Author Archives: Dr. Joris Wiggers

Psychopharmacology for antipsychotic weight gain

Metformin had the most evidence of being effective in preventing weight gain (MD −4.03 kg, 95% CI −5.78 to −2.28; 4 studies, N = 131; low-certainty evidence) and increases in body mass index (BMI) (MD −1.63 kg/m2, 95% CI −2.96 to −0.29; 5 studies, N = 227; low-certainty evidence). Other agents that may be slightly […]
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The Clinical Global Impressions Scale

The Clinical Global Impressions Scale Explication of use in clinical settings: I think it belongs in our EMR. I note the case for 10min med checks…. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880930/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880930/#!po=78.8889

Early trajectory of clinical global impression as a transdiagnostic predictor of psychiatric hospitalisation: a retrospective cohort study – PubMed

Early trajectory of clinical global impression as a transdiagnostic predictor of psychiatric hospitalisation: a retrospective cohort study – PubMed Comment that the use of the Locus does the same ring and substantiates the use of trans diagnostic tools. I wonder how to cross walk locus to CGI. https://pubmed.ncbi.nlm.nih.gov/36966787/

Catatonia subtypes

Here is the summary from the article:  (Bush-Francis Catatonia Rating Scale 2/14 or DSM5, 3/12) Also, here is the link: https://www.psychiatrictimes.com/view/prisoner-of-the-brain-recognizing-the-serious-implications-of-catatonia I found this enlightening, as we can easily miss and mistreat this relatively uncommon disorder easily confused with sedation.

Bipolar 2 treatment options for depression

https://www.psychiatrictimes.com/view/psychopharmacologic-treatment-of-bipolar-ii-depression "In brief summary, our current recommendations are as follows7,8: after considering electroconvulsive therapy for patients who are severely depressed and are in urgent need of treatment, the first-line medication options are quetiapine, lurasidone, cariprazine, lumateperone (all FDA approved), and the combination of lithium and lamotrigine. Olanzapine/fluoxetine is generally not recommended because of the unacceptable […]
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Latuda is a very favourable choice for bipolar depression

This message contains search results from the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM). Do not reply directly to this message Sent On: Sat Mar 25 20:20:45 2023 1 selected item PubMed Results Item 1-1 of 1 (Display the 1 citation in PubMed) 1. CNS Spectr. 2023 Mar […]
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Duration of untreated bipolar disorder increase suicide risk; serious concern for missing the diagnosis in depressed clients

This message contains search results from the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM). Do not reply directly to this message Sent On: Sat Mar 25 20:11:44 2023 1 selected item PubMed Results Item 1-1 of 1 (Display the 1 citation in PubMed) 1. Correlates of long duration […]
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DSM-5 and eating disorders:What’s new

The DSM-5 remains the best approach to categorizes mental disorders, even though it has serious limitations, like no real psychobiological underpinning for any its conditions and arbitrary lines between normal and abnormal.   The research is hampered by incoherence, as the definition ( i.e. the inclusion criteria) of who is considered a subject is quite inconsistent […]
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Neuroprogression of Psychiatric disease

The idea of staging and progression of mental diseases borrows from cancer models describing the natural course of illness.  The psychiatric stages differ with a stage 0 which denotes asymptomatic, genetic vulnerability, and moves through typically 4 stages to full disease.  I have written about bipolar stages in other posts.  In this one, I offer […]
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Perimenopausal Depression Guidelines Released | Psychiatric News

https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2018.10a15?utm_campaign=email&utm_source=etoc&utm_medium=textlink&utm_content=news& Interestingly, the two pearls I learned were: 1. Best evidence among antidepressants for Pristiq, desvenlafaxine. 2. It is acceptable to use HRT for menopausal symptoms 3. CBT for depression is very important