FDA advisors recommend intranasal ketamine in depression


Two FDA advisory committees have voted 14-2 in favour of the use of esketamine for treatment-resistant depression (TRD). The advisors found that the intranasal drug is effective in TRD, and that the benefits outweigh the risks. The esketamine program received a Breakthrough Therapy Designation (BTD) in 2013 based on a phase II study of an intravenous formulation in treatment-resistant depression (Singh et al. Biol Psychiatry 2016;80:424-431). Read More

Always online: problem or addiction?


“Internet addiction” was first described in the dial-up era (Young KS. Psychol Rep 1996;79:899-902), with the prevalence steadily increasing with more widespread internet access. Five years ago, a meta-analysis reported a global prevalence of 6.0% (Cheng et al. Cyberpsychol Behav Soc Netw 2014;17:755-760). More recent estimates have found a prevalence of 17.7% among adolescents in rural Japan (Kojima et al. Psychiatry Clin Neurosci 2019;73:20-26), and 38.2% among university students in Japan (Kitazawa et al. Psychiatry Clin Neurosci 2018;72:531-539). The range in prevalence is largely due to a lack of consensus on diagnostic criteria, which in itself is a reflection of a more fundamental controversy: is Internet overuse an “addiction” or only problematic? Read More

Canadian real-world study of aripiprazole LAI in schizophrenia



Presented at the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting, Miami, Florida, May 29 – June 1, 2018

The first Canadian naturalistic study in patients with schizophrenia has reported high rates of remission rates and low rates of relapse with long-acting aripiprazole over a one-year period (Oluboka et al. ASCP 2018; abstract). Read More

Use of injectable antipsychotics in bipolar I disorder



Comment by Diane McIntosh, BSc Pharmacy, MD, FRCPC – Vancouver, British Columbia

Among the many clinical challenges in the management of bipolar I disorder, the need for effective treatments that maintain symptomatic remission and promote long-term adherence is paramount. Depending on the study population and the methodology employed, up to 60% of patients diagnosed with bipolar disorder do not adhere to treatment recommendations (Colom et al. Bipolar Disord 2005;7(suppl 5):24-31). A recent study reported that patients with bipolar disorder missed doses a mean of three days in the preceding week (Levin et al. J Nerv Ment Dis 2017;205:182-187). Treatment nonadherence is a major risk factor for relapse, readmission to hospital and suicidality (Rascati et al. Psychiatr Serv 2011;62:1032-1040) and is associated with higher rates of work absenteeism and disability (Bagalman et al. J Occup Environ Med 2010;52:478-485). Read More