Clinical Psychopharmacology Research Articles

The effect of music type in ketamine-assisted group therapy on treatment-resistant mental health conditions: a prospective observational study

Introduction Currently, Ketamine is the only safe, effective, and widely used psychedelic-like medicine in Canada. It has demonstrated notably efficacy in providing relief to those experiencing treatment resistant mental health conditions. Pairing Ketamine treatment with psychotherapy, known as Ketamine Assisted Therapy (KAT), has been shown to yield more enduring outcomes. Work by Greenway et al. has demonstrated that playing music following ketamine administration for patients with bipolar disorder can help the patient feel more in control and reduce discomfort (Greenway et al. International Clinical Psychopharmacology 2021; 36 218-220).ObjectivesThe primary objective is to evaluate and compare the subjective clinical efficacy of two different types of music during ketamine-assisted group therapy. This will be explored through various validated psychiatric questionnaires, including the PHQ-9, GAD-7, and PCL-5. The secondary objective is to compare the objective changes in brain activity between the two music types. This will be evaluated using EEG data collected from MUSE headband before and after each ketamine-assisted therapy session.Methods This study is a crossover trial of 32 participants undergoing ketamine-assisted therapy for treatment-resistant mental health conditions. Half of participants will undergo a KAT session with a “weightless” music playlist followed by a session with a “grounding” music playlist. The other half will do the same, in reverse order. All participants will complete several psychiatric questionnaires within 7 days of each session over email. Before and after each session, participants will play a simple game to test executive function while wearing a headband to measure EEG activity.ResultsThe absolute and relative changes to the scores of the questionnaires will be examined between participants and music conditions. The change in brain activity from pre-session to post-session will be compared between the different music conditions as well. As this is a crossover trial, any changes in outcomes due to order effects will be controlled for. Relevant demographic and medical factors will also be controlled for.ConclusionsTo date, no studies have explored the influence that different types of music have on patients experience with KAT in a group therapy setting. With the results of this study, we hope to fine tune and improve the use of music in future KAT administration.Disclosure of InterestNone Declared

In Memoriam: Professor Joseph Biederman’s Contributions to Child and Adolescent Psychiatry

Objective: To provide an overview of Joe Biederman’s contributions to child and adolescent psychiatry. Method: Nine colleagues described his contributions to: psychopharmacology, comorbidity and genetics, pediatric bipolar disorder, autism spectrum disorders, Tourette’s and tic disorders, clinical and neuro biomarkers for pediatric mood disorders, executive functioning, and adult ADHD. Results: Joe Biederman left us with many concrete indicators of his contributions to child and adolescent psychiatry. He set up the world’s first pediatric psychopharmacology clinic and clinical research program in child adolescent psychiatry. As a young faculty member he began a research program that led to many awards and eventual promotion to full professor at Harvard Medical School. He was for many years the most highly cited researcher in ADHD. He achieved this while maintaining a full clinical load and was widely respected for his clinical acumen. Conclusion: The world is a better place because Joe Biederman was here.

Moving forward while looking back: Reflections on the history and future of the journal Experimental and Clinical Psychopharmacology.

In this editorial, the incoming editor for Experimental and Clinical Psychopharmacology (ECP) reflects on the history and future of the journal. The author looks forward to working together with the American Psychological Association publishing community and ECP authors, reviewers, and board members as they navigate changes to their publishing policies and procedures. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dynamic Tracking to Identify Topics and Thematic Evolution of Obsessive-compulsive disorder as an Emerging Topic

This study aims to draw a science map, provide structural analysis, explore the evolution, and determine new trends in research articles published in the field of obsessive-compulsive disorder (OCD). The articles published from 1981 to 2021 were retrieved by searching the related keywords in multiple databases including PubMed, Scopus, and Web of Science, according to their thematic coverage and scope. The papers were analyzed using R and SciMAT software. A total of 1820 articles were analyzed and 4191 keywords plus, and 3242 author keywords were reported in the journals. Moreover, 7482 authors contributed in conducting these studies, of which 111 articles were written by single authors, and the collaborative coefficient was 4.36. Neuropsychopharmacology, International Clinical Psychopharmacology, and Journal of Clinical Psychopharmacology are the most significant journals publishing OCD articles. This study uncovered new insights into the evolution trend of the leading research stream on OCD over the past years. The findings of this study can contribute to developing the OCD Global Research Program and policymakers.

Progress and promise: A brief reflection on my time as editor of Experimental and Clinical Psychopharmacology.

This editorial focuses on William W. Stoops time as editor of Experimental and Clinical Psychopharmacology. Stoops ends his time with gratitude for all who have contributed to the journal's success over the past years, pride for what they have accomplished, and excitement for the journal's future. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

33.2 Clinical Psychopharmacology Management of Emotional Dysregulation and Impulsive Aggression in ASD

33.2 Clinical Psychopharmacology Management of Emotional Dysregulation and Impulsive Aggression in ASD

Artificial Intelligence and the Journal of Clinical Psychopharmacology.

