Curcumin (turmeric) is one of the top supplements for #depression, and in the analysis of 9 #diabetes trials it led to 3.6 lb weight loss. www.ncbi.nlm.nih.gov/pubmed/41211... Caution: rare liver injury, though also has liver protective effects. How to use: chrisaikenmd.com/supplements

Neuromodulation = 1. TMS 2. ECT 3. Transcranial direct current stim (tDCS) 4. Deep brain stim (DBS) 5. Vagus nerve stim (VNS) 6. Magnetic stim therapy (MST) and more Only one works in treatment resistant #schizophrenia: TMS. From new analysis: www.ncbi.nlm.nih.gov/pubmed/41210... #psychiatry

L-theanine improved insomnia and quality #sleep initiation in analysis of 11 RCTs (100-225mg BID): www.ncbi.nlm.nih.gov/pubmed/41176... It's a glutamatergic extract of tea with positive trials in depression, OCD, anxiety, and cognition. How to use: chrisaikenmd.com/supplements Art Y Wang

The GLP-1 semaglutide (#Ozempic) failed to improve mood and executive functioning in this, the first RCT of a GLP-1 for major #depression: www.sciencedirect.com/science/arti... Weight loss was significant (all subjects were overweight/obese). Evidence grade Moderate (8/10): chrisaikenmd.com/ebm

Updates on TMS for depression in podcast interview with Owen Muir @owenmuir.bsky.social 1. How to explain TMS to patients: www.thecarlatreport.com/blogs/2-the-... 2. TMS vs Antidepressants in Teens: www.thecarlatreport.com/blogs/2-the-... #depression #psychiatry #therapy #pmhnp #mentalhealth

Lithium improved bone repair and density in new animal study, in line with recent human findings of a lower risk of osteopenia with #lithium: www.ncbi.nlm.nih.gov/pubmed/41194... (In contrast, SSRI and SNRI antidepressants have osteopenia risks). #psychiatry #pmhnp #bipolar #depression

Sleep deprivation = more impulsive and risk-taking, and new RCT finds it makes us ▪ Chase immediate gains ▪ But more chaotic decision-making, unable to sustain a strategy pubmed.ncbi.nlm.nih.gov/41206488 Evidence: Moderate (6/10) A patient-podcast on CBT-insomnia: pocketpsychpod.com/how-to-sleep

New data on Acetaminophen (Tylenol) --> #Autism/#ADHD: ▪ No evidence of causal link in analysis of 9 systemic reviews ▪ When compared to outcomes in unexposed siblings, the small associations disappeared, suggesting other (eg, genetic) factors explain it: www.bmj.com/content/391/...

Keto and Mediterranean diets compared for mood in health subjects: ▪ Medit better for #depression ▪ #Keto better for impulsivity, weight www.ncbi.nlm.nih.gov/pubmed/41197... How to use Medit for mood: chrisaikenmd.com/antidepressa... Evidence: Low (small, high drop-out, not blinded, 3-mth RCT)

"How to get the best night's #sleep: What the science says" a nice podcast from Nature journal: cms-resources.apps.public.k8s.springernature.io/springer-cms... They focus on light at night. These blue-light blockers improved sleep quality in two RCTs: chrisaikenmd.com/darktherapy #therapy

Saffron improved premenstrual syndrome with a moderate effect size (0.4-0.8) in meta-analysis of 7 randomized trials: pubmed.ncbi.nlm.nih.gov/41151539 Saffron also improved #depression and #sleep quality in recent large trials. How to use it: chrisaikenmd.com/supplements #naturalhealth

FDA approved lumateperone (Caplyta) aug in #major depression: ▪ 42 mg qhs ▪ Effect size 0.6 (good for class) ▪ Lower risk of EPS, akathisia, and metabolic risks within class, but sedating I'll need to update this table from my book, Difficult to Treat Depression, about to go to press. #psychiatry

