Chris Aiken, MD @chrisaikenmd
Editor-in-Chief: Carlat Psychiatry Report. Director: Mood Treatment Center. Never received pharma funding. Posting a daily dose of practice-changing research. moodtreatmentcenter.com Winston-Salem, NC Joined June 2022-
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Update on #Ibogaine > Robust effects in #PTSD and #opioid UD, but trials preliminary and only 1 randomized > Acts on opioid/NMDA receptors, causing risky interactions w/other opioids > Potential for fatal arrhythmia From a new review by Owen Muir et al: pubmed.ncbi.nlm.nih.gov/38518270
Crossword puzzles or computer games? #Crosswords improved cognition & strengthened the memory center (hippocampus) more in this long-term randomized @NEJM trial of 107 older adults: evidence.nejm.org/doi/full/10.10… Intriguing, but difference was small. #memoryloss #dementia #psychiatry
Sharpen your diagnostic skills in the new @CarlatPsych Podcast, where clinicians who live with #mentalillness tell us what the symptoms are really like: podcasts.apple.com/us/podcast/wou… #psychiatry #depression #bipolar #anxiety #addiction #PTSD #psychosis #Schizophrenia Art: Alan D.…
What happens when ~1 million people are prescribed a benzo or z-hypnotic? > 5% took it for over 3 years > Doses rose beyond the max* for a minority (7%) of those on >3 years From a Danish study: pubmed.ncbi.nlm.nih.gov/37727098 *Max = 40mg diazepam if <65, 20mg if >= age 65 #anxiety
#Probiotic/VitaminD combo improved cognition in #schizophrenia in new small RCT, supporting earlier findings of probiotics/cognition: pubmed.ncbi.nlm.nih.gov/38598329 Probiotics also improve metabolic health in schizophrenia. Learn how to improve gut health: moodtreatmentcenter.com/probioticdiet
Chamomile vaginal cream improved sexual dysfunction in this randomized controlled trial of 96 post-menopausal women from Iran: pubmed.ncbi.nlm.nih.gov/35400624 A first, but needs replication. #sexualhealth #sexualwellness #sexpositive
#Esketamine worked on day #1, but was no better than placebo after a month in this large, randomized, industry-sponsored trial in treatment resistant #depression from China. Surprising? Several unpublished trials showed a similar fade.
Curved rooms boosted mood and #creativity more than rectangular rooms in new study (and calmed the heart rate): pubmed.ncbi.nlm.nih.gov/38545212 More studies in Carlat #Psychiatry News youtube.com/watch?v=BrHOEs… #mentalhealth #architecture #psychology
Curcumin (Turmeric) has positive trials in #depression, but it failed to augment the SSRI sertraline (Zoloft) in this new RCT from Iran: pubmed.ncbi.nlm.nih.gov/37071480 Some say Iran only publishes false-positive trials, but nothing is 100%. #psychiatry
What do you think of "safer" #alcohol alternatives (Kin Euphorics, 3 Spirits, Sentia)? They use gaba-ergic herbs that avoid the toxic hangover-inducing acetaldehyde. Addictive? Risky? @ProfDavidNutt et al (bias: developed #Sentia) has review: pubmed.ncbi.nlm.nih.gov/38555118 #recovery
Among #ADHD treatments, amphetamines had a slightly greater risk of causing psychosis than methylphenidate, and atomoxetine (Strattera) had no risk in this new large study, confirming an earlier report from NEJM: pubmed.ncbi.nlm.nih.gov/38609318 #psychiatry #mentalhealth
Brexpiprazole (Rexulti) is an #antipsychotic with potential cognitive benefits. However, it failed to produce those in this large trial of stimulant augmentation in adult #ADHD from @UUtah pubmed.ncbi.nlm.nih.gov/35977005/ #clinicaltrials #psychiatry
How much does placebo account for #ketamine and #esketamine benefits? 72%, from new analysis: pubmed.ncbi.nlm.nih.gov/38525254 Similar to placebo contribution for antidepressants (62-82%). Meds make a real difference, but the power of the placebo is welcome news for the human spirit.
