The Week in Review: November 27-December 1

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This week, Psychiatric Times® discussed a wide variety of psychiatric issues and industry updates, from dopamine detoxification for problem gaming to connections between bacteria and anxiety and depression. Here are some highlights from the week.

FDA Accepts NDA, Grants PDUFA Date for Investigational Schizophrenia Treatment

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Karuna Therapeutics announced that the US Food & Drug Administration (FDA) has accepted its New Drug Application (NDA) for KarXT (xanomeline-trospium) for the treatment of schizophrenia in adults and granted a Prescription Drug User Fee Act (PDUFA) date of September 26, 2024.

“We are pleased the NDA for KarXT has been accepted, and we look forward to working with the FDA during the review process,” said Bill Meury, president and chief executive officer at Karuna Therapeutics, in a press release. “There is a significant need for new treatment options for serious mental illness. If approved, KarXT could be one of the more important new product introductions in neuropsychiatry by providing a novel pharmacological approach for the treatment of schizophrenia.” Continue Reading

Problem Gaming? Consider Dopamine Detoxification

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“It didn’t work,” announced Eric’s exasperated mother. “He’s still up all night and won’t go to school in the morning.” Upon learning that the 16-year-old boy regularly played Fortnite in his bedroom until 4 AM, Eric’s psychiatrist had recommended removing the gaming console from his bedroom. “I’m sorry to hear that. Do you know what’s keeping him awake now?” Eric’s mother was quick to reply, “Sure. Now he stays downstairs with the gaming console all night and never sets foot in his bedroom.”

A substantial body of literature demonstrates how excessive habitual video game play can develop into an impairing disorder. Problematic gaming is often recognized in clinical practice, but can be challenging to treat. Clinicians can start by educating families on how video games interact with the brain’s reward system, making it difficult for some to disengage. Continue Reading

Research Explores Connection Between Bacteria and Depression, Anxiety

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Research from the University of Virginia (UVA) School of Medicine identified a potential connection between the gut bacterium, Lactobacillus, and the management of stress, potentially impacting depression and anxiety.

The study—led by Alban Gaultier, PhD, of the UVA Department of Neuroscience, the Center for Brain Immunology and Glia (BIG Center), and the TransUniversity Microbiome Initiative—aimed to understand how this specific bacterium influences mood disorders by interacting with the immune system. Continue Reading

Constipation Conundrum: A Case of Clozapine-Associated Pseudo-Obstruction and Ogilvie Syndrome

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Case Study

“Mr Franklin” is a 67-year-old man brought in by ambulance from a local psychiatric health facility after 3 days of shortness of breath, fatigue, fever, and chills. His past medical history included chronic obstructive pulmonary disease (COPD), hypertension, hyperlipidemia, and schizophrenia. He was on a legal conservatorship due to history of lethal violence. His chief complaint warranted admission and treatment for acute on chronic COPD exacerbation and chronic bronchopneumonia. Workup was notable for leukocytosis, normocytic anemia, and elevated neutrophil count. His renal and hepatic function were normal.

However, the admitting internal medicine team directed their attention to new concerns: his distended, protuberant abdomen in the setting of constipation, and multiple episodes of a coffee-grounds to brown-appearing emesis. At this time, psychiatry was consulted for medical management of his psychiatric medications for his now-nothing by mouth (NPO) status due to concern for bowel obstruction versus ileus. Continue Reading

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