Author Archives: Dr. Joris Wiggers

J Clin Psychiatry/The Mixed Opioid Receptor Antagonist Naltrexone Mitigates Stimulant-Induced Euphoria: A Double-Blind, Placebo-Controlled Trial of Naltrexone

http://www.psychiatrist.com/JCP/article/Pages/2018/v79n02/17m11609.aspx Adding 50mg Naltrexone to ADHD medicines reduces the risk they are going to be abused and that they will cause euphoria. Seems like a great idea, if you are giving patients stimulants and worry about overuse or diversion. I might consider it a reasonable strategy for ADHD and addiction, too.

Targeting obesity could slow brain aging in psychosis | MDedge Psychiatry

https://www.mdedge.com/psychiatry/article/163735/schizophrenia-other-psychotic-disorders/targeting-obesity-could-slow-brain?utm_source=News_CPN_schizophrenia_041918_F&utm_medium=email&utm_content=Brain aging, psychosis: Could obesity be a risk factor? A better way to protect cognition and brain health in schizophrenia (or anyone gaining weight on antipsychotics). Weight loss. Another reason to ask your doctor what can be done for obesity. There are more and more studies with good approaches.

Effects of 12-month, double-blind N-acetyl cysteine on symptoms, cognition and brain morphology in early phase schizophrenia spectrum disorders – Schizophrenia Research

https://www.schres-journal.com/article/S0920-9964(18)30164-6/fulltext?rss=yes More support for NAC 3600mg a day for negative symptoms and disorganization in schizophrenia. Not positive sx, though. Or cognitive.

Semaglutide: More Weight Loss than Placebo, No Diabetes Required | Endocrinology Network

http://www.endocrinologynetwork.com/diabetes-complications/semaglutide-more-weight-loss-placebo-no-diabetes-required?elq_cid=176288&elq_mid=1088&rememberme=1 Seems like an even better choice for weight loss than liraglutide and you don’t have to be diabetic to use it. Perhaps this will be of use to our patients on antipsychotics. No studies yet. Very low side effects.

The Proposal to Lower P Value Thresholds to .005 | Research, Methods, Statistics | JAMA | JAMA Network

https://jamanetwork.com/journals/jama/article-abstract/2676503?utm_source=silverchair&utm_medium=email&utm_campaign=article_alert&utm_term=mostread&utm_content=olf-widget_04162018&redirect=true Our science is wrong! Egad. We need to raise the bar on what constitutes a positive study. Here is one proposal, seriously considered, to select out studies that are falsely positive, without sacrificing too many falsely negative ones.

A Call to Selective Dementia Screening | Psychiatric Times

http://www.psychiatrictimes.com/geriatric-psychiatry/call-selective-dementia-screening?rememberme=1&elq_mid=1014&elq_cid=176288 Call to screen for dementia in all vulnerable adults, as they age, particularly but not exclusively non-white persons with lower educational history, and no age limit. —Johns Hopkins study, 2018 See your doctor. Nearly 20% of adults with dementia don’t realize it! Over 50% of adults with dementia are undiagnosed. (Don’t panic, odds are […]
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Breakthrough retrospective study for the reduction of risk of repeat stroke or heart attack: antihypertensives.

Published in the journal Neurology, a large retrospective cohort study of over 12,000 patients from 40 hospitals in the Australian Stroke Clinical Registry.1 The study looked at the risk of death following stroke or TIA and whether patients had been prescribed antihypertensive medications. It turns out in this study a 23% reduction in cardiovascular mortality […]
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Vitamin D Screening and Supplementation in Primary Care

https://www.medscape.com/viewarticle/893083?nlid=121889_4641&src=WNL_mdplsfeat_180417_mscpedit_wir&uac=27343DV&spon=17&impID=1609946&faf=1 I hope the reader can access this article. Basically, it says that Vitamin D is overblown, massively, 100 fold over 10 years and for no good reason. It sounds like you have to be very careful at or above 4000 Iu a day, and probably scant evidence it does any good. It increases risk […]
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High Energy Breakfast Diet is an Effective Strategy for Weight Loss and Reduction of the Total Daily Insulin Dose in Type 2 Diabetes

http://www.abstractsonline.com/pp8/#!/4482/presentation/6407 Case to eat like a king in the morning and a pauper in the evening.

Psych News Alert: Study Challenges Halting Antipsychotics in Stabilized Patients With Schizophrenia After Several Years

http://alert.psychnews.org/2018/04/study-challenges-halting-antipsychotics.html This study is strong indication to keep people on antipsychotics indefinitely! Reduces mortality risk, studied up to 16 years.