A daily dose of practice-changing research from the editor of the Carlat Psychiatry Report

Undisclosed industry support by journal authors: ▪ Only 14% did not disclose ▪ But around 90% of those were among the "top 10 highest-earners" https://t.co/zjkJIgxC4S At Carlat we use the same methods in this study to verify that our authors disclose and are conflict free.

Also available in audio https://t.co/SXBP7BUpJf

Suicide risk is high 1st month after psych hospital, confirmed in new Swiss study of 72,275. Those at higher risk: • Younger • Male • Single • Personality or substance d/o • Self-harm 1 in 30 died by suicide within 4 yr of hospital: https://t.co/YS7K3LX81j Help: Dial 988

Undisclosed industry support by journal authors: ▪ Only 14% did not disclose ▪ But around 90% of those were among the "top 10 highest-earners" https://t.co/zjkJIgxC4S At Carlat we use the same methods in this study to verify that our authors disclose and are conflict free.

Why guess when you can know?

In our SAINT TMS podcast.... ▪ A 5-day treatment that brings recovery to 80% of highly refractory depressions ▪ Where to find SAINT centers ▪ A tribute to its architect, the late Nolan Williams https://t.co/ij8SxyofBx

When is medical cannabis useful? • Chemotherapy nausea • Weight restoration in HIV+ Risks: • 1 in 3 medical users develop use disorder • Heart disease with inhalation • High potency THC (≥10%) never recommended due anxiety/psychosis From JAMA: https://t.co/mzzQMRdxYW

SAINT TMS is now available. We take a closer look at its record-breaking effect size. More - https://t.co/qNwQWvYeiH #TMS #Psychiatry #Depression #mentalhealth

GLP1's for alcohol? Here's what controlled trials show: • Best study: exenatide failed (n=127) • Semaglutide worked in a lab setting, with mixed-results in real-world (n=48) • Dulaglutide "worked," but a secondary outcome and barely positive (n=151) https://t.co/sCCHkb6FGq

Study of over a million on medicaid reveals neglect of common cause of death: ▪ Only 30% with new #opioid use disorder received med for it Which could have reduced risk of overdose death by ▪ 86% w/methadone ▪ 77% w/buprenorphine ▪ 30% w/naltrexone https://t.co/PdIG7x5rc3

Light therapy treats many disorders, but not brain fog post-breast cancer surgery in a new trial: https://t.co/xuLlvA9vQj It can augment antidepressants, and it's among the top CAM therapies for Difficult to Treat Depression in new textbook: https://t.co/SXBP7BUpJf

Forest therapy improves • Depression • #Anxiety • Anger • Fatigue • Cognition Best when sessions last >1 hour. From new review: https://t.co/rgfPanQEgz It's among the Top 7 Lifestyle interventions in my next book on Difficult to Treat #Depression: https://t.co/SXBP7BUpJf

Zuranolone (Zurzuvae) barely worked in new, large trial of MDD from Japan: https://t.co/q9rJ1S4pvs Zuranolone is iffy in MDD, but works in postpartum depression. It is one of 8 rapid acting meds; learn how to combine them with therapy in: https://t.co/E4P6HmH8z3

Practical guide to benzo taper from JAMA: https://t.co/6GrgYvkKsO CBT helps, maybe Silexan, and small trials support: ▪ Carbamazepine (200–800 mg/d) ▪ Pregabalin (200–400 mg/d) ▪ Propranolol (60–120 mg/dd) More in deprescribing chapters of new book: https://t.co/SXBP7BUpJf

Exercise improves child #ADHD, but this is the first trial to test it in adults: ▪ Large effect (0.9) ▪ Strength/aerobic 30-40 min/day ▪ Brief mindfulness component https://t.co/6Gec4YPIVR Evidence: Moderate (6/10, high drop-outs, small, single-blind)

Are energy drinks "legal cocaine"? ▪ Similar cardiotoxic mechanisms, not just from caffeine ▪ Heart disease with chronic use, even in young & healthy https://t.co/DHGvLduwhh Stick to coffee, or even better, tea, this TG: https://t.co/kDbLFzs5Ky

Borderline Personality Disorder, DBT = less suicide events vs.SSRI in 6-month, small RCT: https://t.co/KcSYZJPuDM SSRI group got 30-min sessions every 2 wks. DBT group not on SSRI. Open question: DBT helpful, SSRI harmful, or both? Evidence Moderate 6/10 https://t.co/SHT31fiqGA

Difficult to Treat #Depression is now in audio (with tables): https://t.co/SXBP7BUpJf Top tips: • Only a few treatments offer reliable prevention • Subtypes guide the way: vascular, inflammatory, mixed, etc • Therapy is essential; lifestyle just as important

A Floriday is what happens when “Why not?” meets “Why wait?”

Here's what to know about SNT TMS: ▪ Brought full recovery to 80% with refractory depression (avg 5 med failures) ▪ Works within a week ▪ Double blind was intact More in podcast: https://t.co/0XidZtcbyn And new depression textbook (audio out soon) https://t.co/5rlen4NTXp

Does smoking cause irritability in #bipolar? Possibly, concludes Mendelian randomization study, where it accounts for 12% of the irritability: https://t.co/mS2DHdSNdi Other studies suggest smoking causes depression, perhaps through vascular health. Evidence grade: Low (4/10)

#Probiotics improved sexual health in women: https://t.co/3DVPNeQwL5 Mainly sexual function on SSRIs, but also menopause, PCOD, and endometriosis. Also improve depression, cognition, anxiety, and metabolic health in varied populations. How to use: https://t.co/tNYga8bNFC