The first phase II trial of esketamine (Spravato) in teen #depression is out. But like the #ketamine trials in youth, the results are just shy of positive: psych-partners.com/esketamine-i... #psychiatry #pmhnp

Fentanyl's potency calls for a different approach with buprenorphine (Suboxone), but few studies clarify how. This large cohort study argues for better retention at 24 vs 16 mg, without added overdose risk: psych-partners.com/dosing-bupre... What is your experience? #opioidcrisis #medicine

Does Olanzapine ODT (Zyprexa Zydis) cause less weight gain than standard tablets? The trials looked negative, but a new analysis suggests a benefit in those who've never taken an antipsychotic. I'm on the fence; tell me your conclusion: psych-partners.com/less-weight-... #psychiatry #pmhnp

New supplement research: 1. Saffron improved sleep in lung disease That makes 7 positive RCTs for #sleep quality with this antidepressive-herb: psych-partners.com/saffron-for-... 2. Sulforaphane in #autism The broccoli extract has 7 RCTs, but the score is mixed psych-partners.com/broccoli-ext...

I worry about light-at-night and #sleep But this new study woke me up to the effect of rising temps, especially after age 45: psych-partners.com/hot-nights-l... Read on for a surprise tip: a hot evening bath can cool you down more than a cold shower. #psychiatry #pmhnp #therapy #mentalhealth

Do GLP-1s treat #alcohol use disorder? Every positive trial: psych-partners.com/a-glp-1-tria... Is followed by a negative, like new one (though positive on secondary outcomes): psych-partners.com/oral-ozempic... I'll give it a "maybe" #psychiatry #pmhnp #sobriety #ozempic

Memantine: ▪ Improved cognition in small RCT in #bipolar, building on earlier, limited data psych-partners.com/memantine-fo... ▪ Mixed signal in #OCD, possible benefit in SSRI non-responders: psych-partners.com/memantine-in... Not ready for prime-time in #psychiatry, perhaps for refractory cases

Think you know #alcohol use disorder? Well... ▪ 3 meds are approved in US ▪ Another 3 are approved outside the US And new guidelines tell us how to personalize the choice: psych-partners.com/how-to-perso... #psychiatry #pmhnp #sobriety #alcoholism

Does Odysseus suffer #PTSD? Do Homer's botanical potions reveal modern medicines? Learn the ancient #psychology that was in the poem, and what modern elements were brought to the film: psych-partners.com/what-the-ody... #psychiatry #pmnp #therapy #mentalhealth #theodyssey

David Mintz et al details 4 attachment styles that affect medication response: ▪ Secure ▪ Preoccupied: +anxiety, low avoidance ▪ Dismissive patients: low anxiety, +avoidance ▪ Fearful patients: +anxiety +avoidance Learn how to work with each of them: psych-partners.com/attachment-s... #psychiatry

FDA just approved the first triple-reuptake inhibitor for #ADHD. Here's a summary: ▪ Similar efficacy to atomoxetine/viloxazine ▪ Faster onset (like viloxazine) ▪ Possibly better tolerated than either of those More details: psych-partners.com/centanafadin... #psychiatry #pmhnp #therapy

Can you treat #OCD in 4 days? The Bergen approach does that with concentrated exposure therapy, and new analysis of 12 trials (3 randomized)suggests it works: psych-partners.com/treating-ocd... #psychiatry #pmhnp #therapy

Lithium may have heart benefits... ▪ Lower stroke risk ▪ Cardiac remodeling ▪ Less atherosclerosis psych-partners.com/lithium-may-... And new study of 2,945 finds lower cardiovascular risks over 3 years: psych-partners.com/lithiums-car... Caveat: Observational, but supported by animal data

How do you switch from benzos/z-hypnotic to safer options? There's not much research, and this observational study tells us we're twice as likely to succeed if they've been on the old med less than a year. More on that and how to cross-taper: psych-partners.com/switching-to... #psychiatry #pmhnp

When pharm-funded guidelines asked what's 1st line for #anxiety, the answer: SSRIs. When the lavender industry funds them, the answer: Silexan (lavender oil): psych-partners.com/anxiety-medi... You be the judge. #psychiatry #pmhnp #therapy

Now hiring in North Carolina: #Durham and #Asheboro (just outside Greensboro). Looking for psychiatric NP/PA who values quality over quantity, life-long learning, patient-centered care. Our practice combines therapy, meds, and natural approaches. Apply: psych-partners.com/employment #pmhnp

