"clozapine is more effective than other oral antipsychotics in reducing psychiatric hospitalisations and several secondary outcomes in schizophrenia-spectrum disorders, bipolar disorder, inpatient-treated major depressive disorder, & psychotic depression" Article: www.thelancet.com/journals/lan...

New study out in @thelancetpsych.bsky.social! Clozapine was associated with reduced psychiatric hospitalisations compared with other oral antipsychotics across several psychotic and affective disorders, but not borderline personality disorder. Free access! authors.elsevier.com/c/1m2747tf1d...

🧪 Weighing the risks: new review ranks antidepressants by their physical health side effects Antidepressants help many, but how do they affect heart health, weight, blood pressure, or glucose? New Lancet review (out today!) compared 30 meds across 58k ppl. 🧵 THREAD #Antidepressants #SideEffects

🧠 Treating ADHD in psychosis: What does the evidence say about safety? New research tracked over 9,000 people with schizophrenia spectrum disorders over 9 years. What happened when they were prescribed ADHD medication? 🧵 #ADHD #Psychosis #MentalHealthResearch #Schizophrenia

Olisiko hyvä idea, jos yliopistolla aloittava uusi professori saisi miljoonan euron aloituspaketin voidakseen rakentaa omaa tutkimusryhmäänsä? Jos hyvällä aloituspaketilla tuettu professuuri Itä-Suomen yliopistossa kiinnostaa, ks. toimintaohjeet uutisestamme. www.uef.fi/fi/artikkeli...

Should we start meds for #opioid use disorder like buprenorphine in jail? Yes. Associated with 50% lower overdose risk and lower risk of reincarnation: www.ncbi.nlm.nih.gov/pubmed/40929... Evidence grade: Moderate (5/10) chrisaikenmd.com/ebm/ ▪ 13% of US jails provide it Art: Van Gogh

New APA delirium guideline says NO to antipsychotics unless severe danger/distress. They failed in large trials: www.psychiatry.org/getmedia/51e... Use non-pharm approaches (and address underlying cause) in all patients, such as table 9: pmc.ncbi.nlm.nih.gov/articles/PMC...

1- Stopping an antidepressant causes, on average one more discontinuation symptom than not stopping it, according to a systematic review and meta-analysis of 50 studies involving 17,282 participants. #medsky #psychsky jamanetwork.com/journals/jam...

Interesting new analysis of ADHD meds in schizophrenia-spectrum disorders: reduced risk of psychosis with atomoxetine and reduced risk for somatic hospitalizations with lisdexamphetamine. Higher somatic hospitalization with polytherapy, no other negative safety signals. #psychiatry #medsky

Pramipexole lifted treatment-resistant #depression with large effect size (0.87) in 48-wk, placebo-controlled augmentation trial of 150 pubmed.ncbi.nlm.nih.gov/40602411 Used 2.5mg as high dose works better in TRD (vs 1.5mg) but more side effects How to use: www.thecarlatreport.com/articles/308...

I gotta say I find a lot of AI discourse around higher ed very confusing. "if ChatGPT can write your essays is college even worth it?" did people think math teachers were assigning problem sets because *they* couldn't figure out the answers?

People with #schizophrenia lived longer on #clozapine than other antipsychotics in this 11-year study of 41,695 from Hong Kong, confirming earlier findings: www.ncbi.nlm.nih.gov/pubmed/40412... Long-acting injectables (LAIs) also had an edge, particularly paliperidone. #psychiatry #pmhnp

Small (N=31) but important phase 2 trial in @thelancetpsych.bsky.social indicates semaglutide is safe and effective in people with schizophrenia on clozapine: 13.9% mean weight loss in 3 years with no difference in PANSS scores or clozapine levels. doi.org/10.1016/S221... #medsky #psychiatry

Extremely interesting narrative review on lithium's potential as a disease-modifying drug in bipolar disorder published in @thelancetpsych.bsky.social #medsky #psychiatry

