Opioid analgesics such as codeine, hydrocodone, and tramadol undergo metabolism that is mediated by the polymorphic CYP2D6 isoenzyme, and research has shown that a CYP2D6 genotype-guided approach to pain control can optimize effectiveness and/or minimize adverse drug reactions associated with these analgesics in patients with different CYP2D6 genotypes (Smith et al., 2019).
Hardly a week goes by that I don't find myself reading about the “mind-body connection” in a non-medical publication. The article is typically focused on some common physical disease (diabetes, arthritis, whatever) that, to the reporter's putative amazement, has just been shown to be affected by psychological or psychiatric factors. If you're a regular reader of the Update, I doubt you'll find such reports surprising. Indeed, when I talk with healthcare providers across specialties, I rarely encounter skepticism about this “connection” — a change, to be clear, from my early days in medicine, when “supratentorial” factors were often noted with borderline derision.
A retrospective cohort study with a 10-year follow-up has found that lithium treatment does not result in increased risk of physical disorders compared with lamotrigine and valproate. The study examined results for groups of patients using the medications for bipolar disorder and for other illnesses.
A nationwide cohort study conducted in Finland has found that risk of clozapine-induced agranulocytosis, while greater than that associated with other antipsychotics, decreases considerably with longer-term use of the medication. The study's findings lend support to the idea that hematological monitoring requirements for patients receiving clozapine could be relaxed over time, the investigators stated. Study results were published online April 29, 2024, in Lancet Psychiatry.
The potential risks associated with administration of psychedelic drugs call for a standardized approach to patient informed consent that addresses factors such as potentially disturbing symptoms and the danger of patient exploitation, authors of a recently published article suggest. The diverse contexts for therapeutic use of these substances and the variety of providers potentially involved in their administration necessitate strong informed consent procedures, the authors explained. The special communication was published online April 10, 2024, in JAMA Psychiatry.
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