Artificial Intelligence and the Journal of Clinical Psychopharmacology.

Improving Efficiency and Effectiveness of Psychopharmacology Practice: What Must Be Done and What Shouldn't Be Done

As the science and the data underlying psychopharmacology treatments has become roughly equal to the science underlying medical illness, the level of quality care to achieve psychopharmacology clinical competence in practice has become more difficult for clinicians. This article aims to fill the gap in teaching psychopharmacology and raise the quality level by describing the core tasks for prescribing quality clinical psychopharmacology. We describe reasons why the quality is low, the most common clinical practices that are not being done, and most importantly, delineate the necessary elements for initial and ongoing follow-up visits. The goal is an integrated approach incorporating objective, subjective, and relational factors in psychopharmacology practice. [ Psychiatr Ann . 2023;53(7):294–297.]

Racial and Ethnic Disparities in Physical and Mental Health Care and Clinical Trials.

Historically, in the United States, scientific racism has been used to justify differential treatment of Black, Indigenous, People of Color (BIPOC) populations compared with the White population. Discrimination toward BIPOC populations by the medical community has contributed to racial and ethnic disparities in health care that persist to this day. At the 2022 American Society of Clinical Psychopharmacology Annual Meeting, a panel of 5 experts from the areas of academia, advocacy, and clinical research discussed racial and ethnic disparities in mental health care. This Academic Highlights summarizes and expands on that discussion by tracing the history of scientific racism from the colonization of the US to present-day health inequities, illustrating the ongoing problem of low diversity in clinical trials, and outlining solutions through community engagement.

Juvenile Delinquency around the World: Public Psychiatry

Delinquency population in the world increased from 18 million to 250 million between 1992 and 2007. The World Health Organization (WHO) reported that approximately 200,000 youth homicides occur among individuals aged between 10 and 29 years old, with the main perpetrators being youths themselves. For many young people today, traditional patterns guiding the relationships and transitions between family, school, and work are being challenged. Lifestyle trajectories are becoming more varied and less predictable. The restructuring of the labor market, extension of the maturity gap, and limitation in the opportunities to become an independent adult are all challenges. About 70% of delinquent youth are affected with the mental disorder, and 1 in 5 suffers from mental illness so severe as to impair their ability to function. Treatments that include professional clinical care, psychopharmacology, and psychotherapy and psychosocial interventions are helpful. The WHO advocates a need to develop a comprehensive guideline to deal with almost every social area with main environmental and socialization processes including family, school, and community to prevent and treat juvenile delinquency.

Drugs in the Developmental Stage (Psychotropics)

In recent years, it is common for a single drug to be developed for multiple diseases almost simultaneously, e.g., pimavanserin and psilocybin. Although there was gloomy news for the field of neuropsychopharmacology, such as withdrawal of the world's leading mega-pharmaceutical companies from the development of CNS drugs, drugs based on novel mechanisms of action have been investigated. This is a new dawn in the field of clinical psychopharmacology.

Clozapine: A Scientific Analysis of Global Publications during 1970-2021

Aim: This study evaluates the research output on Clozapine included in Scopus database during 1970-2021. Materials and Methods: The quantitative and qualitative analysis of publications on “Clozapine” covered in Scopus database during 1970-2021 was undertaken. The results obtained were further analysed using additional features in Scopus database. Results: 7399 publications on “Clozapine” were obtained from Scopus international database and these publications received 189068 citations, averaging 25.55 citations per paper (CPP). There was initial rise in the number of publications per year from 1988 to 1995, after that the number of publications has remained relatively stable. Authors from USA, U.K. and Germany contributed to the largest number of publications (2136, 709 and 457 publications respectively), and publications with authors from USA, Canada and Germany registered the highest CPP and relative citation index (RCI). The authors from King’s College London, U.K, The Zucker Hillside Hospital, USA and University of Toronto, Canada published the highest number of publications. The organization that registered the highest CPP and RCI was Sandoz International GmbH, Switzerland, Long Island Jewish Medical Centre, USA and Vanderbilt University, School of Medicine, USA. The authors who published the highest number of publications were H.Y. Meltzer (USA), J.A. Lieberman (USA) and A. Weizman (Israel). The authors who registered the highest CPP and RCI were R.W. Kerwin (U.K.) and J.P. Lindermayer. The journals that published the highest number of publications were Journal of Clinical Psychopharmacology (351 papers), Journal of Clinical Psychiatry (282 papers), and American Journal of Psychiatry (255 papers). The most impactful publications were published in Archives of General Psychiatry, Schizophrenia Bulletin, Journal of Pharmacology and Experimental Therapeutics, and American Journal of Psychiatry. Conclusion: This study suggests that the numbers of publications on clozapine have remained stable over the years and maximum research has emerged from the developed countries.