Varenicline, combined with behavioral counseling, increased vaping abstinence in youth who vape nicotine and do not regularly smoke tobacco. https://ja.ma/4jvML5W

1- New international guidelines for algorithmic treatment (INTEGRATE) of #schizophrenia were just published: #medsky www.thelancet.com/journals/lan... (paywall, unfortunately)

Our new study, published in PAIN, analyzed age-standardized mortality in 116,006 non-cancer long-term users of opioids. Multifold risk of mortality vs the general population, especially due to suicide, accidents, and accidental poisoning. www.doi.org/10.1097/j.pain.0000000000003653 #medsky 🧪 #episky

New study on 3357 Canadian hypertension patients (followed on median 4.6 years) showed no difference between morning vs. bedtime dosing for CV outcomes, casting further doubt on the dramatic results of the MAPEC and Hygia trials. www.doi.org/10.1001/jama.2025.4390 #medsky 🧪

New study from our group! In a Swedish cohort of 1772 individuals with cannabis-induced psychosis, antipsychotics and especially LAIs, were effective in preventing re-hospitalization. Open access! Published in the British Journal of Psychiatry www.doi.org/10.1192/bjp.2025.72

The average longest duration between ANC checks was 88 days, consistent with a 2020 consensus guideline recommending quarterly in patients with continuous clozapine treatment for > 1 year who never had an ANC < 2000/μL. www.jpn.ca/content/45/3...

Super interesting (but preliminary) study published in Neuron, indicating: -Transplanting gut microbiota from women with fibromyalgia into mice induces pain -Replacing fibromyalgia microbiota with healthy microbiota alleviated pain both in mice and humans doi.org/10.1016/j.ne... #medsky 🧪

Study in BC 🇨🇦 sees no change in opioid or stimulant harms 1 year after decriminalization. "The findings do not support decriminalization in isolation as an effective policy at reducing drug overdose harms." Keep an eye on that opioid hospitalization trend, though www.doi.org/10.1001/jama.2025.3006

New short report in the American Journal of Psychiatry indicates that self-reported non-medical use of prescription stimulants, opioids, and benzodiazepines in adolescents decreased notably between 2009 and 2022 in US adolescents: www.doi.org/10.1176/appi.ajp.20240674 🧪

Lithium is best at decreasing the risk of depression-related hospitalisation in bipolar disorder, according to new cohort study buff.ly/bHzIaxb #BipolarDisorder #BipolarDepression #Lithium #MoodStabilisers 🧵 THREAD

SOUL phase 3b trial: Among participants with type 2 diabetes & cardiovascular disease, chronic kidney disease, or both, oral semaglutide was associated with a lower risk of cardiovascular events than placebo after 4 years of follow-up. nej.md/4hHII5M #ACC25 @accintouch.bsky.social

H/T @yan-holtz.bsky.social -- all OurWorldInData Datasets available in an R package - fantastic! 🧪📊

New meta-analysis finds co-occurring psychotic disorders are negatively associated with OAT retention, but no evidence of association between co-occurring psychotic disorders and illicit drug use (in OAT). doi.org/10.1007/s404...

Quetiapine may pip lithium to the augmentation post in 'treatment resistant depression': results from the LQD study buff.ly/Y7jCajZ #LQDstudy #Quetiapine #Lithium #Depression #RCT 🧵 THREAD

Clozapine is a life-saving medication for people with schizophrenia. The clozapine REMS was a barrier to effective to mental healthcare. The REMS is now gone. I recommend adopting these evidence-based monitoring guidelines proposed by this task force: pmc.ncbi.nlm.nih.gov/articles/PMC... #medsky

Insightful editorial raising questions about the role of esketamine in the treatment of depression, including "marginal effect sizes after the first week, the lack of controlled long-term efficacy data, and negligible evidence for efficacy against suicidality." psychiatryonline.org/doi/10.1176/...

