The Week in Review: September 25-29

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This week, Psychiatric Times® discussed a wide variety of psychiatric issues and industry updates, from connections between cannabis use and schizophrenia to some non-psychiatric medications that may worsen symptoms of major depression. Here are some highlights from the week.

FDA Approves First Oral Selective 5HT1A Receptor Agonist for MDD

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A new class of antidepressants has emerged, as the US Food and Drug Administration approved the first oral selective 5HT1A receptor agonist for the treatment of major depressive disorder in adults. Gepirone hydrochloride extended-release tablets (Exxua) is the first approved medication with this novel mechanism of action.

This approval marks a number of unique accomplishments. Not only is Exxua the first in this class of antidepressants, but the FDA approval comes without warnings or adverse reactions related to sexual dysfunction or weight gain. It also overcame a number of obstacles, having been rejected 3 times by the FDA before finally receiving the green light. Continue Reading

Non-Psychiatric Medications With Potential to Worsen Symptoms in Major Depression

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Residual depressive symptoms are common in MDD. Medical comorbidities are an identified risk factor for persistent depressive symptoms. Although the mechanism(s) of this association is/are not clear, inflammation and childhood adversity—which are associated with both medical conditions and worse treatment outcomes in depression—may play a role.

Patients with depressive and medical comorbidities often use non-psychiatric medications that may themselves be associated with increased risk of depressive symptoms. Continue Reading

Concussion Awareness

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A traumatic brain injury (TBI) occurs when brain function is altered due to an external impact to the head or body, or from inertial forces such as rapid acceleration-deceleration of the brain within the skull. National data show that approximately 3-4 million new cases of TBI occur each year in the United States, and concussion accounts for as many as 75% to 90% of all TBIs. Recent studies report that concussions in youth and adolescents are on the rise, particularly in 10- to-19 year-olds, as well as in older adults over the age of 65. Falls are the primary cause of concussion in elderly adults, while youth sustain concussions due to sports and recreational-related injury.

About 25% of all concussions occur on the job in working age adults, primarily in the manufacturing, construction, and transportation industries.A significant percentage of individuals that sustain a concussion are not evaluated in the emergency department, but are either seen in physicians’ offices or out-patient settings. Continue Reading

Cannabis and Schizophrenia: Implications in the Legalization Era

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The increasing acceptance and legalization of cannabis use worldwide has underscored the need to understand its potential health implications. One area of significant concern is the association between cannabis use and schizophrenia, a severe mental disorder characterized by thought and emotional disturbances. This association is particularly important, given the global burden of schizophrenia, which affects more than 20 million individuals worldwide, according to the World Health Organization.

A Mendelian randomization study by Vaucher, et al, provided observational evidence of an increased risk of schizophrenia associated with cannabis use. Rentero, et al, highlighted the importance of differentiating between cannabis-induced psychosis and schizophrenia for therapeutic purposes. Ortiz-Medina, et al, emphasized the need for more research to fully understand the relationship between cannabis use and psychosis. Continue Reading

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