Tag: Goodwin

Reading of the Week: The Best of 2022

January 12, 2023 /

From the Editor

Welcome 2023.

It’s our tradition that we begin the New Year by reviewing the best of the past year; so, this week, we look back at 2022.

But a bit of a break from tradition: this year, we haven’t organized the papers by different categories, instead choosing eight great papers. Some have been published in big journals; others, not so big. They cover a variety of topics, from prevention to cutting-edge treatments. The one common thread: all are clinically relevant. And, yes, there is a Person of the Year. Spoiler alert: he had a big career and likes to mention Groucho Marx.

An observation about this past year: the quality of scholarship was very high. We’ve picked good papers – but could have picked scores of others. It’s a comment we’ve made in past years, and a good reason for optimism as our field grows more sophisticated and relevant.

DG

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Reading of the Week: Psilocybin for Treatment-Refractory Depression – the New NEJM Paper

November 10, 2022 /

From the Editor

“Severe depression eased by single dose of synthetic ‘magic mushroom’”

– CNN, 3 November 2022

For its proponents, psilocybin could be the breakthrough we have been waiting for in depression treatment. For its critics, psilocybin lacks evidence.

What to make of psilocybin? Dr. Guy M. Goodwin (of the University of Oxford) and his co-authors attempt to answer that question with a phase 2 double blind trial focused on those with treatment-resistant depression, offering participants psilocybin at three different doses, in addition to therapy. The resulting paper was just published in The New England Journal of Medicine and has received much attention (including, yes, coverage by CNN). They find: “participants with treatment-resistant depression, psilocybin at a single dose of 25 mg, but not 10 mg, reduced depression scores significantly more than a 1-mg dose over a period of 3 weeks but was associated with adverse effects.” 

The future of depression treatment?

We discuss the big paper and the review the accompanying Editorial by Bertha K. Madras (of Harvard University). We also have comments from Dr. Ishrat Husain (of the University of Toronto), one of the study co-authors.

So does psilocybin offer a breakthrough? Read on and decide for yourself.

(Note that there will be no Reading next week.)

DG

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Reading of the Week: Guest Contribution – Dr. David Goldbloom on Lithium and Self Harm

May 26, 2016 /

From a Contributing Editor, Colleague and Friend of the Editor

Sixty-seven years ago, Australian psychiatrist John Cade published his case series on manic patients treated with lithium – truly the dawn of the modern era in psychopharmacology. Two decades passed before lithium came to Canada, and almost three before it came to the United States. In the treatment of mania, it was the first significant drug alternative to the only other enduring treatment from that time – electroconvulsive therapy.

Dr. John Cade (and Lithium)

Today, however, lithium suffers from under-promotion (there is no money to be made on it by the pharmaceutical industry) and under-exposure in the training of residents despite the evidence of its benefit that continues to emerge.

Here is a new paper that looks at suicide and self-harm during maintenance treatment of people with bipolar disorder treated with lithium, valproate or the increasingly popular second-generation antipsychotic drugs. And here is an old paper that reminds us what a difference lithium had already made in the economics of mental illness by 1980.

– David Goldbloom, OC, MD, FRCP(C) Continue reading