized controlled trial (funded by the manufacturer) assigned 11

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Research Update

Update: Is Watching 13 Reasons Why Bad for Teens?

Topics: Bullying | Contagion | Media | Prevention | Research Update | Risk | Suicidality | Suicide | teens

Review of: Niederkrotenthaler T et al, JAMA Psychiatry 2019. doi: 10.1001/jamapsychiatry.2019.0922 Several studies have examined whether Netflix’s 13 Reasons Why is good or bad for teens. Results have been mixed. In the CCPR March/April 2019 issue, we reported a study finding that most suicidal ideation decreased after watching the first season of

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Research Update

Oral vs Extended-Release Naltrexone for Opioid Use Disorder

Topics: Addiction Treatment | Naltrexone | Opioid Use Disorder | Research Update

Review of: Sullivan MA et al, Am J Psychiatry 2017;174(5):459–467 Extended-release (XR) naltrexone (Vivitrol) is FDA approved for opioid use disorder and has shown efficacy in several trials. It works best for patients who have already successfully detoxed from opioids and who are highly motivated to abstain. But what about oral naltrexone? While i

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Research Update

Does Extended-Release Naltrexone Worsen Psychiatric Symptoms?

Topics: Naltrexone | Opioids | Research Update

Review of: Latif Z et al, JAMA Psychiatry 2019;76(2):127–134 Extended-release (XR) naltrexone (Vivitrol) is an injectable version of naltrexone that lasts for 4 weeks and is FDA approved for opioid use disorder (OUD). Although effective, there is some concern that XR naltrexone may cause or worsen psychiatric symptoms because of its opioid blockade

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Research Update

Gabapentin Enacarbil XR Efficacy Less Than Expected for AUD

Topics: Addiction | Addiction Treatment | Alcohol | Alcohol use disorder | Alcoholism | Clinical practice | extended-release | Medication | Novel Medications | Pharmacology | Psychopharmacology | Research Update

Review of: Falk DE et al, Alcohol Clin Exp Res 2019;43(1):158–169 Gabapentin enacarbil extended-release (GE-XR) (Horizant) is an extended-release version of gabapentin. GE-XR is a prodrug, meaning that once ingested it is metabolized into gabapentin. It is currently approved for treatment of postherpetic neuralgia and restless legs syndrome. It di

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Research Update

Can Buprenorphine Improve PTSD Symptoms?

Topics: Addiction | Addiction Treatment | Antidepressants | Buprenorphine | Co-occurring disorders | Comorbidity | Dual diagnosis | Medication | Opioid Use Disorder | Pharmacology | PTSD | Research Update | SSRIs

Review of: Lake EP et al, Am J Addict 2019;28(2):86–91 For many years, the mainstay of treatment for PTSD has been the SSRI class of medications, but many of our patients still suffer crippling symptoms despite optimal antidepressant medication dosing. PTSD is often accompanied by opioid misuse, sometimes in an effort to self-treat the hyperarousal

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Research Update

Pharmacology for GAD: Complex Choices

Topics: Cymbalta | Duloxetine | Effexor | Generalized Anxiety Disorder | Lyrica | Pharmacology | Pregabalin | Research | Research Update | SSRIs | Venlafaxine

Review of: Slee A et al, Lancet 2019;393(10173):768–777 Study Type: Network meta-analysis With over 2 dozen choices, how do we pick a medication for generalized anxiety disorder (GAD)? The authors of this network meta-analysis sought to answer this question. Network meta-analysis allows researchers to gauge treatments that haven’t been directly c

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Research Update

Olanzapine for Anorexia Nervosa

Topics: Anorexia Nervosa | Antipsychotics | Eating Disorders | olanzapine | Research | Research Update

Review of: Attia E et al, Am J Psychiatry 2019;176(6):449–456 Type of study: Randomized, double-blind, placebo-controlled trial Antipsychotics have been tried in anorexia since 1960, but their success has been mixed and often outweighed by their risks. Seven controlled trials have tested atypical antipsychotics in anorexia, and although most were p

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Research Update

Is There a Case for Cannabis in the Treatment of Pain?