Amphetamines raise the risk of #opioid #overdose death. So it's alarming that ~1 million amphetamines were prescribed on discharge from the ED, often with opioids: pubmed.ncbi.nlm.nih.gov/36738570 Rising rates likely reflect the scarcity of outpatient #psychiatry resources
Update on #ketamine 1. Large, rapid effect in #depression 2. Mixed results in #PTSD 3. Preliminary trials in #alcohol, #opioid, #cocaine use 4. Toxicity (liver/bladder/cognition) with high-dose recreational use From review by Owen Muir et al: pubmed.ncbi.nlm.nih.gov/38518272
New use for fluoxetine (Prozac). It treated refractory bed-wetting in children in this RCT, but the benefit declined over time (in primary monosymptomatic nocturnal enuresis): pubmed.ncbi.nlm.nih.gov/36043350 Need to weigh against risks of antidep in children #psychiatry #Pediatrics
1st lumateperone (Caplyta) RCT in major #depression: > Aug #antidepressants, medium effect size (0.6) > 6 wks, 485 pts, 1-2 failed med trials > Fatigue, dry mouth, tremor main side effects Data unpublished, summary here: ir.intracellulartherapies.com/news-releases/… 2nd trial anticipated in summer.
Modafinil (Provigil) s not an energy pill. It has failed in many trials of medical #fatigue, including this new, large phase-III trial in cancer-fatigue: ncbi.nlm.nih.gov/pmc/articles/P… Also failed in RCTs of antipsychotic-related fatigue #psychiatry #medicine
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Journal of Clinical P.. @JCPjournal
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Kindly #deprescribe -.. @Altostrata
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لولو @ikkjrpp
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Social Media is a Ces.. @robotturkeyguy
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عمر بن سليم�.. @IbnSughayir
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Journal of Clinical P.. @JCPjournal
755 Followers 51 Following Journal of Clinical Psychopharmacology keeps clinician-scientists and trainees up-to-date on the latest clinical developments in psychopharmacologic agents.
Michael Ostacher, MD,.. @RecoveryDoctor
3K Followers 1K Following Professor of Psychiatry & Beh Sciences @StanfordMed decreasing stigma/increasing evidence/improving care. Food tweets. Digital Ed @BMJMentalHealth Opinions mine
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Martin Plöderl @PloederlM
3K Followers 633 Following Clinical Psychologist, Psychotherapist, Cyclist, bin privat hier
Kindly #deprescribe -.. @Altostrata
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Baitoushan白头山 R.. @obamunista
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E @helloestef
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˗ˏˋ ꒰ ♡ ꒱ ˎ.. @_transcendenta
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M Herrera-Rivero @HerreraR_biomed
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NiCo Tymmesa @nicotymmesa
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Antonei B Csoka, PhD @abcsoka
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NIMHANS Digital Acade.. @vknNIMHANS_ECHO
2K Followers 16 Following Right KnowledgeII Right time|| Right place|| saves life. Building skilled capacity for Quality care #Addiction #Mental Health
ale @alemier121
131 Followers 442 Following 🌘✝️🇵🇸 I like studying cognition nowadays, used to be history, should've been finance
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595 Followers 549 Following Psicólogo UC, fotógrafo aficionado e inviernista. The greatest illusion of this world is the illusion of separation.
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578 Followers 109 Following Turning data into information: Official Statistics. Previously science: Cognitive Neuroscience. Posts along those lines. @ancetetere.bsky.social
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Daisuke MATSUYOSHI @dicemt
840 Followers 294 Following Cognitive Neuroscientist. Natl Inst Radiol Sci (QST-NIRS) and Araya Inc. https://t.co/Wo8AaI4vfp | All opinions are standing on the shoulders of giants
My first ever commentary on self-criticism and its relation to disordered eating is just out on #IJED! doi.org/10.1002/eat.24… @IntJEatDisord
@chrisaikenmd @NEJM The classic word search will always be my fav dumbbell squats for the brain! ✌️💖💫
@chrisaikenmd @CarlatPsych In support of the decision to not disclose the identity of speaker like yours truly, from a person who made a different podcast with a different choice: open.substack.com/pub/thefrontie…
@MyLynnKnow @drjprogers @MarkOldhamMD @ChaseSamsel @KBrahmbhattMD @MGHPsychiatry @QuantPsychiatry @MegBenningfield @StephanHeckers @AACAP @DrKelliD @GeorgeKirov1 @DrPaulCroarkin @chrisaikenmd @DrJacciClauss Thank you, my friend! I am very grateful for the care you all provide these kiddos!
