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first:border-none first:pl-0 " href="/clinical-case-collective/expanding-possibilities-in-mdd-exploring-rapid-acting-therapeutic-options?utm_source=website&utm_medium=spotlight&utm_campaign=MDD-CCC_Sept24"> Expanding Possibilities in MDD: Exploring Rapid-Acting Therapeutic Options </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/major-depressive-disorder"> | Major Depressive Disorder </a><div class="mt-4 max-w-[125px]"></div></div><div class=""><a class="block cursor-pointer text-primary hover:underline px-2 pb-3 hover:text-black border-l border-current pl-auto first:border-none first:pl-0 " href="/topics/schizophrenia"> | Schizophrenia/Psychosis </a><div class="mt-4 max-w-[125px]"></div></div></div></div></div></nav><div id="the-week-in-review-october-16-20" class="container mx-auto flex m-1 min-h-[57vh] 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stroke="currentColor" fill="none" stroke-width="2" viewBox="0 0 24 24" stroke-linecap="round" stroke-linejoin="round" style="color:#818285;margin-bottom:6px;background:white;cursor:pointer" height="1.25rem" width="1.25rem" xmlns="http://www.w3.org/2000/svg"><polyline points="6 9 6 2 18 2 18 9"></polyline><path d="M6 18H4a2 2 0 0 1-2-2v-5a2 2 0 0 1 2-2h16a2 2 0 0 1 2 2v5a2 2 0 0 1-2 2h-2"></path><rect x="6" y="14" width="12" height="8"></rect></svg></a></button></div></div><div><div class="flex flex-wrap"><p class=" text-primary font-semibold">News</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1"></div><p class=" text-primary font-semibold">Article</p><div class="h-[16px] border-l-2 border-gray-400 mt-1 mx-1 "></div><time class="text-gray-500 " dateTime="2023-10-21T13:00:00.000">October 21, 2023</time></div><h1 class="text-[26px] font-medium leading-8">The Week in Review: October 16-20</h1><div class="py-3 text-gray-600 md:flex flex-col md:justify-between"><div class="flex flex-col xs:flex-row"><p class="mr-1 self-start">Author(s):</p><div class="flex flex-col xs:flex-row mb-3 md:mb-0"><div class="flex flex-wrap"><span class="text-md mr-2"><a class="text-author text-gray-500 hover:text-primary underline hover:no-underline decoration-gray-400" href="/authors/erin-o-brien">Erin O'Brien</a></span></div></div></div><div class="max-w-full"><div class="flex flex-wrap sm:flex-nowrap items-center w-fit my-2"></div><div class="w-full flex flex-col sm:flex-row justify-between mt-2"><div class="block md:hidden "><div class="mt-2 flex items-center max-w-fit"><button title="The Week in Review: October 16-20" aria-label="facebook" class="react-share__ShareButton" style="background-color:transparent;border:none;padding:0;font:inherit;color:inherit;cursor:pointer"><svg viewBox="0 0 64 64" width="32" height="32"><circle cx="32" cy="32" r="31" fill="#3b5998"></circle><path d="M34.1,47V33.3h4.6l0.7-5.3h-5.3v-3.4c0-1.5,0.4-2.6,2.6-2.6l2.8,0v-4.8c-0.5-0.1-2.2-0.2-4.1-0.2 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background: #7F7F7F; color: white; padding: 2px; border-radius: 100%; } </style></div></div></div></div><div class=" lg:w-full flex flex-col lg:flex-row lg:items-center lg:justify-end"></div><p class="py-2 mb-2 text-sm italic text-gray-600">From long-acting injectable antipsychotics for managing schizophrenia to mental health responses to the recent conflict in Israel, here are highlights from the week in Psychiatric Times.</p><div class="py-2"><div class="blockText_blockContent__TbCXh"><div class=""><div style="width:70%;float:center;max-width:525px;margin:0 auto 1rem;clear:both;cursor:pointer" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%271500%27%20height=%27824%27/%3e"/></span><img alt="Chepko Danil_AdobeStock" title="Chepko Danil_AdobeStock" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Chepko Danil_AdobeStock" title="Chepko Danil_AdobeStock" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=1920&q=75 1x, /_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 2x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Chepko Danil_AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/51d3cd8b64698f18bbaa58a4dd6d2804957c12c0-1500x824.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">This week, <em>Psychiatric Times</em>® discussed a wide variety of psychiatric issues and industry updates, from long-acting injectable antipsychotics for managing schizophrenia to mental health responses to the recent conflict in Israel. Here are some highlights from the week.</p><p class="pb-2"></p><p class="pb-2"><strong>The Earlier, the Better: Long-Acting Injectable Antipsychotics for Managing Schizophrenia</strong></p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:pointer" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%273840%27%20height=%272563%27/%3e"/></span><img alt="yuriygolub/AdobeStock" title="yuriygolub/AdobeStock" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="yuriygolub/AdobeStock" title="yuriygolub/AdobeStock" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F410e07703273add7b7083d232fff44aab83becbb-3840x2563.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F410e07703273add7b7083d232fff44aab83becbb-3840x2563.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">yuriygolub/AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/410e07703273add7b7083d232fff44aab83becbb-3840x2563.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">Medication discontinuation is very common in schizophrenia, leading to relapse, treatment resistance, and poor outcomes. Long-acting injectable (LAI) antipsychotics offer a solution to poor adherence, explained Sanjai Rao, MD, at the 2023 Annual Psychiatric Times™ World CME Conference.</p><p class="pb-2">“By some estimates, up to half our patients will discontinue medications within the first 6 months of treatment, and perhaps up to 75% will discontinue medications within a year and a half of treatment. When this happens, even if it is after just a single psychotic episode, this can lead to relapse. The more often this happens to your patient, the more often they relapse and the longer it is going to take to get them back to something resembling remission,” said Rao, who is clinical professor of psychiatry and associate residency training director at the University of California, San Diego; site director of residency training at the VA San Diego Healthcare System in San Diego, CA. <a target="_blank" href="https://www.psychiatrictimes.com/view/the-earlier-the-better-long-acting-injectable-antipsychotics-for-managing-schizophrenia"><strong>Continue Reading</strong></a></p><p class="pb-2"></p><p class="pb-2"><strong>Mental Health Responses to the Recent Conflict in Israel</strong></p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:pointer" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%2710000%27%20height=%276500%27/%3e"/></span><img alt="Meysam Azarneshin_AdobeStock" title="Meysam Azarneshin_AdobeStock" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Meysam Azarneshin_AdobeStock" title="Meysam Azarneshin_AdobeStock" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F9c124bc9556d0231051d4df77160237579a5891e-10000x6500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F9c124bc9556d0231051d4df77160237579a5891e-10000x6500.