Authors, editors, and gender in the Experimental and Clinical Psychopharmacology: An update.

The Experimental and Clinical Psychopharmacology journal was examined based on authorship and gender from 2007 to 2020. Data were calculated for total authorship by gender (women and men), authorship as first author by gender, articles with at least one woman as an author, articles with at least one man as an author, and collaborative articles. There were 3,442 listed authors across 794 articles. Women and men accounted for 43.3% and 55.5% authorship, respectively, irrespective of authorship order. Women were listed as first authors 48.3%, and men were listed as first authors 51.5%. Editorial boards were also examined based on gender from 2006 to 2021. The total number (and percentage) of women on editorial boards increased across editorial terms, with the present term showing the highest inclusion of women. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

J Guy Edwards, FRCPsych, FRCP, FRCGP (Hon), DPM, HonMFPH, Founding Editor of Human Psychopharmacology.

J Guy Edwards, FRCPsych, FRCP, FRCGP (Hon), DPM, HonMFPH, Founding Editor of Human Psychopharmacology.

CONTINUING AN EXPLORATION OF AVOIDANT/RESTRICTIVE FOOD INTAKE DISORDER (ARFID): FRAMEWORKS FOR ASSESSMENT AND TREATMENT AND ONGOING CHALLENGES

Participants will increase their knowledge for assessing avoidant/restrictive food intake disorder (ARFID) focusing on identifying subtypes and individual biopsychosocial contributors. Case-based breakout groups will then allow for application of this knowledge in order to help the practitioner develop more effective treatment plans, using both standardized and individualized approaches that integrate a created clinical tool, multidisciplinary therapies, and psychopharmacology.

Steven R. Tulkin (1943-2022).

Memorializes Steve R. Tulkin. (1943-2022). Steve was the first Director, in the nation, of the first Postdoctoral Master's of Science Program in Clinical Psychopharmacology, at Alliant International University (1999-2014). Many hundreds of psychologists, around the globe, have earned their Master's of Science in Clinical Psychopharmacology (MSCP) from Alliant. In 2007, Steve helped to create the American Psychological Association (APA) Division 18/Alliant partnership to fund Native psychologists in their training in Clinical Psychopharmacology, so as to facilitate their practice as prescribing psychologists on tribal lands. Steve left this world peacefully on January 17, 2022. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Treatment of Agitation in Individuals With Bipolar Disorder or Schizophrenia: Lessons Learned for Clinical Psychiatry and Psychiatric Drug Development.

Six lessons can be learned from the pivotal registration trials for sublingual dexmedetomidine (SLD) for the treatment of agitation in individuals with bipolar disorder or schizophrenia: (1) Knowing the function of a well-defined circuit in the brain, such as the locus coeruleus (LC), facilitates the development of central nervous system drugs. (2) Agitation can be conceptualized both clinically and physiologically. From both perspectives, agitation can present and escalate along a spectrum from mild, characterized as mainly hyperaroused (possibly only a subjective experience with no observable manifestations in its mildest form), to moderate to severe. In the severe state, the patient poses a potential danger to self and others. The level of agitation a patient is experiencing can determine the most appropriate treatment. Behavioral techniques may be sufficient for the mild state. As agitation progresses beyond mild severity, medication intervention becomes needed. SLD can be effective when agitation is moderate or even more severe. At this stage, patients can recognize and be distressed by their symptoms and participate in treatment. When agitation has escalated to such a severe state that patients can no longer participate in treatment, then intramuscular or intravenous medication may be needed. In quite severe cases, physical restraint as well as medication may be required. The Positive and Negative Syndrome Scale-Excited Component (PANSS-EC or PEC), a subscale of the PANSS, is a helpful instrument to assess where an individual is along the agitation spectrum. The PEC has been used in studies of pharmacological treatments for agitation, and it is accepted by the US Food and Drug Administration as the primary rating instrument in pivotal efficacy studies of treatments for agitation. (3) Where the patient is on the agitation spectrum is a function of the activity of the LC, which can be one factor in determining the SLD dose that will optimize the patient's clinical outcome. Clinical outcome is optimized when complete resolution of agitation is rapidly achieved, and adverse effects either do not occur or are not clinically meaningful. The adverse effects of greatest interest with SLD are decreases in resting systolic and diastolic blood pressures, reductions in these blood pressures under orthostatic stress, and lower resting heart rate. (4) To ensure safety, the subjects in 2 healthy volunteer studies were not administered doses equivalent to those used to treat agitated patients. The highest dose which a healthy volunteer tolerated in those studies was 40µg. Agitated patients were treated with 120 and 180µg doses. Thus the difference in doses was 3- to 4.5-fold. Agitated patients could also receive 2 additional half doses with an interval of 2 hours between the first and second administrations. For context, there are other examples of situations in which the dose of a drug that is well tolerated by healthy volunteers is lower than the dose that is well tolerated by patients. For example, it has long been accepted that patients with an acute relapse of schizophrenia can tolerate and need higher doses of D2 antagonists for efficacy than healthy volunteers can tolerate who will generally experience substantial sedation if given what is a clinically effective dose in such patients. (5) Agitation is a state phenomenon that may not recur when it is effectively treated, so that the treatment effect can persist for 24 hours despite the plasma half-life of the drug being 2 to 3 hours. (6) Given the established function of the LC, the fact that the dose response and the time curve of the effect are virtually identical in agitated individuals with bipolar disorder or schizophrenia supports the conclusion that the drug is not treating the syndromic diagnoses of bipolar disorder and schizophrenia but rather the state of being agitated because of overactivity of the LC. These 6 lessons are consistent with the discussions in numerous earlier columns in this series and are critical for both the practice of clinical psychopharmacology and psychiatric drug development.

