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IN THIS MONTH'S ISSUE:
October 2014

ADHD, Stimulants, and Young Hearts
Stimulant medications, such as methylphenidate (Ritalin and others), are associated with a small increase in the risk of cardiovascular events in children and adolescents, and a slightly greater risk in those with attention-deficit/hyperactivity disorder (ADHD).

Estradiol for Schizophrenia?
In a double-blind, randomized, placebo-controlled trial, women with schizophrenia or schizoaffective disorder had a small but statistically significant improvement in previously treatment-resistant psychotic symptoms when treated with transdermal estradiol.

Rapid Clozapine Titration: Additional Comments
Some patients with schizophrenia may benefit from very gradual (rather than rapid) titration of clozapine (Clozaril and others), especially if they are taking concomitant benzodiazepines.

In Brief
Mindfulness Training Promotes Recovery from Stress in Military Personnel; Compound in Pomegranates May Help Slow Neurodegenerative Disorders

Pregnenolone for Bipolar Depression?
Adjunctive treatment with the neurosteroid pregnenolone may improve depressive symptoms in patients with bipolar disorder.

Allopurinol in Acute Mania?
Preliminary findings indicate benefit from adding allopurinol (Zyloprim and others) to valproate (Depakene and others) for the treatment of acute mania.

A Message from Alan J. Gelenberg, M.D.

When I first started writing BTP in the 1970s, it was to bridge the gap between new knowledge in our field and its application to patient care. Over the decades since, the need for this bridge has become even greater. Neuroscience rockets forward. Psychiatrists and other clinicians have a broader array of treatments for patients with mental disorders than we even dreamed of back then. But we have less time to spend with patients and less time to keep up with developments that affect treatment decisions. Our medications, and those prescribed by colleagues in other specialties, are more varied, complex, and prone to interactions. What were formerly crisp boundaries between major psychopharmacologic categories are now murky.

This makes the modern practice of psychiatry challenging—but also fun and promising. With the expanding armamentarium of treatment options comes enhanced ability to alleviate suffering. The mission of BTP remains constant, even while the field grows. We are still here to bridge the gap, to make science applicable and relevant, and to help you in your day-to-day work relieve distress and improve function in patients' lives.