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Meysam Azarneshin_AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/9c124bc9556d0231051d4df77160237579a5891e-10000x6500.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">The war between Israel and Hamas that broke out on Saturday, October 7, has had a profound impact on Israel, affecting not only the general population but also psychiatric patients and the professionals who treat them. This article describes the response to this challenging situation.</p><p class="pb-2"><strong><em>Psychiatric In-Patient Treatment</em></strong></p><p class="pb-2">Israel's severe psychiatric patients are primarily served by a network of standalone psychiatric hospitals positioned across the country, with a total of approximately 3300 beds. Although some of these facilities are partially fortified against missile attacks, most remain vulnerable. Hospitals situated near the borders face potential casualties from missile attacks, as they lack protection against bombs; a missile landed in one of them with no casualties. Approximately 160 psychiatric patients have been evacuated from one of these hospitals near the border to hospitals situated more centrally. <a target="_blank" href="https://www.psychiatrictimes.com/view/mental-health-responses-to-the-recent-conflict-in-israel"><strong>Continue Reading</strong></a></p><p class="pb-2"></p><p class="pb-2"><strong>Concurrent Treatment of Eating Disorders and PTSD Leads to Long-Term Recovery</strong></p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:pointer" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%273840%27%20height=%272560%27/%3e"/></span><img alt="Xavier Lorenzo/AdobeStock" title="Xavier Lorenzo/AdobeStock" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Xavier Lorenzo/AdobeStock" title="Xavier Lorenzo/AdobeStock" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F96c6daa013d9867ec6135d694bec684696299efa-3840x2560.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F96c6daa013d9867ec6135d694bec684696299efa-3840x2560.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Xavier Lorenzo/AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/96c6daa013d9867ec6135d694bec684696299efa-3840x2560.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">Research shows an undeniable connection between posttraumatic stress disorder (PTSD) and eating disorders (EDs). Individuals with significant traumatic histories and/or PTSD have more severe ED symptoms, more suicidality, and more anxiety and depressive symptoms. Studying the intersection between these 2 mental health illnesses helps us understand how to treat them together moving forward, specifically in higher levels of care, including residential ED treatment programs.</p><p class="pb-2">Groundbreaking research published in the <em>Journal of Eating Disorders </em>shows the effectiveness of integrating trauma treatment with evidenced-based ED treatment in residential programs. The conventional thinking in psychiatry had been that it was best to refrain from trauma work while in intensive treatment settings, deferring this to later outpatient treatment. <a target="_blank" href="https://www.psychiatrictimes.com/view/concurrent-treatment-of-eating-disorders-and-ptsd-leads-to-long-term-recovery"><strong>Continue Reading</strong></a></p><p class="pb-2"></p><p class="pb-2"><strong>Orexin: The New Kid on the Insomnia Block</strong></p><div class=""><div style="width:40%;float:right;max-width:525px;margin:0 0 1.5rem 1.5rem;clear:both;cursor:pointer" class=" figure"><div class="flex-none relative text-center"><span style="box-sizing:border-box;display:inline-block;overflow:hidden;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;position:relative;max-width:100%"><span style="box-sizing:border-box;display:block;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0;max-width:100%"><img style="display:block;max-width:100%;width:initial;height:initial;background:none;opacity:1;border:0;margin:0;padding:0" alt="" aria-hidden="true" src="data:image/svg+xml,%3csvg%20xmlns=%27http://www.w3.org/2000/svg%27%20version=%271.1%27%20width=%273840%27%20height=%272560%27/%3e"/></span><img alt="Princeoflove/AdobeStock" title="Princeoflove/AdobeStock" src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain"/><noscript><img alt="Princeoflove/AdobeStock" title="Princeoflove/AdobeStock" srcSet="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4bc04110aae0eb4618f24634e57fc32b00a4397e-3840x2560.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75 1x" src="/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2F4bc04110aae0eb4618f24634e57fc32b00a4397e-3840x2560.jpg%3Ffit%3Dcrop%26auto%3Dformat&w=3840&q=75" decoding="async" data-nimg="intrinsic" style="position:absolute;top:0;left:0;bottom:0;right:0;box-sizing:border-box;padding:0;border:none;margin:auto;display:block;width:0;height:0;min-width:100%;max-width:100%;min-height:100%;max-height:100%;object-fit:contain" loading="lazy"/></noscript></span></div><div id="image-caption" class="text-gray-500 italic"><div class="blockText_blockContent__TbCXh"><p class="pb-2">Princeoflove/AdobeStock</p></div></div><div class="top-[-100%] block w-[1px] transition-opacity duration-500 ease-in-out opacity-0 overflow-hidden"><img class="m-auto absolute inset-0 max-w-[0%] max-h-[0%] border-[3px] border-solid border-white shadow-[0px_0px_8px_rgba(0,0,0,0.3)] box-border transition ease-in-out duration-500" src="https://cdn.sanity.io/images/0vv8moc6/psychtimes/4bc04110aae0eb4618f24634e57fc32b00a4397e-3840x2560.jpg?fit=crop&auto=format"/></div></div><style> #image-caption p{ font-size: 12px; max-width: 525px; margin: 0 auto; text-align: center; } </style></div><p class="pb-2">Dual orexin receptor antagonists (DORAs), the newest kid on the insomnia treatment block, do not adversely effect sleep architecture, explained Paul P. Doghramji, MD, at the 2023 Annual Psychiatric Times™ World CME Conference. He also explained DORAs do not have rebound insomnia, tolerance issues, or withdrawal symptoms. Doghramji, Senior Family Physician at Collegeville Family Practice, told attendees how orexins work, and then reviewed the currently available DORAs.