@chrisaikenmd Even an initial rapid response can be life-saving if it gets a patient motivated to lean into treatment and/or prevents a suicide attempt. I think esketamine's indication for MDD with acute suicidality is more important than its indication for treatment-resistant MDD.
Despite limitations of the phrase “wounded healers” this is an excellent short listen; nuanced practical tips re interviewing & diagnostic skills. Helpful for almost any clinician, regardless of experience level. @chrisaikenmd podcasts.apple.com/us/podcast/the…
@chrisaikenmd This study looks amazing but I would like to see an experiential study supporting these findings - how people make meaning from being immersed in a given environment
Ha gayret, az kaldı gabapentin'in keşfedilmesine...
What do you think of "safer" #alcohol alternatives (Kin Euphorics, 3 Spirits, Sentia)? They use gaba-ergic herbs that avoid the toxic hangover-inducing acetaldehyde. Addictive? Risky? @ProfDavidNutt et al (bias: developed #Sentia) has review: pubmed.ncbi.nlm.nih.gov/38555118 #recovery
Beware of anything that looks too good and is sold as harmless substitute of a harmful substance. #harmreduction is for drug users. These aren't for non users to start experimenting. #addiction
What do you think of "safer" #alcohol alternatives (Kin Euphorics, 3 Spirits, Sentia)? They use gaba-ergic herbs that avoid the toxic hangover-inducing acetaldehyde. Addictive? Risky? @ProfDavidNutt et al (bias: developed #Sentia) has review: pubmed.ncbi.nlm.nih.gov/38555118 #recovery
@chrisaikenmd @UUtah REXULTY AD saying how her mother fidgeted with her fingers no that's not what they were doing back in the day women of that age were always using their hands working caring for children caring for others and because they can't anymore that's why she's holding them rubbing them
@chrisaikenmd @UUtah Functional dopamine system blockade failed in ADHD? Who could have thought...
@chrisaikenmd @UUtah Not shocked about that one. 🙃
@chrisaikenmd Amphetamines can impact neurotransmitter balance more strongly which leads to in an increase risk of psychosis. Overstimulation of the CNS, changes in gene expression, or withdrawal somehow influences psychosis as an outcome.
@chrisaikenmd I know anecdotal evidence is not science. But only one week of atomoxetine took my friend (this past Christmas) from suicidal ideation to suicidal attempt. I heard how his discourse gradually became darker. He came back to his previous self immediately after his psychiatrist…
@chrisaikenmd On the other hand, they work better than Strattera.
@chrisaikenmd Yeah maybe so but still... that 28% is still gunna result in an utterly awesome two hour adventure to find the right angle to get through your own garden gate, and delightfully followed by an internally playfully argument with your own brain that 'spummacated' is not a real word!…
@chrisaikenmd My open question is how much of the beneficial effect is due to mu agonism?
@chrisaikenmd Couldn’t agree more. I don’t think we speak enough about expectancy effect, placebo and nocebo enough with pts. Their perceptions of meds is just as important as the med itself IMO. COMT involvement w this potentially fascinating.
Large six-region meta-analysis finds no association between ADHD medications and #cardiovascular risk bit.ly/4aOtfy5 #nursepractitioner #mentalhealth #psychiatry #medicine #primarycare #medicine #mhchat #ADD #stimulants #methylphenidate #ADHD #ADHDtwitter #amphetamines…
@DebiecJacek @chrisaikenmd “Patients that are under resourced and have trouble accessing healthcare also may come to the ED for a bridge prescription to help manage their symptoms.” It’s ED as PCP. 55% under age 25. It’s also 7 in 10,000 ED visits so not exactly pandemic proportions.
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