The Week in Review: February 17-21

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This week, Psychiatric Times discussed a variety of psychiatric issues and industry news, including a novel agent for the treatment of schizophrenic psychosis and the continued antimedication movement.

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Xanomeline-Trospium as a Novel Agent for Treatment of Psychosis in Schizophrenia

Recent research indicates that xanomeline-trospium effectively reduces both positive and negative psychotic symptoms in adults with schizophrenia, as measured by the Positive and Negative Syndrome Scale. Common side effects include gastrointestinal issues; however, the treatment does not significantly cause extrapyramidal symptoms or weight gain. This novel therapy targets muscarinic receptors rather than dopaminergic ones, offering a distinct mechanism of action. While the US Food and Drug Administration has approved xanomeline-trospium for schizophrenia, further studies are needed to compare its efficacy with existing treatments. Read more.

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Using CBT to Empower Black Patients

In a conversation between Judith S. Beck, PhD, and Janee M. Steele, PhD, the 2 discuss how cognitive behavioral therapy can be adapted to empower Black patients by addressing internalized racism and negative core beliefs, thereby enhancing therapeutic outcomes. The 2 encourage clinicians to employ culturally sensitive strategies, such as Socratic questioning and validation, to establish strong therapeutic alliances. Incorporating elements that promote racial empowerment and pride is essential to mitigate the psychological impacts of racism and foster well-being. Techniques like bibliotherapy can enhance critical consciousness, encourage social action, and strengthen racial pride, contributing to overall psychological resilience. These approaches aim to create a more effective and affirming therapeutic experience for Black patients. Read more.

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Guardians of Necessity: How Insurance Companies Enhance Psychiatric Care

Insurance companies play a crucial role in psychiatric care by prompting discussions about necessary treatments and ensuring that interventions are both effective and justified. While often criticized for denying coverage, their oversight encourages clinicians and policymakers to evaluate the appropriateness of various interventions, promoting a holistic approach to mental health. This process helps maintain a balance between patient needs and the sustainability of healthcare systems. By demanding evidence of medical necessity, insurers contribute to the overall quality and efficiency of psychiatric services, despite public frustrations and misconceptions about their role in healthcare delivery. Read more.

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The Ongoing Movement Against Psychiatric Medications

The movement opposing psychiatric medications, often termed "antipsychiatry," has historical roots and continues to influence public perception of mental health treatments. Critics argue that psychiatric drugs are overprescribed and question their efficacy, sometimes portraying them as harmful. This perspective can deter individuals from seeking necessary treatment, potentially exacerbating mental health issues. While it is essential to acknowledge and address legitimate concerns about side effects and overreliance on medication, it is equally important to recognize the benefits these treatments offer to many patients. A balanced understanding is crucial to ensure informed decisions in mental health care. Read more.

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Frontal Lobe Syndrome: Improving Patient Quality of Life

Frontal lobe syndrome (FLS) arises from damage to the frontal lobes, leading to executive dysfunction and behavioral changes that can mimic psychiatric disorders. Accurate diagnosis necessitates a thorough evaluation, including medical history, neurological examinations, and imaging, to rule out other cognitive impairments. Treatment focuses on managing symptoms and enhancing quality of life through both pharmacological and nonpharmacological approaches. Nonmedical interventions, such as cognitive rehabilitation and behavioral therapies, are essential in addressing the cognitive and behavioral manifestations of FLS, aiming to improve patient outcomes and daily functioning. Read more.