</p><p class="pb-2">Suvorexant was the first DORA on the market, approved in 2014 for difficulties with sleep onset and/or maintenance, he said. Available in 5, 10, 15, and 20 mg doses, Doghramji finds most patients do best at the 20 mg dose but suggested starting with the 10 mg dose. It has a half-life of 15 hours and a Tmax of 2 hours. The most common adverse effects in trials were somnolence, headache, abnormal dreams, dry mouth, cough, and upper respiratory infection. <a target="_blank" href="https://www.psychiatrictimes.com/view/orexin-the-new-kid-on-the-insomnia-block"><strong>Continue Reading</strong></a></p><p class="pb-2"></p><p class="pb-2">See more recent coverage from <em>Psychiatric Times </em><a target="_blank" href="https://www.psychiatrictimes.com/">here</a>. And be sure to stay up-to-date by subscribing to the <em>Psychiatric Times </em><a target="_blank" href="https://www.psychiatrictimes.com/view/enews?tfa_2=navbar">E-newsletter</a>.</p><p class="pb-2"></p><p class="pb-2"><em>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.</em></p><p class="pb-2"></p></div></div><div class="flex items-center lg:w-3/4 mb-4 pb-12"></div><div class="jsx-19ede9f0a5a45918 py-4 relative bg-primary md:px-8 -ml-6 xs:ml-0 w-screen xs:w-auto"><div class="jsx-19ede9f0a5a45918 px-4 sm:px-0"><div class="flex justify-between items-center py-1 space-x-4 border-0 select-none sm:border-b border-secondary"><div class="text-3xl text-white text-lg sm:text-3xl">Related Videos</div></div></div><div style="scroll-snap-type:none" class="jsx-19ede9f0a5a45918 flex items-start overflow-x-auto space-x-4 py-4 relative mx-auto w-full pl-4"><a id="" class="w-[200px] h-fit space-y-3 flex-none select-none no-underline" style="scroll-snap-align:center;text-decoration:none" href="/view/the-importance-of-sports-psychiatry-in-an-athletes-well-being"><div class="w-full shadow-md shadow-gray-800 overflow-hidden relative bg-white aspect-video"><span 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Here are some highlights from the week.\n\n\n\nThe Earlier, the Better: Long-Acting Injectable Antipsychotics for Managing Schizophrenia\n\n\n\nMedication discontinuation is very common in schizophrenia, leading to relapse, treatment resistance, and poor outcomes. Long-acting injectable (LAI) antipsychotics offer a solution to poor adherence, explained Sanjai Rao, MD, at the 2023 Annual Psychiatric Times™ World CME Conference.\n\n“By some estimates, up to half our patients will discontinue medications within the first 6 months of treatment, and perhaps up to 75% will discontinue medications within a year and a half of treatment. When this happens, even if it is after just a single psychotic episode, this can lead to relapse. The more often this happens to your patient, the more often they relapse and the longer it is going to take to get them back to something resembling remission,” said Rao, who is clinical professor of psychiatry and associate residency training director at the University of California, San Diego; site director of residency training at the VA San Diego Healthcare System in San Diego, CA. Continue Reading\n\n\n\nMental Health Responses to the Recent Conflict in Israel\n\n\n\nThe war between Israel and Hamas that broke out on Saturday, October 7, has had a profound impact on Israel, affecting not only the general population but also psychiatric patients and the professionals who treat them. This article describes the response to this challenging situation.\n\nPsychiatric In-Patient Treatment\n\nIsrael's severe psychiatric patients are primarily served by a network of standalone psychiatric hospitals positioned across the country, with a total of approximately 3300 beds. Although some of these facilities are partially fortified against missile attacks, most remain vulnerable. Hospitals situated near the borders face potential casualties from missile attacks, as they lack protection against bombs; a missile landed in one of them with no casualties. Approximately 160 psychiatric patients have been evacuated from one of these hospitals near the border to hospitals situated more centrally. Continue Reading\n\n\n\nConcurrent Treatment of Eating Disorders and PTSD Leads to Long-Term Recovery\n\n\n\nResearch shows an undeniable connection between posttraumatic stress disorder (PTSD) and eating disorders (EDs). Individuals with significant traumatic histories and/or PTSD have more severe ED symptoms, more suicidality, and more anxiety and depressive symptoms. Studying the intersection between these 2 mental health illnesses helps us understand how to treat them together moving forward, specifically in higher levels of care, including residential ED treatment programs.\n\nGroundbreaking research published in the Journal of Eating Disorders shows the effectiveness of integrating trauma treatment with evidenced-based ED treatment in residential programs. The conventional thinking in psychiatry had been that it was best to refrain from trauma work while in intensive treatment settings, deferring this to later outpatient treatment. Continue Reading\n\n\n\nOrexin: The New Kid on the Insomnia Block\n\n\n\nDual orexin receptor antagonists (DORAs), the newest kid on the insomnia treatment block, do not adversely effect sleep architecture, explained Paul P. Doghramji, MD, at the 2023 Annual Psychiatric Times™ World CME Conference. He also explained DORAs do not have rebound insomnia, tolerance issues, or withdrawal symptoms. Doghramji, Senior Family Physician at Collegeville Family Practice, told attendees how orexins work, and then reviewed the currently available DORAs.\n\nSuvorexant was the first DORA on the market, approved in 2014 for difficulties with sleep onset and/or maintenance, he said. Available in 5, 10, 15, and 20 mg doses, Doghramji finds most patients do best at the 20 mg dose but suggested starting with the 10 mg dose. It has a half-life of 15 hours and a Tmax of 2 hours. The most common adverse effects in trials were somnolence, headache, abnormal dreams, dry mouth, cough, and upper respiratory infection. Continue Reading\n\n\n\nSee more recent coverage from Psychiatric Times here. And be sure to stay up-to-date by subscribing to the Psychiatric Times E-newsletter.