Paliperidone palmitate-induced enuresis: a case report

IntroductionSchizophrenia is a severe mental illness that requires long-term treatment with antipsychotics and the intramuscular (IM) long-acting injectable (LAI) formulations may enhance treatment adherence. Some antipsychotics have been associated with enuresis, including atypical antipsychotics such as risperidone(6.2%), quetiapine(6.7%), olanzapine (9.6% ) and clozapine (20.7%) [1]. Although oral paliperidone has been related to urinary incontinence, there is only 1 report of urinary incontinence linked to monthly paliperidone palmitate [2]. [1] Harrison-Woolrych, M., Skegg, K., Ashton, J., Herbison, P., Skegg, D.C., 2011. Nocturnal enuresis in patients taking clozapine, risperidone, olanzapine and quetiapine: comparative cohort study. British Journal of Psychiatry 199, 140–144. doi:10.1192/bjp.bp.110.087478 [2] Karslıoǧlu, E.H., Özalp, E., Çayköylü, A., 2016. Paliperidone Palmitate-induced Urinary Incontinence: A Case Report. Clinical Psychopharmacology and Neuroscience 14, 96–100. doi:10.9758/cpn.2016.14.1.96ObjectivesTo establish an association between paliperidone palmitate and enuresis.MethodsCase report and a narrative review of the literature.ResultsThe patient was a 25-year-old healthy man when he was diagnosed with schizophrenia. Doctors prescribed paliperidone palmitate (LAI) 200mg monthly and he started to complain of enuresis. He was clearly suffering with this unpleasant and embarrassing adverse effect so the LAI was reduced to 150mg. Enuresis remained, so it was prescribed oxybutynin 20 mg/day and the patient improved.ConclusionsWe reported a case in which enuresis is likely to be associated with high-dose paliperidone LAI (with no clinical evidence of an organic cause). To treat it, the most effective strategy was oxybutynin 20 mg/day. This case is also important to show the impact of this symptom, which is not actively investigated.DisclosureNo significant relationships.

"Dual use of alcohol and cannabis among college students: A reinforcer pathologies approach." Correction to Reed et al. (2021).

Reports an error in "Dual use of alcohol and cannabis among college students: A reinforcer pathologies approach" by Gideon P. Naudé, Derek D. Reed, Tyler J. Thornton and Michael Amlung (Experimental and Clinical Psychopharmacology, 2021[Aug], Vol 29[4], 407-417). In the original article, in the Method section under Principal Components Analyses, it reads "We used a loading of ≥ 4.0 ... " when it should read "≥ 0.40." The correct loading criterion is listed in the Table 3 note. Analyses were run using the correct criterion. In Table 3, the loading for BP1 under the alcohol amplitude factor is "-0.4" when it should be "-0.04." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2020-25392-001). The reinforcer pathologies model proposes 2 behavioral economic constructs interact in addiction: operant demand and delay discounting. These constructs manifest as behavioral markers of addiction in the form of excessive reinforcer value and strong preference for immediate access and consumption of this reinforcer despite suboptimal long-term outcomes. The first aim of this investigation was to identify the degree to which delay discounting (of money and alcohol) and demand for alcohol differ between college student drinkers (N = 185) who do and do not co-use cannabis. As a second aim, we sought to replicate the 2-factor solution for alcohol and cannabis demand within a college sample. Results suggest dual users have significantly stronger Persistence and Amplitude for alcohol, demonstrate steeper delay discounting of alcoholic drinks, and are at greater risk for alcohol use disorder than individuals who drink yet do not use cannabis. These results provide further support for the reinforcer pathologies model and contribute to the literature on dual-substance use in the college population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

People With Depression More Likely to Believe Vaccine Misinformation

People With Depression More Likely to Believe Vaccine Misinformation