The Week in Review: October 3-7

From the at-home ketamine experience to the Wit v United Behavioral Health reversal, here are highlights from the week in Psychiatric Times.

This week, Psychiatric TimesTM covered a wide variety of psychiatric issues and industry updates, from the at-home ketamine experience to the consequences of the Wit v United Behavioral Health reversal. Here are some highlights from the week.

Federal Court Gives Green Light to Deny Coverage

Nearly every psychiatric clinician I know has experienced it: Their patient’s health plan determines—with little justification—that the needed treatment is “not medically necessary.” The clinician is then forced to spend valuable time fighting for coverage of the treatment that is validated by accepted clinical standards of care. Meanwhile, families confront their options: spending life savings, taking on burdensome debt, or going without treatment.

With more than 7.1 million American adults not receiving the mental health treatment they need because of cost, ensuring health plans cover the services patients need is essential to maintaining and increasing access to care. At the root of this issue is who makes the determinations about whether treatment is needed— and what standards should be and must be followed. Continue Reading

Calcium-Channel Blocker and Adenosine Modulator Use and Risk of Hospitalization in Bipolar Disorder

Inadequate response and treatment resistance remain issues in bipolar disorder. One approach to identifying novel treatments is drug repurposing, whereby a drug approved for 1 disease is investigated for its potential for a new indication. Previous reviews include the adenosine modulator allopurinol and calcium-channel blockers (CCBs) for potential repurposing in bipolar disorder, although evidence for the latter has been inconclusive.

Allopurinol and dipyridamole are adenosine modulators that may have potential in the treatment of bipolar disorder and other severe mental illnesses. Allopurinol is a xanthine oxidase inhibitor used to treat gout and hyperuricemia. Dipyridamole is an antithrombotic and vasodilator that inhibits adenosine reuptake. Continue Reading

The Online, At-Home Ketamine Experience: A Clinician’s Dilemma

There has been a recent proliferation of online health care businesses that offer at-home ketamine through virtual visits to patients suffering from a variety of mental health conditions. Ketamine is FDA approved for anesthesia and pain management but not for depression or any other psychiatric disorder. HCPs in many countries, however, can prescribe ketamine off label for nonapproved indications.

Ketamine can be rapid acting and studies have shown effectiveness in treatment-resistant depression (TRD), suicidal ideation, and other psychiatric conditions. The therapeutic effects are often attributed to its antagonistic effects on the NMDA receptor, 1 of 4 subtypes of inotropic glutamate receptors located throughout the central nervous system. Continue Reading

Understanding the Fear of Missing Out

In the late 1800s, postcards were the preferred way to brag about your summer travel. In the 1960s, these were replaced with slide carousels and projectors. A polite inquiry into a host’s vacation over dinner might have resulted in hastily dimmed lights and an hourlong presentation. In the 1980s and ‘90s, Polaroids gave us instant access to memorable moments.

Today, social media continues to feed our need to live vicariously through others—except now we can tap into the lives of hundreds of other people whenever we want. It is easy for hours to slip by as we scroll through the lives of others. This is when we are most vulnerable to the sticky trap of FOMO: the fear of missing out. Continue Reading

See more recent coverage from Psychiatric TimesTM here. And be sure to stay up-to-date by subscribing to the Psychiatric TimesTM E-newsletter.

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