\n\n\n\nDo 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.\n\n","description":"From long-acting injectable antipsychotics for managing schizophrenia to mental health responses to the recent conflict in Israel, here are highlights from the week in Psychiatric Times.","author":[{"@type":"Person","name":"Erin O'Brien"}]}</script></div></div><div class="flex-none w-[300px] z-[9999] relative hidden md:block"><div style="top:5rem" class="sticky custom-spacing"><div class="collapse-container " style="overflow:hidden;max-height:900px;transition:max-height .4s ease-in-out"></div></div></div></div><div id="div-gpt-ad-pixel" style="width:1px;height:1px" class=""></div><noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-5V9L5PL" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript><div id="footerOuterWrap" class="w-full bg-primary flex flex-col items-center justify-center"><div class="container w-[1340px]"><div id="footerInnerWrap" class="bg-primary w-full py-12"><div 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The results, derived from a large, multicenter outpatient study, show that the treatment leads to sustained symptom improvement while maintaining a favorable safety profile with minimal adverse effects. The new information was presented via poster session at the 30th Annual Nevada Psychiatric Association National Psychopharmacology Update.","_key":"31f28595797b"}],"_type":"block","style":"normal","_key":"65463d0288eb"},{"markDefs":[],"children":[{"_key":"82f77602ed00","_type":"span","marks":["strong"],"text":"Sustained Symptom Improvement Over 52 Weeks"}],"_type":"block","style":"normal","_key":"a8ae6f93a6e0"},{"style":"normal","_key":"b6bff1a5afd9","markDefs":[],"children":[{"text":"The EMERGENT-5 trial followed 277 participants, all of whom had stable schizophrenia symptoms with no prior exposure to xanomeline and trospium. 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Additionally, there were no significant changes in prolactin levels or movement-related adverse effects, such as tardive dyskinesia.","_key":"4e556496bd40"}],"_type":"block","style":"normal","_key":"3d38f4ade0bf"},{"_type":"block","style":"normal","_key":"8ee789bde97d","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Study Design and Participant Demographics","_key":"f02d3bd543e6"}]},{"style":"normal","_key":"c81fa330ca8d","markDefs":[],"children":[{"_key":"9eb3ba0c4bc1","_type":"span","marks":[],"text":"The study enrolled a diverse population, with 66.3% male and 33.7% female participants. Racial and ethnic diversity was also represented, with 68.7% identifying as Black or African American, 29% as White, and 21% as Hispanic or Latino. All participants initiated treatment with a twice-daily regimen, titrating from 50 mg xanomeline and 20 mg trospium chloride to a maximum dose of 125 mg xanomeline and30 mg trospium chloride over the course of the trial."}],"_type":"block"},{"markDefs":[],"children":[{"_key":"7819c358fe12","_type":"span","marks":["strong"],"text":"Future Implications for Schizophrenia Treatment"}],"_type":"block","style":"normal","_key":"52b3355f6978"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"With the US Food and Drug Administration approval of xanomeline and trospium for schizophrenia, the EMERGENT-5 trial provides long-term data supporting its efficacy and safety. 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It is crucial to recognize PTSD as a brain disease, with trauma leading to structural changes in the brain. Different trauma types can result in varied symptom presentations, necessitating thorough screening and diagnosis. Treatment should be personalized, considering psychotherapy, pharmacotherapy, and alternative therapies. Innovative research, including brexpiprazole-sertraline combinations, MDMA-assisted therapy, and augmented reality, holds promise for future PTSD management, highlighting the importance of continued exploration and development in this field.","_createdAt":"2025-02-13T18:47:06Z","thumbnail":{"caption":"Vitalii Vodolazskyi/AdobeStock","asset":{"_type":"reference","_ref":"image-27b873c52bbaee74fe59c241f89e07739253dac9-5200x3467-jpg"},"_type":"mainImage","alt":"PTSD"},"gptTakeaways":"• PTSD is a complex disorder, often underdiagnosed, affecting diverse populations beyond military contexts, with trauma types influencing symptomology.\n\n• Recognizing PTSD as a brain disease is crucial, with trauma causing structural brain changes, impacting emotional regulation and symptom presentation.\n\n• Thorough screening and diagnosis are essential, using tools like the Clinician-Administered PTSD Scale and PTSD Checklist for DSM-5.\n\n• Treatment should be individualized, incorporating psychotherapy, pharmacotherapy, and alternative therapies, while avoiding unnecessary polypharmacy.\n\n• Innovative research, including brexpiprazole-sertraline combinations, MDMA-assisted therapy, and augmented reality, offers promising future PTSD management options.","summary":"Check out these 7 insights and perspectives on recognizing and treating PTSD.","body":[{"_type":"figure","disableLightBox":true,"alt":"PTSD","alignment":"left","imgcaption":[{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Vitalii Vodolazskyi/AdobeStock","_key":"0154d3454986"}],"_type":"block","style":"normal","_key":"3a6e33bdfafa"}],"widthP":50,"disableTextWrap":false,"_key":"d87d1f0e49f0","asset":{"_ref":"image-27b873c52bbaee74fe59c241f89e07739253dac9-5200x3467-jpg","_type":"reference"}},{"_type":"block","style":"normal","_key":"c3691c456dc2","markDefs":[],"children":[{"_key":"fc530935f664","_type":"span","marks":[],"text":"“Trauma underlies a lot of psychiatric problems.