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.
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.
Bone Health Benefits of Lithium
Lithium, commonly used to treat bipolar disorder, appears to provide additional health benefits, including improved bone health. A study found that women taking lithium had significantly higher bone mineral density compared to those on other mood stabilizers. This finding is supported by another study linking lithium to a lower risk of osteoporosis, showcasing its positive effects beyond traditional psychiatric treatment. The implication is that lithium may not only enhance mood stabilization but also promote overall skeletal health, challenging previous concerns about its toxicities.
Hopeful Insights for PTSD Treatment
Recent research offers encouraging insights regarding psychotherapy approaches for PTSD, particularly for individuals with multiple traumas. Contrary to previous beliefs, a large review concluded that psychotherapy outcomes for patients with single and multiple trauma histories are similar, demonstrating effective therapeutic effects across both groups. This raises optimism for clinicians treating patients with complex trauma histories, suggesting they can expect substantial improvements through therapy. The significant effect size observed signals that psychotherapy can be markedly beneficial, paralleling some of the most effective medication treatments in other domains.
Research updates on benzo discontinuation, iloperidone in mania, lithium, schizophrenia, ECT, a new circadian psychotherapy, and therapy for multi-trauma PTSD.
Chris Aiken and Kellie Newsome, PMHNP have disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.
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