From ChatGPT's internal audit. Each week ▪ 1.2 million (0.15%) express suicidal intent ▪ 560,000 (0.07%) have signs of emergency mania/psychosis New algorithm performs better those who use it for therapy, but still veers off in suicide conversations 1 in 10 times: pubmed.ncbi.nlm.nih.gov/41167716

Probiotics may help #autism, from meta-analysis of 8 small RCTs: pubmed.ncbi.nlm.nih.gov/41139591 Bigger impact over > 3 mth and in younger children. (Gut health is implicated in autism, but confidence limits in analysis barely positive) How to use them: chrisaikenmd.com/supplements #therapy

#Sleep deprivation linked to worse outcomes in this first-of-its kind study of surgeons: pubmed.ncbi.nlm.nih.gov/41117395 Evidence grade low (4/10): chrisaikenmd.com/ebm Photo: Weird Al. #psychiatry #surgery #medicine

Night owls procrastinate more in college, and have more #depression/anxiety, concludes new cross-sectional study: www.ncbi.nlm.nih.gov/pubmed/41140... Evidence grade low (3/10) They benefit from blue-light blockers glasses and dawn simulators; how to use them: chrisaikenmd.com/darktherapy

New #therapy for #depression, Dynamic Interpersonal Therapy, had better long-term effects than CBT or med: pubmed.ncbi.nlm.nih.gov/41135204 Focuses on attachment, mentalization, and recurring patterns in relationships. Evidence grade moderate 7/10 chrisaikenmd.com/ebm #psychology #psychiatry

Daylight savings changes worsen sleep, especially in the Spring and for night owls, concludes new analysis: pubmed.ncbi.nlm.nih.gov/41110263 Dawn simulators help adjust to these changes and improve winter #depression: chrisaikenmd.com/dawnsimulator

Camouflaging is when people on the #autism spectrum mask their symptoms or imitate normal interactions to avoid standing out. It can work, but it's also a cause of distress, as new study finds: pubmed.ncbi.nlm.nih.gov/41120451 How do you manage this potential side effect of social skills training?

Is "warm milk before bed" more than just a folk remedy? Milk/dairy improved sleep quality in new analysis of 8 RCTs and 6 other studies, whether in day or night: pmc.ncbi.nlm.nih.gov/articles/PMC... Likely through tryptophan/probiotics. #psychiatry #psychology #nutrition #taylorswift

FDA approved folinic acid (Leucovorin) for #autism, a controversial move based on 2 small RCTs and the endorsement of a Florida man. Folate is impaired in autism, 84% have genetic problems in its metabolism: pubmed.ncbi.nlm.nih.gov/41112632 Can also use methylfolate: chrisaikenmd.com/supplements

Here's why you need to know about white matter hyperintensities. They are linked to... ▪ #Depression in elderly (vascular type) ▪ Antidepressant non-response ▪ 3x risk of stroke ▪ 2x risk of dementia ▪ 2x risk of suicide in new analysis of mood disorders: www.ncbi.nlm.nih.gov/pubmed/41107...

Shift work causes insomnia, particularly after 24 hours of shift work per week, concludes prospective observational study of nurses: www.ncbi.nlm.nih.gov/pubmed/41063... Shift work also contributes to #depression, obesity, heart disease, cancer. How to manage: chrisaikenmd.com/darkbedroom

Is #autism linked to dark triad traits of: 1. Machiavellianism (cunning, manipulative) 2. Narcissism 3. Sociopathy No, concludes new study, which finds low levels of the first two and no increase of #3. www.ncbi.nlm.nih.gov/pubmed/41090... Good to hear positive news about mental differences.