… Posttraumatic stress disorder [PTSD] is not only underdiagnosed, but it’s also misdiagnosed a lot,” Matthew Robinson, PhD, shared with his colleagues in the recent Psychiatric Times custom video series "},{"_type":"span","marks":["em"],"text":"Optimizing Diagnosis, Treatment, and Management of PTSD in the Community","_key":"41f25083f0f2"},{"marks":[],"text":". The panel, which also included Tory Woodard, NP, and Michael Asbach, DMSc, PA-C, and was moderated by Arash Javanbakht, MD, shared their insights and perspectives on recognizing and treating PTSD.","_key":"71ac2ec37404","_type":"span"}]},{"children":[{"marks":["strong"],"text":"1. Limited views of PTSD need to be rejected.","_key":"092161e80739","_type":"span"}],"_type":"block","style":"normal","_key":"4c0d05d342a3","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Javanbakht, director of the Stress, Trauma, and Anxiety Research Clinic at Wayne State University, emphasized that PTSD is a multifaceted psychiatric disorder triggered by exposure to traumatic events. Although originally considered a disorder of military veterans and war refugees, it has grown to include people of all ages and backgrounds, including those outside of the military. Traumatic experiences include personal assaults, accidents, violence, or natural disasters, he added.","_key":"db055d0b9177"}],"_type":"block","style":"normal","_key":"cc50fe9aedc9"},{"_type":"block","style":"normal","_key":"a97bf57023bd","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Asbach added, “PTSD is far more prevalent than we might expect,” with causes such as rape, physical assault, serious accident or injury, shooting, and even threats against family members.","_key":"3bb1de1d97d8"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"The panel emphasized the importance of evaluating individuals from all backgrounds. Woodard, a board-certified family psychiatric nurse practitioner at LifeStance Health in Mount Juliet, Tennessee, said marginalized and low socioeconomic communities are often at risk for PTSD.","_key":"45096446f592"}],"_type":"block","style":"normal","_key":"cf534e17e53b"},{"style":"normal","_key":"fdff18df924c","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Any type of previous trauma or earlier life experience can be a risk factor for PTSD,” added Robinson, research psychologist in Dissociative Disorders and Trauma Research Program, McLean Hospital, and an instructor in Psychology, at Harvard Medical School in Boston, Massachusetts.. “And then lack of social support, not having other resources or ways of recovering in the face of traumatic stressors, is a risk factor.”","_key":"c0dfcadbfecf"}],"_type":"block"},{"style":"normal","_key":"0fb5c9ff8218","markDefs":[],"children":[{"text":"2. PTSD is often underdiagnosed and misdiagnosed.","_key":"08abbbef6f4c","_type":"span","marks":["strong"]}],"_type":"block"},{"markDefs":[],"children":[{"text":"It is important to evaluate patients who present with other psychiatric complaints, the panel noted. They agreed many patients who originally present with a different diagnosis or complaint actually have underlying PTSD that had been previously missed.","_key":"1fec2ea0453d","_type":"span","marks":[]}],"_type":"block","style":"normal","_key":"40e5ff511dbf"},{"markDefs":[],"children":[{"_key":"468eb8369618","_type":"span","marks":[],"text":"Trauma and PTSD are underestimated, Woodard said. “I found that a lot of disorders that my clients had—whether it be bipolar disorder, major depression, anxiety, or panic attacks—was actually trauma…in these marginalized patients,” he explained."}],"_type":"block","style":"normal","_key":"224774669bee"},{"_key":"4f0ec08ced63","markDefs":[],"children":[{"text":"Javanbakht similarly said that cases of psychosis, schizophrenia, and dissociative symptoms can actually be cases of PTSD.","_key":"3047eb54312f","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"_key":"bdf6609fecec","markDefs":[],"children":[{"text":"“PTSD and trauma underlies a lot of psychiatric disorders,” Robinson added. “Especially when patients have been traumatized early in life, the symptoms can be mischaracterized.”","_key":"da66a702d2fa","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"children":[{"_type":"span","marks":["strong"],"text":"3. PTSD is a brain disease and should be approached as such.","_key":"cd269da944f9"}],"_type":"block","style":"normal","_key":"70894d1c40ee","markDefs":[]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“It’s important to see PTSD as a disease of the brain and the body,” Javanbakht said. “Trauma leads to PTSD, but there are a lot of other things that it leads to: depression, anxiety, substance use.”","_key":"1eb200784f60"}],"_type":"block","style":"normal","_key":"8734d32d39ba"},{"_type":"block","style":"normal","_key":"d223d9035e56","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Asbach, a psychiatric physician assistant at DENT Neurologic Institute in Buffalo, New York, is intrigued by the structural changes within the brain following trauma that appear in structural neuroimaging, further emphasizing the brain disease notion. “It may be too reductive, but we can think about PTSD as something that is more in line with posttraumatic brain injury,” he said. “There can be changes to brain volume, but also changes to how the amygdala is lighting up, overactivity changes in the wiring that are making the brain basically predisposed to having a level of hyperarousal that simply doesn’t go away.”","_key":"09c3518bf557"}]},{"_type":"block","style":"normal","_key":"ea51a3e0d08a","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Javanbakht likes to use the brain model when talking with patients, especially when discussing psychopharmacology as an option. “As you mentioned, the amygdala is hyperactive and you can even see the hippocampus starts to shrink,” he said. “The more chronic the illness gets, the smaller the hippocampus is; prefrontal cortical areas are shrunken and less active; and there’s less emotional regulation. It helps patients to see, ‘It’s not me. I’m not weak. There is a real biological change occurring here…that affects the whole body.’”","_key":"0b09d2c528d4"}]},{"children":[{"_key":"5cfb5eb4664d","_type":"span","marks":["strong"],"text":"4. Trauma types may result in different presenting symptomology."