Tag: safety

Reading of the Week: New Tech for Old Problems? An App for Negative Symptoms, Chatbots & Suicidality, Notes in the Age of AI Scribes

From the Editor

The voices became quieter, and the paranoia lessened. But my patient continued to complain about his lack of motivation. He left the hospital, but he never rejoined the workforce. Negative symptoms are difficult to treat.

Could an app help? In a new JAMA Network Open paper, Abhishek Pratap (of Boehringer Ingelheim Pharmaceuticals) and his co-authors attempt to answer that question. They describe a randomized clinical trial of 457 individuals with negative symptoms of schizophrenia, comparing those receiving an app (CT-155) intervention featuring evidence-based psychosocial treatments against an active control. “These findings support CT-155 as a potential adjunctive therapy for patients for an indication of negative symptoms of schizophrenia with a high unmet need for FDA-approved pharmacologic treatments specifically targeting negative symptoms.” We discuss the paper and its implications.

As more and more people turn to chatbots for mental health advice, we should ask: how can we make them safer? In a new Comment from npj Digital Medicine, Joanna M. Streck (of Harvard University) and her co-authors describe experimentation with an AI chatbot and the lessons learned. “We describe suicide safety monitoring features for a chatbot implemented in a high-risk clinical setting and make recommendations for chatbot design alongside human-monitoring and triage.”

Finally, in the third selection, Dr. Danilo Rojas-Velasquez (of Harvard University) writes about clinical notes and language in a paper for Academic Psychiatry. He offers suggestions for learners, noting how language affects care – a topic now even more relevant with the growing use of AI scribes. “We watch language do its quiet work, and we write notes that will, in turn, shape how the next team thinks.”

DG

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Reading of the Week: Are the Pills Safe? JAMA Psychiatry on Antidepressants, NICE on Withdrawal Symptoms

From the Editor

They are popular, but are they safe?

It’s the question that patients often ask about antidepressants. Though SSRIs have been on the market for decades – and older antidepressants for much longer – people continue to question their overall safety. Online forums relate stories of problems; news articles have linked them to suicidal thoughts in youth and other issues; regulatory agencies have acted on their doubts – the FDA, as an example, issued a black box warning for SSRIs use in adolescents.

This week, in our first selection, we consider a new paper from Linköping University’s Elena Dragioti and her co-authors. In this JAMA Psychiatry paper, the authors use a systematic umbrella review, drawing on meta-analyses of observational studies. “This study’s findings suggest that claimed adverse health outcomes associated with antidepressants may not be supported by strong evidence and may be exaggerated by confounding by indication; no absolute contraindication to the use of antidepressants was found to be currently supported by convincing evidence.”

We discuss the paper and the methodology.

antidepressants

In the second selection, we draw from the recently revised UK NICE guideleines, which provide advice on withdrawal symptoms and tapering strategies. “There is substantial variation in people’s experience…”

DG

 

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