Trazodone is very effective at improving sleep quality in #depression, concludes new review: www.ncbi.nlm.nih.gov/pubmed/41081... That’s something we can’t say for most antidepressants (serotonergics can make sleep worse), nor for most sleep meds (orexins are an exception). #psychiatry #pmhnp

Ketamine failed against midazolam (IV) in new trial of inpatient #depression: pubmed.ncbi.nlm.nih.gov/41123905 Was earlier success (against IV saline) due to unblinding? Or is it that benzos are well-established rapid-acting antidepressants (they just don't last). Evidence grade: Moderate (8/10)

Antioxidants for #autism? Trials are small, but systematic review highlights NAC, l-carnosine, omega-3, sulforaphane (from brocolli), CoQ10 as the best of the lot www.ncbi.nlm.nih.gov/pubmed/41071... Evidence moderate (~6/10) chrisaikenmd.com/ebm How to use them: chrisaikenmd.com/supplements/

The diet for #depression recommends 6 eggs/wk: chrisaikenmd.com/antidepressa... Same number may prevent cognitive decline (but more harms vascular health): ncbi.nlm.nih.gov/pubmed/41061... How? Choline, omega-3, D/B-vitamins, antioxidants Evidence = Moderate 4/10

Light #therapy treats perinatal #depression, and new trial shows sustained benefits 7 months later (even though the light was only used for 5 weeks): www.ncbi.nlm.nih.gov/pubmed/41070... Evidence: Moderate (6/10) How to use light therapy (new recs for LED boxes): chrisaikenmd.com/lighttherapy

A common med hair-loss med (finasteride) causes #depression and #suicide, concludes 8 studies in this report that examines why this signal was suppressed for 20 years Likely mechanism = lowers allopregnanolone, neurosteroid that modulates GABA (benzo) receptors pubmed.ncbi.nlm.nih.gov/41004169

Does response to the first stimulant dose predict later response in #ADHD? It did in new study of methylphenidate, using Qb test to compare immediate and 2-month response: www.ncbi.nlm.nih.gov/pubmed/41053... Art: Grace Venditti #psychiatry #pmhnp

Do GLP-1s treat #alcohol use d/o? Belief is high, evidence is thin, so take it with a grain of salt when this case-control study of diabetes looks for the GLP most effective against alcohol. Winners = Tirzepatide, semaglutide: www.ncbi.nlm.nih.gov/pubmed/41058... Evidence: Low 3/10

Child sexual abuse causes shame/depression, particularly for those who believe in a loving God, concludes: www.ncbi.nlm.nih.gov/pubmed/41052... Usually those beliefs have a protective effect. Anyone have insights? Evidence low 3/10 www.chrisaikenmd.com/ebm Art: pubmed.ncbi.nlm.nih.gov/33519578

What time of day should you get sunlight to improve #sleep quality? Morning, concludes new cross-sectional study. Afternoon also helped, but not as much. www.ncbi.nlm.nih.gov/pubmed/41053... Evidence grade: Low (3/10) www.chrisaikenmd.com/ebm #psychiatry #pmhnp #naturalhealth #therapy

Does topiramate reduce #cocaine use? Analysis combines 10 small trials, suggesting it helps abstinence short term but does not lower cravings: www.ncbi.nlm.nih.gov/pubmed/41047... Also useful for treatment-resistant #PTSD. How to use: www.thecarlatreport.com/articles/343... #psychiatry #pmhnp

JAMA editorial says GLP-1's are ready for mainstream in psychiatry for weight gain on meds and metabolic dysregulation in psychiatric patients: pubmed.ncbi.nlm.nih.gov/40991279/ Learn how to use them: www.thecarlatreport.com/articles/535... #psychiatry #pmhnp #medicine

Before prescribing valproate in women: ▪ Check pregnancy ▪ Educate on contraception ▪ Sign consent From: pubmed.ncbi.nlm.nih.gov/41060070 Exposed fetuses have 11% teratogen risk, and 30-40% risk of cognitive and psych problems.

Prazosin treats #PTSD (nightmares + daytime symptoms), but what about doxazosin? Nope. Just failed in RCT, making that 3 negative RCTs (it barely crosses the blood-brain barrier): pubmed.ncbi.nlm.nih.gov/41042258 How to use prazosin: www.thecarlatreport.com/blogs/2-the-...

