The Week in Review: March 11-15

Chepko Danil_AdobeStock

This week, Psychiatric Times® discussed a wide variety of psychiatric issues and industry updates, from mild cognitive impairment and serotonin system degeneration to an update on pimavanserin for negative symptoms of schizophrenia.

Phase 3 Antipsychotic Candidate Pimavanserin Fails to Achieve Primary Efficacy Endpoint

freshidea/AdobeStock

Recently released topline data from the phase 3 ADVANCE-2 trial reveals that the antipsychotic candidate pimavanserin did not achieve the primary efficacy endpoint of control of negative symptoms in patients with schizophrenia. Acadia Pharmaceuticals intends to discontinue research on pimavanserin for schizophrenia, following this failure.

"Treatments to improve the negative symptoms in schizophrenia, a large unmet need, remain elusive," said John J. Miller, MD, Editor in Chief of Psychiatric Times. "Pimavanserin (Nuplazid), an inverse serotonin 2A receptor agonist, failed to separate from placebo in a Phase 3 double-blind study of 454 adults with schizophrenia treated for 26 weeks. We will await ongoing clinical trials with drugs of different mechanisms of action in our continued attempt to develop a treatment to improve negative symptoms." Continue Reading

Mild Cognitive Impairment and Serotonin System Degeneration

AkuAku_AdobeStock

A reduction in serotonin transporter (5-HTT) in parts of the brain involved with executive function, emotion, and memory has been detected in persons with mild cognitive impairment (MCI).

In a new study comparing a group with MCI to healthy, age-matched controls, this marker of serotonin system degeneration in those with MCI and cortical deposition of amyloid-ß were both correlated with cognitive impairment associated with progression to Alzheimer disease (AD). Although the investigators emphasize that correlation of lower serotonin transporter levels with the development of MCI does not show causation, it does suggest a potential therapeutic role for serotonergic medication in early, preclinical stages of AD. Continue Reading

Are We Over-Diagnosing ADHD Based on “Hyperactivity"?

Feng Yu_AdobeStock

The diagnosis of attention-deficit/hyperactivity disorder (ADHD) continues to be the focus of controversy in psychiatric literature. I would like to begin by critically examining the “H” in “hyperactivity,” as suggested by S. Nassir Ghaemi, MD. I concur with Dr Ghaemi that distractibility and “hyperactivity” are not part of the same psychological problem.

Since 1991, when I started to observe the behaviors of children diagnosed with ADHD, I have noticed that “hyperactivity” is associated with either a mood disease or anxiety. I have hundreds of cases documented in 3 books, and as of today, I have not found 1 case in which the increased activity, physical or psychological, is associated with a diagnosis of ADHD. Continue Reading

Dune and The Third Coming of the Psychedelics

amixstudio/AdobeStock

The publication of the book Dune in 1965 came at the height of the use and abuse of psychedelics in what could be called the first coming of the psychedelics in the United States. Now, years after they became federally illegal in 1970, they are being researched and used again in what could then be called their second coming. Besides their potential to help treatment-resistant depression, anxiety, and trauma, they may be beneficial for loneliness, opiate addiction, and traumatic brain injuries.

We also should not forget the long world-wide use of psychedelics by the indigenous over millennia. In the “Stoned Ape Theory,” ingesting psilocybin regularly in diets is said to have potentially led to the rapid evolution of brain size and abilities. Continue Reading

See more recent coverage from Psychiatric Times here. And be sure to stay up-to-date by subscribing to the Psychiatric Times E-newsletter.

Do you have a comment on any of these or other articles? Have a good idea for an article and want to write? Interested in sharing your perspectives? Write to us at PTeditor@mmhgroup.com.