Fawaz Ahmed Bakri Gali’s Post

#Lithium reduced suicidality 49% in this new analysis of 13 randomized controlled trials (Caveat: Suicide was not the primary outcome in these studies): https://lnkd.in/eK6dg5qB Bottom Line: Don't avoid lithium to prevent suicidal overdose; the data suggests the opposite. NEW: Carlat #Psychiatry News, with in depth coverage of the daily studies posted on this feed: https://lnkd.in/es9s3KdU The April episode features #MDMA therapy, #lithium, #PTSD, #bipolar, #clozapine, #schizophrenia, #ECT, and a circadian therapy for #depression

It's So Hard To Understand That 60% Of DSM-5 Was Manipulated By Big Pharma And How Long And Irreversible Physical, Mental And Emotional Damage We Have To Cause To Break What Scientific Proven Doesn't Work!!! Evidence does not confirm that lithium prevents suicide: a reply to Bschor et al Joanna Moncrieff 1, Martin Plöderl 2 3, Zainab Nabi 1, Jacki Stansfeld 1, Lisa Wood 1 Pharmacotherapy is an effective treatment modality across psychiatric disorders. Nevertheless, many patients discontinue their medication at some point. Evidence-based guidance for patients, clinicians, and policymakers on rational discontinuation strategies is vital to enable the best, personalized treatment for any given patient. Nonetheless, there is a scarcity of guidelines on discontinuation strategies. In this perspective, we therefore summarize and critically appraise the evidence on discontinuation of six major psychotropic medication classes: antidepressants, antipsychotics, benzodiazepines, mood stabilizers, opioids, and stimulants. For each medication class, a wide range of topics pertaining to each of the following questions are discussed: (1) Who can discontinue (e.g., what are risk factors for relapse?); (2) When to discontinue (e.g., after 1 year or several years of antidepressant use?); and (3) How to discontinue (e.g., what's the efficacy of dose reduction compared to full cessation and interventions to mitigate relapse risk?). We thus highlight how comparing the evidence across medication classes can identify knowledge gaps, which may pave the way for more integrated research on discontinuation.😡 American Psychiatric Association Institute of Psychiatry, Psychology & Neuroscience Psychedelic Support Psychology Today Institute of Psychiatry, Psychology & Neuroscience JAMA Psychiatry American Board of Sports and Performance Psychiatry Multidisciplinary Association for Psychedelic Studies (MAPS) Psychedelic Support Psych Congress NP Institute Neurodiversity in Business (NiB) - the Neurodiversity Charity Neuroscience News Neurodiverse Brains in the Workplace NeuroGifted® Neurodiversity Education Academy The Neurodiversity Awareness Event Autism Innovation Community Foundation... Maybe When You Experience It Yourself With A Love One, Then Maybe If Your EGO Doesn't Get In The Way You Will Understand!!! Remember The Extrapyramidal Effects And Invasive Irreversible Damage To The Kidney, Even Without Really Understand How Lithium Works!!! Maybe You Love So Much TESLA Vehicles That Blind Your Common Sense!!!

Should you continue #antipsychotic polypharmacy or lower to a single med in schizophrenia? This 9-mth randomized trial found lower relapse rates and side effects (akathisia, parkinsonism, dyskinesia) in institutionalized #schizophrenia with antipsychotic reduction: https://lnkd.in/eqZeX5pB Here's the earlier results on psychosis outcomes: https://lnkd.in/enhm-7WW #psychiatry

Aside from any CYP interactions, DM is considered serotonergic by itself. MOA could be multifold.

1. Propranolol helps to relieve the peripheral symptoms of anxiety in dose ranges between 20-40mg/day. It's particularly useful to manage peripheral physical symptoms and hence can be used by people with severe social anxiety to calm them down, say before an important presentation. (I would still prefer paroxetine) 2. It does nothing for Psychic anxiety - which is best managed by ssri and benzos, which are still the gold standard for managing anxiety disorders. 3. Old is gold, stick to propranolol - atenolol and pindolol not so much!

Dextromethorphan successfully augmented SSRI #antidepressants in this new, small RCT (it's an ingredient in the rapid acting Auvelity, where it is paired with bupropion): https://lnkd.in/e3hzzE7M The patients had not failed the SSRI, so it's really an enhancement study. They confirmed dextromethorphan reached "therapeutic" levels (0.5–5.9 ng/ml). #psychiatry #pmhnp #depression

IN NOVELBRAIN'S 3rd VIDCAST WE MOVE FROM THEORY TO CLINICAL PRACTICE AND DISCUSS REAL CASES HELPED BY TRANSCRANIAL MAGNETIC STIMULATION (rTMS). THREE PEOPLE WITH RESISTANT DEPRESSION WITH SUICIDE, CHRONIC PAIN PROBLEMS AND SEVERE OCD WHO WERE DESPERATE AND FINALLY ACHIEVE RELIEF OF THEIR SYMPTOMS WITH THIS PIONEER METHOD AND IMPROVE THEIR QUALITY OF LIFE.  #psychiatrist #psychiatry #thessaloniki #depressiontreatment #depression #tmstherapy #dépression   #chronicpainrelief #tms #chronicpainsyndrome #chronicpainmanagement #chronicpain #chronicpainawareness #neuromodulation #OCD WATCH THE FULL VIDEO IN https://lnkd.in/dvPsAFam

The FDA’s 14-1 vote to ease access to clozapine by removing the burdensome REMS registration requirement is a long-overdue decision and a huge win for patients with treatment-resistant schizophrenia. Clozapine has been widely recognized as the gold standard for managing treatment-resistant schizophrenia and holds potential for bipolar disorder if studies are expanded. The previous REMS restrictions created unnecessary barriers, preventing many patients in desperate need from accessing this life-changing medication. In contrast, European countries have managed to provide access to clozapine without imposing such stringent requirements, allowing more patients to benefit. It’s frustrating that these limitations persisted for so long in the U.S., delaying care for countless individuals. This regulatory shift finally aligns access in the U.S. more closely with global standards. The timing is interesting—it’s as if this change was rushed through before the incoming administration, which might not prioritize such reforms. Whatever the political dynamics, this decision is a step in the right direction for mental health care. Removing the REMS requirement opens the door to more equitable treatment and could inspire further research into clozapine’s broader applications, such as for bipolar disorder. It’s worth noting that we still face challenges, like addressing the variable quality and bioavailability of generic clozapine, which remains an issue. Generics need to meet the same standards as the original formulation to ensure consistent therapeutic outcomes. Moving forward, we should also focus on expanding research and education on clozapine’s potential, breaking the stigma surrounding its use, and ensuring it reaches all who need it.

Interesting read of risks vs benefits of REMS in use and accessibility of Clozapine.

A new clinical trial shows cytisinicline, combined with behavioral support, is a promising and well-tolerated treatment for adults aiming to quit vaping nicotine e-cigarettes. Participants treated with cytisinicline and behavioral support showed more continuous abstinence from from e-cigarette use compared to those treated with the placebo. Read the full trial: https://lnkd.in/d6y6Ai3B #NJPA #Psychiatry #MentalHealth