The potential link between insulin resistance and bipolar disorder is causing a “paradigm shift in psychiatry,” remarked Dr. Cynthia Calkinan, associate professor of psychiatry at Dalhousie University in Halifax, Nova Scotia, Canada.

Researchers studied the effects of four repeated low doses of LSD, administered under lab conditions every three to four days, using approximately 1/8th the dose typically used to “trip” on LSD.

Study: This meta-analysis includes 232 randomized, double-blind, placebo-controlled trials of drug monotherapy for major depressive disorder submitted to the FDA between 1979 and 2016, and comprises nearly 75,000 adult and child participants. Conclusion: Patients with depression are likely to improve substantially from acute treatment of their depression with drug or placebo. Although the mean effect of antidepressants is only a small improvement over placebo, the effect of active drug seems to increase the probability that any patient will benefit substantially from treatment by about 15%.

This is an 8-year follow-up to the author’s initial report of a randomized phase II study in patients with newly diagnosed primary CNS lymphoma treated with high-dose methotrexate-based induction chemotherapy followed by whole-brain radiotherapy (WBRT) or high-dose chemotherapy (thiotepa-busulfan-cyclophosphamide) with autologous stem-cell transplantation (ASCT). They conclude that 40 Gy WBRT should be avoided in first-line treatment in this population because of its neurotoxicity and suboptimal efficacy in reducing relapses, while ASCT appears to be highly efficient in preventing relapses.

Dr. Jonathan Abbas, Director of the Acute Leukemia and Blood Cancer Program with Tennessee Oncology in Nashville, shares key strategies and considerations for managing patients with t-AML and AML-MRC.

JAK inhibitors provide a relatively tolerable drug option for controlling symptoms, reducing splenomegaly, and improving quality of life, but often at the expense of worsening cytopenias and without halting disease progression or preventing leukemic transformation. In this article, the authors review FDA–approved JAK inhibitors as well as those in late-phase clinical trials, and provide a schema for choosing among the available options for patients with MF.