}],"_type":"block","style":"normal","_key":"f2f2d71f0f82","markDefs":[]},{"alt":"FIGURE 1. Exploring Symptom Clusters in PTSD","disableLightBox":true,"alignment":"right","disableTextWrap":false,"_type":"figure","imgcaption":[{"markDefs":[],"children":[{"text":"FIGURE 1.","_key":"d9741176e76e","_type":"span","marks":["strong"]},{"_key":"53cce7d5c802","_type":"span","marks":[],"text":" Exploring Symptom Clusters in PTSD"}],"_type":"block","style":"normal","_key":"2b72a5cfd1d3"}],"widthP":60,"blank":true,"_key":"78f0aba09526","asset":{"_ref":"image-f77644e57196afce4103129373cdefe1a4d8ca13-1220x518-png","_type":"reference"}},{"_type":"block","style":"normal","_key":"6363f3ddd51f","markDefs":[{"_type":"link","href":"https://www.psychiatrictimes.com/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Ff77644e57196afce4103129373cdefe1a4d8ca13-1220x518.png%3Ffit%3Dcrop%26auto%3Dformat\u0026w=3840\u0026q=75","_key":"61401208cc6c","nofollow":true,"blank":true}],"children":[{"_type":"span","marks":[],"text":"Javanbakht led the panel in discussing how PTSD can manifest differently depending on the trauma type (","_key":"64ffae022b58"},{"marks":["strong","61401208cc6c"],"text":"Figure 1","_key":"0a6cedc5377f","_type":"span"},{"_type":"span","marks":[],"text":").","_key":"3814efa5fba6"}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“We as humans are very sensitive to what other humans do to us,” he said, referring to patients who are refugees. “We have seen that trauma types that are more interpersonal, more victimization types or war traumas, have a worse impact even through the time, and the course of illness is worse than, for example, natural disasters.”","_key":"6ae048896797"}],"_type":"block","style":"normal","_key":"1356e6718000"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Robinson agreed that there seems to be different symptom clusters. “Early life trauma—physical and sexual abuse in childhood—show up and present with lots of different symptoms, and maybe not the classic type of expected presentation,” he said. “People might expect someone with PTSD to be jumpy, hyperaroused, very alert. But, especially with early life trauma, we see patients having almost the opposite effect, where they are numbed, shut down, and having a hard time interacting or engaging.”","_key":"0afae092995f"}],"_type":"block","style":"normal","_key":"a28abfa98aaa"},{"_key":"c5ccf423cf97","markDefs":[],"children":[{"_type":"span","marks":[],"text":"Robinson is currently researching the ways the brain responds in different types of PTSD. “What we see with dissociative PTSD is that the prefrontal cortex is actually overacting on the amygdala, oversuppressing it, whereas in hyperaroused types of PTSD you see under-regulation,” he said.","_key":"4500687e6532"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"5. Ask about and screen for trauma to assist in diagnosis.","_key":"c856e2c383af"}],"_type":"block","style":"normal","_key":"83d7f3eccba6"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“I always say to my trainees: Sex and trauma, if you don’t ask your patients about them, a lot of times, patients won’t tell you about it,” Javanbakht said. “A lot of times we are hesitant about asking, because we don’t know what to do, and we feel uncomfortable around it.”","_key":"5804209cf231"}],"_type":"block","style":"normal","_key":"9f58ab8f54df"},{"style":"normal","_key":"5bc9e476c17f","markDefs":[],"children":[{"text":"Diagnosis can be complicated because patients may be reluctant to explore or discuss the issue. “I think a lot about trauma in the ‘just world’ theory: the mentality that I’m a good person and so good things will happen to me. And then, when something terrible happens, such as an index trauma, it kind of hurts. It cuts against that theory,” Asbach explained.","_key":"7c0c423305e7","_type":"span","marks":[]}],"_type":"block"},{"children":[{"_type":"span","marks":[],"text":"Thus, patients may present with “nonspecific, vague, or even somatic complaints like insomnia and headaches,” especially in a primary care setting, Asbach explained. “We know that only about 50% of PTSD is diagnosed or recognized, and part of that may be due to a lack of resources or a lack of ability in our very confined settings to be able to truly make a thorough assessment of these patients.”","_key":"951c64ee795d"}],"_type":"block","style":"normal","_key":"7746c932356d","markDefs":[]},{"style":"normal","_key":"588b9a9b94d6","markDefs":[],"children":[{"marks":[],"text":"Even worse, the panel noted that PTSD diagnosis tends to be delayed, taking an average of 8.7 years following a traumatic incident for patients to receive a diagnosis. Sometimes this is a result of a delayed onset of the PTSD, because the person was overly resilient or it took a trigger years later for the patient to actually develop the disorder, Woodard said.","_key":"95060be65f59","_type":"span"}],"_type":"block"},{"_type":"block","style":"normal","_key":"a2efb4e2006f","markDefs":[{"href":"https://www.psychiatrictimes.com/_next/image?url=https%3A%2F%2Fcdn.sanity.io%2Fimages%2F0vv8moc6%2Fpsychtimes%2Fb904ea5e7bf6f651a6b16615b884f2ed04381ef4-1224x432.png%3Ffit%3Dcrop%26auto%3Dformat\u0026w=3840\u0026q=75","_key":"66dee9207391","nofollow":true,"blank":true,"_type":"link"}],"children":[{"text":"The panel discussed the importance of leveraging tools to assist in diagnosis, especially the Clinician-Administered PTSD Scale for ","_key":"6c80d4a3334b","_type":"span","marks":[]},{"_type":"span","marks":["em"],"text":"DSM-5","_key":"03b588046e84"},{"_key":"8cff136bdd07","_type":"span","marks":[],"text":", which Woodard said was the “gold standard” in assessing symptoms ("},{"_type":"span","marks":["strong","66dee9207391"],"text":"Figure 2","_key":"829afeea1979"},{"_type":"span","marks":[],"text":").","_key":"204cc2d7e2d2"}]},{"alignment":"right","disableLightBox":true,"asset":{"_ref":"image-b904ea5e7bf6f651a6b16615b884f2ed04381ef4-1224x432-png","_type":"reference"},"widthP":50,"disableTextWrap":false,"imgcaption":[{"children":[{"_type":"span","marks":["strong"],"text":"FIGURE 2.","_key":"67d77556acf9"},{"_type":"span","marks":[],"text":" Diagnostic Tools","_key":"c95e2789e94d"}],"_type":"block","style":"normal","_key":"a81eeb55dc2c","markDefs":[]}],"_type":"figure","alt":"FIGURE 2. Diagnostic Tools","_key":"4448a3e585c8"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"On the other hand, Asbach likes the PTSD Checklist for ","_key":"752f24b692f9"},{"_type":"span","marks":["em"],"text":"DSM-5","_key":"71c4c5eb8678"},{"_type":"span","marks":[],"text":" (PCL-5), which he said is his preferred option. As a psychopharmacologist who sees many patients, he also likes the Primary Care PTSD Screen for ","_key":"b3a831ccf6b3"},{"_type":"span","marks":["em"],"text":"DSM-5","_key":"5439652ef066"},{"_type":"span","marks":[],"text":" with its quick 5 questions for its ease of use among patients. Then, for a deeper dive, he uses the 20-question self-rating PCL-5.","_key":"9f06abaef2bb"}],"_type":"block","style":"normal","_key":"36fa258ddebc"},{"_type":"block","style":"normal","_key":"f5fef7b1a35c","markDefs":[],"children":[{"text":"6. Treatment is not one size fits all.","_key":"5da44becc94f","_type":"span","marks":["strong"]}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"“I think it’s important for us to meet the patient where they’re at,” Asbach said in terms of developing a treatment strategy. “Every patient’s going to be different in what they’re capable of achieving, especially early on in the process.”","_key":"04d3948a7b92"}],"_type":"block","style":"normal","_key":"c051a657124d"},{"style":"normal","_key":"c4ed30f74594","markDefs":[],"children":[{"_key":"a1480f588f05","_type":"span","marks":[],"text":"Current treatment options include psychotherapy (eg, cognitive behavioral therapy, exposure therapy, and eye movement desensitization), pharmacotherapy (eg, sertraline and paroxetine, which are FDA approved), and alternative/complementary therapies (eg, yoga, art, and mindfulness)."