As 2021 winds to a close, here’s a look back at some of the most relevant developments that took place in our field this year. NEI Members can access the full article of essential psychopharmacology highlights from 2021 and earn CME/CE credit.
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Article Highlights
Guidelines For The Use Of Ketamine For Treatment-Resistant Depression: An international expert opinion on the use of ketamine for treatment-resistant depression (TRD) was
published this year. Although the various formulations of ketamine have not been compared directly in randomized controlled trials, intranasal esketamine and intravenous ketamine have the strongest evidence of short-term efficacy and safety in patients with TRD, particularly in the context of adult major depressive disorder.
Factors Associated With Stimulant Treatment Outcomes in ADHD:
Stimulant medications are the first-line recommended treatment for attention deficit hyperactivity disorder (ADHD); however, many patients discontinue treatment or switch to nonstimulant ADHD medications. A recent
study investigated the genetic, clinical, and sociodemographic factors that influence stimulant treatment initiation, discontinuation, and switch to nonstimulant medications in ADHD.
Effects of Gabapentin With Abstinence in Alcohol Use Disorder: Gabapentin blocks calcium channels containing the alpha 2 delta 1 subunit and has other actions that may affect both glutamatergic and GABAergic neurotransmission, much the same as drinking alcohol does. It is FDA-approved for the treatment of neuralgia, partial seizures, and restless legs syndrome; however, recent
studies are investigating gabapentin as a potential medication for mitigating withdrawal and preventing relapse in alcohol use disorder.
Switching Antipsychotics to Ameliorate Weight Gain: Atypical antipsychotics are often associated with detrimental metabolic changes that may influence treatment adherence, quality of life, and mortality. In this
meta analysis, the authors investigated the benefits of switching from one antipsychotic to another with less propensity for metabolic changes.
Patients With Social Anxiety Disorder Treated for Sleep Problems May Have Better Outcomes: Social anxiety disorder (SAD) is associated with sleep disturbance, which may, in turn, interfere with learning and memory processes that are integral for exposure therapy. A recent
study tested the relationships between exposure therapy outcomes and sleep disturbances both at baseline and before and after exposure-based therapy sessions in adults with SAD.
US Food and Drug Administration (FDA) Approvals
> Novel Once-Daily Treatment for ADHD: The FDA has approved a new, once-daily oral stimulant medication for treatment of attention deficit hyperactivity disorder (ADHD) in people aged 6 years and older. The new drug, AZSTARYS (formally KP415), consists of a novel prodrug, serdexmethylphenidate, coformulated with immediate-release d methylphenidate.
> Atypical Antipsychotic With Less Adverse Effects: The FDA approved Alkermes’ LYBALVI, a combination of olanzapine and samidorphan, for the treatment of adults with schizophrenia and/or bipolar I disorder. LYBALVI is a once-daily, oral atypical antipsychotic that works as a maintenance monotherapy for the acute treatment of manic or mixed episodes, or as an adjunct to lithium or valproate.
> New Treatment for ADHD in Pediatric Patients: The FDA approved Qelbree (viloxazine extended-release capsules) for the treatment of attention-deficit hyperactivity disorder (ADHD) in pediatric patients 6 to 17 years of age. Viloxazine is considered a “multimodal agent” in that it both blocks the norepinephrine (NE) reuptake pump and directly modulates several serotonin (5-HT) receptors with elevation of intrasynaptic serotonin levels.
> Treatment for Schizophrenia to Be Administered at 6-Month Intervals: The FDA approved a 6-month injection form of the long-acting atypical antipsychotic paliperidone palmitate (Invega Hafyera, Janssen Pharmaceuticals) for the treatment of schizophrenia in adults. Invega Hafyera is the first long-acting schizophrenia medication to be injected once every 6 months.
> First Treatment for Idiopathic Hypersomnia: The FDA approved the first treatment for adult idiopathic hypersomnia, a condition in which patients experience chronic excessive daytime sleepiness, sleep inertia, prolonged yet non-restorative nighttime sleep and naps, and cognitive impairment. Xywav®, previously approved for the treatment of cataplexy and excessive daytime sleepiness associated with narcolepsy, is an oral solution of calcium, magnesium, potassium, and sodium oxybate.
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References:
McIntyre RS et al. AJP. 2021;178(5):383-399. Abstract
Brikell I et al. AJP. 2021;178(9):854-864. Abstract
Prisciandaro JJ et al. AJP. 2021;178(9):829-837. Abstract
Siskind Det al. Schizophrenia Bulletin. 2021;47(4):948-958. Abstract
Dutcher CD et al. Depression and Anxiety. 2021;38(11):1182-1190. Abstract
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