In bipolar I, mood stabilizers are essential to prevent mania, but for #bipolar II depression therapy alone (social rhythm) may work, and in this trial reduced reduced suicidality independent of med: pubmed.ncbi.nlm.nih.gov/41037752 Social Rhythm Guide: amzn.to/4nYddI0

New study in Nature identifies two types of #autism: pubmed.ncbi.nlm.nih.gov/41034588 Early diagnosis (age 1-6) = genetically distinct from those diagnosed later (7-14). They also differed in timing of problems, suggesting these are different disorders. #psychiatry #pmhnp #neurodivergent

More evidence that #cannabis impairs fertility in women, causing eggs to mature fast with more DNA mutations. Not just the smoke, but THC and its metabolites. Case-controlled study: pubmed.ncbi.nlm.nih.gov/40925892 Evidence grade: Moderate (4/10): chrisaikenmd.com/ebm #obgyn #psychiatry #pmhnp

Should we test for fatty liver in #psychiatry? Rates are double in chronic mental illnesses, and new study suggests depression plays a causative role, possibly through effects on metabolic health: www.ncbi.nlm.nih.gov/pubmed/41031... Tips for liver health: chrisaikenmd.com/fattyliver

Memantine improved social impairments in youth with #autism in small randomized trial (20 mg): www.ncbi.nlm.nih.gov/pubmed/41032... Improvements correlated with baseline glutamate levels, in line with the mechanism. Evidence grade: Moderate (8/10): chrisaikenmd.com/ebm #psychiatry #pmhnp

Single dose IM #ketamine improved treatment resistant #PTSD in small, short-term RCT, opioid as control: pubmed.ncbi.nlm.nih.gov/41030011/ Caution: Reports of PTSD worsening after ketamine, like www.psychiatrist.com/jcp/how-do-w... Evidence grade: Moderate (6/10) chrisaikenmd.com/ebm

Rx for benzos and z-drugs raised the risk of alcohol/drug use disorders 2-3 fold in large, prospective, 14-year study of people compared to their twins or to matched controls: pubmed.ncbi.nlm.nih.gov/41035208 Evidence grade: Moderate 6/10 (high quality observational study, can't prove causation)

Update on food/sleep, from pubmed.ncbi.nlm.nih.gov/40988908 ▪ More sugar = worse sleep quality ▪ Eat at night = delay sleep by 30 min ▪ Skip breakfast = worse sleep quality/cognition ▪ Sleep deprivation causes weight gain (as do 3 above) #psychiatry #neurology #nutrition #pmhnp #therapy #diet

Brain fog is common in #longCOVID. Track it with this newly validated rating scale: chrisaikenmd.com/brainfogscale pubmed.ncbi.nlm.nih.gov/40987251 First step = Exercise, good sleep, healthy diet, stress reduction (eg, mindfulness). What have you found helpful for it? #covid #pmhnp #psychiatry

Which med is most effective for binge eating? 1st: Topiramate or lisdexamfetamine (Vyvanse) 2nd: Bupropion-naltrexone combo (reduced weight but not binging) Concludes new analysis of 12 trials: pubmed.ncbi.nlm.nih.gov/40984657 But 1st line = therapy (and eating more protein/fiber)

Today #Medicare reverted to pre-pandemic telehealth coverage, requiring an in-person visit before telehealth, and in-person at least every 6 months: telehealthresourcecenter.org/resources/th... The abrupt reversal is a side effect of the government shutdown.

Probiotics improved cognition after 3 months in meta-analysis of 21 RCTs, mainly in: ▪ Older adults ▪ Children ▪ Depression Benefits in processing speed, memory, and spatial ability pubmed.ncbi.nlm.nih.gov/40983638 How to use #probiotics: chrisaikenmd.com/supplements #naturalhealth #mentalhealth