The Carlat Psychiatry Podcast cover image

The Carlat Psychiatry Podcast

Six Research Updates

Aug 5, 2024
Recent research reveals the risks of discontinuing benzodiazepines, highlighting higher mortality rates in older patients. Lithium showcases its surprising health benefits, enhancing bone density in bipolar disorder. Innovative therapies, including ECT, show promise for PTSD and schizophrenia. A controlled trial suggests structured sleep and daily activities can significantly boost recovery from major depression. Exciting developments in psychotherapy offer hope for those battling multi-trauma PTSD, showcasing effective treatment options.
16:10

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Quick takeaways

  • Discontinuing benzodiazepines can unexpectedly lead to a higher mortality risk, especially among patients also using opioids, necessitating careful management during tapering.
  • Lithium not only stabilizes mood in bipolar disorder but also enhances bone health, presenting a dual benefit that shifts previous perceptions of its toxicity.

Deep dives

Risks of Benzodiazepine Discontinuation

Stopping benzodiazepines may unexpectedly lead to increased mortality, especially in patients previously on opioids. A large retrospective study indicated that those who discontinued benzodiazepines had a 1.6 times higher risk of death compared to those who continued their use, regardless of whether they were also taking opioids. This suggests that well-intentioned tapering might cause patients to seek more dangerous alternatives, as evidenced by previous research on opioid withdrawals. Ultimately, careful management and potentially prolonged tapering strategies are recommended to mitigate risks associated with benzodiazepine withdrawal.

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