}],"_type":"block"},{"markDefs":[],"children":[{"_key":"96e605f54ba9","_type":"span","marks":[],"text":"“Psychopharmacology is always a good thing in the sense that it has a low barrier to entry with PTSD. I often approach this in terms of targeting those symptom clusters,” he added, noting that he also considers comorbidities (eg, mood and anxiety) when prescribing medications."}],"_type":"block","style":"normal","_key":"846aaa45e5f3"},{"_key":"eb6219d09104","markDefs":[],"children":[{"_type":"span","marks":[],"text":"There are also medications that could worsen symptoms, like emotional blunting associated with benzodiazepines when there is dissociation, Asbach said.","_key":"1ee2b0815c79"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Thus, Asbach takes a very intentional approach. “We’re not looking to just paper over symptoms, but rather be very careful and very targeted in our prescribing,” he explained. This approach ensures there isn’t any unnecessary polypharmacy. “In a patient with PTSD, where we have a lot of nonspecific symptoms, we have a lot of physical comorbidities and may have many different medications on board and may actually muddy the waters. This makes it more challenging for us to really gauge what the outcomes can even be with our medication intervention.”","_key":"acce2eb773a2"}],"_type":"block","style":"normal","_key":"40d2a7c3285f"},{"children":[{"_type":"span","marks":["strong"],"text":"7. Innovative research may lead to better treatments.","_key":"0c8c44b325b0"}],"_type":"block","style":"normal","_key":"8a6d98c67eff","markDefs":[]},{"_key":"e7f26fc3fdf7","markDefs":[],"children":[{"_type":"span","marks":[],"text":"The panel expressed their excitement about the renewed interest and reinvestment in PTSD, with several options under investigation. One agent is a combination of brexpiprazole and sertraline; a supplemental new drug application has been submitted.","_key":"05c1d15fe107"}],"_type":"block","style":"normal"},{"_type":"block","style":"normal","_key":"a3087f6a33b4","markDefs":[],"children":[{"_type":"span","marks":[],"text":"“Brexpiprazole is a medication that has a fairly favorable side effect profile. And there are some aspects of brexpiprazole that can be quite exciting if we’re thinking about symptom-focused treatment within PTSD,” Asbach said. “This may have a role in enhancing serotonin deficiency, which…[may be] a potential problem within PTSD. But also it may have a role within the dopamine receptors as well. And we talked about motivation arousal as being a concern. 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McSweeney","url":"megan-mcsweeney"}],"thumbnail":{"alt":"Yuparet/AdobeStock","caption":"Yuparet/AdobeStock","asset":{"_type":"reference","_ref":"image-ab7da8966014ad1be562e621a9f5b7a2397b9d28-5824x3264-jpg"},"_type":"mainImage"},"body":[{"imgcaption":[{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Yuparet/AdobeStock","_key":"7e8a755f127c"}],"_type":"block","style":"normal","_key":"d5d61780be8c"}],"_type":"figure","_key":"4f324b740360","alignment":"left","asset":{"_ref":"image-ab7da8966014ad1be562e621a9f5b7a2397b9d28-5824x3264-jpg","_type":"reference"},"disableTextWrap":false,"disableLightBox":true,"alt":"Yuparet/AdobeStock","widthP":50},{"style":"normal","_key":"98b5f205f0c5","markDefs":[],"children":[{"marks":["strong"],"text":"CONFERENCE REPORTER","_key":"6eac6ae47114","_type":"span"}],"_type":"block"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"A new phase 2, open-label clinical trial has demonstrated that SPN-820, a novel antidepressant, provides rapid and substantial improvement in adults with major depressive disorder (MDD).","_key":"bdae7aacba2b"},{"_type":"span","marks":["sup"],"text":"1","_key":"be92106c7c17"},{"marks":[],"text":" Patients taking SPN-820 alongside their existing antidepressant medication showed significant symptom relief within hours of administration, with continued progress over the study period. SPN-820 is an oral formulation of NV-5138 with a novel mechanism of action. The new information was presented via poster session at the 30th Annual Nevada Psychiatric Association National Psychopharmacology Update.","_key":"aa1a91a4990d","_type":"span"},{"_type":"span","marks":["sup"],"text":"1","_key":"8db05b12d2f3"}],"_type":"block","style":"normal","_key":"c04caab05bdf"},{"_type":"block","style":"normal","_key":"a3eb5b12e15a","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Study Design and Patient Response","_key":"a6a034d922cf"}]},{"_key":"e988afa7445e","markDefs":[],"children":[{"_type":"span","marks":[],"text":"This 10-day phase 2 study evaluated SPN-820 as an adjunct treatment for MDD in patients who had not achieved full symptom relief from conventional antidepressants. The trial included 40 participants aged 18 to 65 with moderate to severe MDD symptoms.","_key":"2d98511265b6"}],"_type":"block","style":"normal"},{"children":[{"marks":[],"text":"Patients received 2400 mg of SPN-820 every 3 days, administered orally. The study’s primary efficacy measures were the HAM-D6 and MADRS score changes, while safety outcomes included adverse events, vital sign monitoring, and assessments for dissociative symptoms, hallucinations, and suicidality.","_key":"05c9f804bf0d","_type":"span"}],"_type":"block","style":"normal","_key":"c705f20f50e1","markDefs":[]},{"style":"normal","_key":"5a1038e0995b","markDefs":[],"children":[{"_type":"span","marks":[],"text":"By day 10, more than half of the participants achieved symptom remission, a result that suggests SPN-820 could be an effective alternative for patients who do not fully respond to traditional antidepressants.","_key":"2baa8549aa5d"}],"_type":"block"},{"_key":"37c50ef84133","markDefs":[],"children":[{"marks":["strong"],"text":"Rapid Reduction in Depression Symptoms","_key":"75e787988b90","_type":"span"}],"_type":"block","style":"normal"},{"style":"normal","_key":"5f93969e5e98","markDefs":[],"children":[{"_key":"4b684b24649a","_type":"span","marks":[],"text":"Preclinical research shows SPN-820 increases neuroplasticity by acting intracellularly to enhance activity of Mechanistic Target of Rapamycin Complex 1."