Topics: Cannabidiol | Cannabis | Marijuana | Opioids | Pain | Research | Research Update

Review of: Da Vita et al, JAMA Psychiatry 2018;75(11):1118-1127 Study Type: Meta-analysis of placebo-controlled trials In the midst of the opioid epidemic, researchers are looking for new ways to treat chronic pain. Interestingly, states that have legalized medical marijuana have fewer opioid prescriptions but no clear reduction in mortality over

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Research Update

Another Black Eye for Prazosin in PTSD?

Topics: Hypnotics | Insomnia | Nightmares | Prazosin | PTSD | Research | Research Update | Sleep | Suicidality

Review of: McCall W et al, J Clin Psychopharmacol 2018;38(6):618–621 Study Type: Randomized single-blind controlled trial (pilot study) Prazosin has become a mainstay in the pharmacologic treatment of PTSD. A selective antagonist of the noradrenergic alpha-1 receptor, it has modest benefits in sleep and nightmares that are supported by around ha

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Research Update

Moderate Alcohol Use Associated With Reduced Risk of Dementia

Topics: Alcohol Use | Dementia | Geriatric Psychiatry | Research Update

Review of: Sabia S et al, BMJ 2018;362:k2927 Type of study: Prospective cohort study Excessive alcohol use is neurotoxic, but some studies have found that moderate alcohol intake might actually reduce the risk of dementia. Most of these studies, however, have focused on geriatric patients. What about the cumulative impact of alcohol over one’s lifet

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Research Update

Amphetamines Stand Out in ADHD

Topics: ADHD | Amphetamines | Research Update

Review of: Cortese S et al, Lancet 208;5:727–738 Type of study: Meta-analysis With so many medications available to treat ADHD, wouldn’t it be nice to know if some are better than others? In this comprehensive meta-analysis, researchers sought to compare the relative efficacy and tolerability of both stimulant (methylphenidate and am

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Research Update

Rapid-Onset Gender Dysphoria in Adolescents and Young Adults

Topics: Child Psychiatry | Gender Dysphoria | Research Update

Review of: Littman L, PLOS ONE 2018;13(8):e0202330 Rapid-onset gender dysphoria (ROGD) is a newly coined but non-standardized characterization of gender dysphoria (GD). In this conceptualization, GD begins abruptly during or after puberty in adolescents or young adults (AYAs) with no prior symptoms of GD. Clusters of GD outbreaks have been noted by p

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Research Update

How Helpful Is Computerized Testing for ADHD?

Topics: ADHD | Child Psychiatry | Research Update | Technology

Review of: Hollis C et al, J Child Psychol Psychiatry 2018;59(12):1298–1308 With busy clinic schedules and the ever-burgeoning load of documentation, computerized diagnostic aids are in more demand than ever. For ADHD, the gold standard is still a clinical assessment with information from parents and teachers, but those reports are difficult to obt

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Research Update

Would Treating Kids With ADHD Help Their Mothers?

Topics: ADHD | Child Psychiatry | Research Update | Working With Families

Review of: Gokcen C et al, J Child Adolesc Psychopharm 2018;28(5):350–353 Parenting a child with ADHD can be challenging. Parents often report feeling stressed, burned out, or depressed while caring for their children with ADHD. When ADHD medications lead to significant improvements in a child’s behavior, can that alleviate symptoms in parents? A

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Research Update

Is Watching ‘13 Reasons Why’ Bad for Teens?

Topics: Research Update

Review of: Zimerman A et al, J Am Acad Child Adolesc Psychiatry 2018;57(8):610–613 13 Reasons Why, a popular Netflix series, stirred controversy when it portrayed the bullying and suicide of a teenager. Although the program increased awareness of these issues, some clinicians argued that it glamorized suicide and would be detrimental to vulnerable

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Research Update

Does Augmenting Varenicline with Bupropion Work Better than Varenicline Alone?

Topics: Bupropion | Research Update | Smoking Cessation | Varenicline

Review Of: Cinciripini PM et al, Addiction 2018;113:1673-1682 We have a good array of smoking cessation treatments to choose from, including nicotine replacement therapy (NRT), bupropion, and varenicline. Varenicline is the most effective monotherapy agent, somewhat better than bupropion and single-product NRT, and comparable to combination NRT. Theo

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