Naturals for antipsychotic weight gain get a meta-analytic review. No clear winner, but melatonin/probiotics look like reasonable starts: psych-partners.com/nutraceutica... Exercise, diet, and meds are also options, reviewed here: psych-partners.com/best-add-on-... #schizophrenia #bipolar

Is haloperidol a first-line augmentation strategy for #OCD? That's what the new CANMAT guidelines propose, but I have a different idea, and invite your input on this friendly debate: psych-partners.com/guidance-and... #psychiatry #pmhnp

Here's a quick guide to distinguishing #ADHD from #Borderline Personality Disorder (#BPD), and how to navigate treatment when the two overlap. Inspired by a new studying comparing symptoms in the two: psych-partners.com/adhd-vs-bord... #psychiatry #pmhnp #therapy

Task-force report on circadian rhythms in #bipolar is out; how to use it in practice: psych-partners.com/circadian-th... Includes dark #therapy, light therapy, social rhythm therapy, and how to destigmatize #bipolar with circadian education (I played a small role in the task-force). #psychotherapy

Does an SSRI prevent #PTSD when taken shortly after a #trauma? It did in a new trial, but I have doubts, and discuss other ways to prevent PTSD with more robust data: psych-partners.com/fluoxetine-t... #psychiatry #pmhnp #therapy

Looking for #PMHNP or PA who values quality over quantity, life-long learning, and patient-centered care. Our practice combines therapy, meds, and natural approaches. We have an opening in #Asheboro NC, a quiet town just outside Greensboro (population 800K): psych-partners.com/employment

I'm reposting this after discovering more problems (thanks @ploederl.bsky.social). BOTTOM LINE: No trials have tested antidepressants in preschool children. This one has major flaws, including some that erode trust in the whole paper. See why psych-partners.com/fluoxetine-f... #psychiatry #pmhnp

Fluoxetine: A Problematic Trial in Ages 4-6 - PsychPartners

The first trial to test fluoxetine (Prozac) in children as young as four with major depression. See the results, the safety signal that didn't match the data, and what to do next.

psych-partners.com

Chris Aiken, MD@chrisaikenmd.bsky.social · 3w ago

Here's the first trial to test fluoxetine for #depression in children under 6: psych-partners.com/fluoxetine-f... Positive signal, but agitation is a risk, and a single study doesn't change the fact that Parent-Child Interaction #Therapy has the best evidence in this age group. #psychiatry #pmhnp

New guidelines on substance use disorders from the British Association for Psychopharmacology. Main change is nicotine, where varenicline rises to #1, nicotine replacement combos move up, and bupropion is downgraded: psych-partners.com/new-guidelin... #psychiatry #pmhnp

Our final Carlat podcast on #Psychiatry for Women covers: ▪ Sexual side effects ▪ Unique medical risks ▪ Transgender psychopharm ▪ Psychotherapy by gender www.thecarlatreport.com/blogs/2-the-... #pmhnp #depression #womenshealth

Here's how weight loss meds for antipsychotics ranked in new meta-analysis: psych-partners.com/best-add-on-... 1 Semaglutide (11 kg) 2 Liraglutide (5.4 kg) 3 Topiramate (4 kg) 4 Metformin (4 kg) 5 Exenatide (3 kg) For non-med options, diet, exercise, probiotics, and melatonin. #psychiatry #pmhnp

Here's how to personalize #opioid use d/o meds for: ▪ Benzo and alcohol use ▪ Renal and heart disease ▪ HIV ▪ Pregnancy ▪ Adolescents psych-partners.com/matching-opi... #psychiatry #pmhnp

Here's the first trial to test fluoxetine for #depression in children under 6: psych-partners.com/fluoxetine-f... Positive signal, but agitation is a risk, and a single study doesn't change the fact that Parent-Child Interaction #Therapy has the best evidence in this age group. #psychiatry #pmhnp

Pancreatitis is a rare side effect of GLP-1 agonists like #Ozempic. But a new large study suggests they both raise and lower the risk, with the lower risk from alcohol reduction: psych-partners.com/can-glp-1s-b... #psychiatry #pmhnp

How to disguise a drug-trafficking ring as a medical practice: ▪ Remove non-ADHD screening questions ▪ Incentivize clinicians with up to $720,000 a year (and fire those who resist) ▪ Advertise rapid #ADHD assessments It's all in the Done convictions: psych-partners.com/six-years-in... #psychiatry