Tag: Cannabinoid

Reading of the Week: Antidepressants & Side Effects – the New Lancet Paper; Also, Medical Cannabis & Addiction, and AI Hallucinations

From the Editor

What are the physical side effects of antidepressants? In a new, impressive Lancet study, Toby Pillinger (of King’s College London) and his co-authors attempt to answer that old question with a new approach: the first systematic review and meta-analysis. They drew on 168 RCTs that measured physical health effects of antidepressants, including almost 59 000 participants and comparisons of 30 antidepressants. “We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters.” We consider the paper and its implications.

How safe is cannabis for those taking it for medical purposes? Dr. Beth Han (of NIMH) and her colleagues report findings from a US survey in a new JAMA Psychiatry brief report, focusing on cannabis use disorder (CUD). They report that cannabis use wasn’t less addictive when used for medical reasons. “Clinicians should consider addiction risk before recommending medical cannabis and, if they do, should monitor for CUD emergence.”

The BMJ runs humorous articles in its Christmas issue. The journal doesn’t disappoint this year. Dr. Roberto A. Correa Soto (of the Universidad de los Andes) and his co-authors write about AI hallucinations and doctor BS (yes, you read that correctly). Frankly, the paper is worth reading for the profanity alone. “Both doctors and large language models (LLMs) are driven to produce misinformation – ‘bullshit’ and ‘hallucinations’ – owing to a shared pressure to provide answers, prioritising the appearance of competence over accuracy.”

There will be no Readings for the next three weeks. 

DG

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Reading of the Week: Suicide & Physicians – the New CJP Paper; Also, Cannabis and Psychiatry (BJP) and Tom Insel on Mental Health Care (Atlantic)

From the Editor

Despite what we may wish to believe, physicians are mortal. We can develop illnesses – even mental disorders. And some (too many) suicide. Past studies have shown that doctors die by suicide more than the general population. But the data wasn’t Canadian.

In the first selection, Dr. Manish M. Sood (of the University of Ottawa) and his co-authors consider suicide by Canadian physicians. In a new Canadian Journal of Psychiatry paper, they do a population-based, retrospective cohort study drawing on more than a decade and a half of data. They write: “Physicians in Ontario are at a similar risk of suicide deaths and a lower risk of self-harm requiring health care relative to nonphysicians.” We look at the paper.

In the second selection, Dr. Julia Jiyeon Woo (of McMaster University) and her co-authors review cannabis from the perspectives of clinicians and patients. In a new British Journal of Psychiatry paper, they note: “This growing discrepancy between clinicians’ and patients’ perspectives on cannabinoids can be extremely damaging to the therapeutic alliance.” They offer practical suggestions.

And in the third selection, Dr. Thomas Insel (of the Steinberg Institute) considers what’s right and what’s wrong with mental health care. As the director of NIMH, he oversaw $20 billion of funding; in his new book, excerpted in the pages of The Atlantic, he calls for mental health reform. He writes: “There are only two kinds of families in America: those who are struggling with mental illness and those who are not struggling with mental illness yet. To ensure that we serve all families well, we don’t necessarily need to know more to do better.”

DG

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Reading of the Week: Canada Day – With Papers on Cannabis, Chatbots, Depression, Nutraceuticals and Benzodiazepines in Pregnancy

From the Editor

It’s Canada Day.

Let’s start by noting that not everyone has a day off. Some of our colleagues are working – perhaps in hospitals or vaccine clinics. A quick word of thanks to them for helping our patients on a holiday.

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Appropriately, this week’s selections will focus on Canadian work.

What makes a paper “Canadian” for the purposes of this review? That is, how do we define Canadian? Things could get complicated quickly when considering journal papers. Does the second author order “double double” at Tim Hortons? Has the senior author eaten poutine for breakfast? Is the journal’s action editor hoping that the Canadiens bring the Cup home?

Let’s keep things simple: all the papers selected this week have been published in a Canadian journal and the papers are clinically relevant for those of us seeing patients in Canada.

There are many papers that could have been chosen, of course. I’ve picked five papers – a mix of papers that have been featured previously in past Readings, and some new ones. All but one of the selected papers are recent.

Please note that there will be no Readings for the next two weeks.

DG

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