},{"_key":"7087e6962db5","_type":"span","marks":["sup"],"text":"1 "},{"_type":"span","marks":[],"text":"The study results show that SPN-820 produced meaningful symptom relief within just 4 hours of the first dose. Patients experienced an average 50% reduction in Montgomery–Åsberg Depression Rating Scale (MADRS) scores. By day 10, 84.2% of participants met the MADRS response criteria, and 63.2% achieved remission, demonstrating the potential long-term benefits of this novel treatment.","_key":"22848c65176b"},{"_type":"span","marks":["sup"],"text":"1","_key":"4cd089ecd861"}],"_type":"block"},{"_key":"277f06179721","markDefs":[],"children":[{"text":"Additionally, the Hamilton Depression Rating Scale (HAM-D6) scores showed significant improvement early in treatment, reinforcing SPN-820’s rapid-acting antidepressant properties.","_key":"84bc745537f8","_type":"span","marks":[]}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"","_key":"c59aa4d08669"}],"_type":"block","style":"normal","_key":"4dacd45d9d94"},{"children":[{"_type":"span","marks":["strong"],"text":"Safety and Tolerability Profile","_key":"ae334d203132"}],"_type":"block","style":"normal","_key":"774860c14cf8","markDefs":[]},{"children":[{"_type":"span","marks":[],"text":"SPN-820 was well tolerated, with no serious adverse events reported. Only 1 patient discontinued treatment due to worsening hypertension, which was deemed unrelated to the study drug.","_key":"a16856621117"}],"_type":"block","style":"normal","_key":"6c1fb8177d8d","markDefs":[]},{"_type":"block","style":"normal","_key":"9749d8cdb52a","markDefs":[],"children":[{"_key":"7b42de612e17","_type":"span","marks":[],"text":"Common mild-to-moderate adverse events included headache, nausea, somnolence, dizziness, and fatigue, occurring in a minority of participants. Notably, there were no reports of dissociative effects, hallucinations, or psychosis, side effects commonly associated with other rapid-acting antidepressants such as ketamine-derived treatments."}]},{"markDefs":[],"children":[{"_type":"span","marks":[],"text":"Suicidal ideation among participants also decreased significantly during the trial, further highlighting the potential mental health benefits of SPN-820.","_key":"65197617bce8"}],"_type":"block","style":"normal","_key":"bc10e8a192ac"},{"children":[{"_type":"span","marks":["em"],"text":"For complete conference coverage, click ","_key":"a336a66da566"},{"text":"here","_key":"0d2eeb4b7992","_type":"span","marks":["em","dfc86a0e7bf4"]},{"_type":"span","marks":["em"],"text":".","_key":"9f52061ee389"}],"_type":"block","style":"normal","_key":"d7c38229fe87","markDefs":[{"blank":true,"_type":"link","href":"https://www.psychiatrictimes.com/latest-conference","_key":"dfc86a0e7bf4"}]},{"children":[{"_type":"span","marks":[],"text":"","_key":"af13f9b6c79a"}],"_type":"block","style":"normal","_key":"615eda99e3d1","markDefs":[]},{"_key":"3d40c08926e6","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Reference","_key":"ee0a09493400"}],"_type":"block","style":"normal"},{"markDefs":[],"children":[{"_key":"b6da85e3fa85","_type":"span","marks":[],"text":"1. Ceresoli-Borroni G, Targum SD, Alleyne N, et al. Efficacy and safety of SPN-820 for adults with major depressive disorder: Primary results from a phase 2, open-label trial. Presented at: Nevada Psychiatric Association 30"},{"_type":"span","marks":["sup"],"text":"th","_key":"b3511e321ed6"},{"_key":"0db62850b853","_type":"span","marks":[],"text":" Annual Psychopharmacology Update; February 13, 2025."}],"_type":"block","style":"normal","_key":"62a6ffc15c36"}],"documentGroup":null,"_updatedAt":"2025-02-12T18:25:50Z","url":"spn-820-shows-rapid-and-significant-improvement-in-major-depressive-disorder-symptoms","authorMapping":[{"_rev":"HG9itg5Um8jvM5zF8KyjU8","_id":"0dd98119-9102-491d-98b5-9cd27b8be6f7","biography":[{"_key":"37d6c0564341","markDefs":[],"children":[{"_type":"span","marks":["strong"],"text":"Ms McSweeney","_key":"67ccf07444ee"},{"_type":"span","marks":[],"text":" ","_key":"3e163b408efc"},{"_type":"span","marks":["em"],"text":"is an assistant editor at ","_key":"b70df96f70e5"},{"_type":"span","marks":[],"text":"Psychiatric Times","_key":"52d2e41075d5"},{"marks":["em"],"text":".","_key":"85b80e6c3bc5","_type":"span"}],"_type":"block","style":"normal"}],"authorType":"author","displayName":"Megan McSweeney","_createdAt":"2024-11-25T16:17:55Z","_updatedAt":"2024-11-25T16:17:55Z","url":{"current":"megan-mcsweeney","_type":"slug"},"firstName":"Megan","lastName":"McSweeney","_type":"author"}],"gptSummary":"A phase 2 clinical trial has shown that SPN-820, a novel antidepressant, offers rapid and significant improvement in major depressive disorder (MDD) symptoms. Administered alongside existing antidepressants, SPN-820 provided symptom relief within hours, with continued progress over 10 days. The trial involved 40 participants with moderate to severe MDD, showing a 50% reduction in MADRS scores and 63.2% achieving remission. SPN-820 was well tolerated, with no serious adverse events, and reduced suicidal ideation. 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Participants experienced a 15.2-point improvement in the Montgomery-Åsberg Depression Rating Scale (MADRS) and a 57.7% remission rate. The treatment was well-tolerated, with stable vital signs and no reports of sedation or dissociative symptoms. At a 6-month follow-up, 77.8% of patients remained in remission, with most requiring only 1 to 4 treatments. GH001's rapid and sustained effects, coupled with the need for infrequent clinic visits, suggest it could become a transformative therapy for individuals with treatment-resistant depression. 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The constant exposure to negative news and social media content heightens stress levels, creating a cycle of emotional distress. The 24-hour news cycle amplifies fear and uncertainty, while social media fosters unrealistic body standards and cyberbullying, further impacting mental well-being. Political divisiveness and media bias contribute to social hostility, exacerbating mental health struggles. As media saturation grows, its psychological effects become more evident, underscoring the need for mindful consumption to mitigate stress and maintain emotional balance in an era of information overload. 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