Relapse in substance-induced psychosis and associated risk factors. A Nationwide register-linkage study from Sweden by Venla Ellilä @utu.fi and colleagues buff.ly/3D0TmGv

The end of the clozapine REMS ... sort of. The FDA no longer expects prescribers/pharmacies/patients to participate in REMS but "still recommends that prescribers monitor patients’ ANC according to the monitoring frequencies described in the prescribing information." www.fda.gov/drugs/postma...

What is the effect of ketamine on suicidal ideation (SI) in people with major depressive disorder (MDD)? A large cohort study using aggregated EHR data (N=515,000 pts w/ recurrent MDD) found that ketamine over time reduced SI more than antidepressants. pmc.ncbi.nlm.nih.gov/articles/PMC...

New study! Despite continuous use of LAI D2 blockers, 45% of first-episode schizophrenia patients relapsed in 10 years, suggesting non-dopaminergic pathophysiology. Risk of breakthrough psychosis decreased over time, opposing dopamine supersensitivity theory. dx.doi.org/10.1176/appi.ajp.20240321

New evidence for treating AUD with semaglutide: phase 2 RCT including 48 participants showed a decrease in laboratory alcohol self-administration (and some self-measured outcomes). www.doi.org/10.1001/jamapsychiatry.2024.4789

Welcome to Bluesky @thelancetpsych.bsky.social, finally I can tag you here.

New Lancet Psychiatry study on 105,495 individuals with bipolar disorder in Sweden: lithium reduces the risk of hospitalisation for depression (aHR 0·75, 95% CI 0·67–0·85) mania (0·61, 0·54–0·68), and somatic hospitalisation (0·86, 0·80–0·93), unlike any other drug. doi.org/10.1016/S221...

There does not appear to be an overall increased risk of overdose for individuals co-prescribed a stimulant medication with opioid agonist therapy. Open access research by Samantha Young and colleagues https://buff.ly/412Kl8I

Unironically a good idea.

New research from our team, published in Lancet Psychiatry! Switching to clozapine after a first psychosis relapse significantly reduces the risk of a second relapse compared to non-clozapine treatments. Open access: doi.org/10.1016/S221... 🧪 #medsky #episky #psychiatry #schizophrenia

Lisdexamfetamine appears to reduce methamphetamine use over a 12-week treatment period. Read the open access research by Nadine Ezard and colleagues https://buff.ly/4gRwNmb

We published our analysis on the fatal overdose risk associated with pregabalin and gabapentin as a Letter to the Editor in PAIN. I believe the title wraps it up nicely: Pregabalin is associated with a higher overdose risk but the risk with gabapentin is not negligible. dx.doi.org/10.1097/j.pa...

Substance use significantly raises suicide risk, with higher impacts on women. Alcohol, opioids, tobacco, and more are linked to increased mortality. Read the latest meta-analysis in DADR for more details: https://buff.ly/4j78GBi

Between 2020 and 2023, buprenorphine dispensing increased among adolescents but decreased among young adults, despite ongoing high rates of opioid use disorder. https://ja.ma/4go5vn6

Brexpiprazole [Rexulti] (2-3 mg flex dosing) + sertraline (150 mg fixed) beat sertraline + placebo for PTSD symptoms in a large-scale trial published in JAMA Psychiatry (n=416; LS mean CAPS difference at 10 wks −5.59, 95% CI [−8.79, −2.38] P < .001). Dropouts high (35%+), but *more* in PBO group.

New preprint 🚨 We identified metabolites (e.g. glycine conjugated bile acids and glutamate) associated with progressive alcohol-related liver disease (ALD) when compared to non-progressive ALD (simple steatosis) Excellent collaboration with Peter Stärkel's group! www.medrxiv.org/content/10.1...

I've been waiting for this!

🌟 ICYMI: Altmetric now tracks Bluesky mentions! ✔️ Comprehensive social media coverage 📊 Mentions reflected in your Altmetric score 🌐 Stay ahead in tracking research discussions Your research is moving to new spaces—don’t miss a thing! Read more here: www.altmetric.com/bl... #AcademicSky

Time to activate Bluesky with some blue skies.