A new risk with benzodia discontinuation, a new approval in bipolar disorder,

ECT and schizophrenia, circadian therapy for depression, and hope for multi-trauma PTSD.

It's all in this batch of six research updates.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Today, we bring you six research updates, starting with a new risk with stopping benzos.

On this podcast, we've raised attention to the risks of long-term benzodia use, particularly

in the elderly and people taking opioids.

Well, this study challenges that message. It was a large retrospective analysis

that looked at what happens when patients either come off or stay on a benzodiazepine.

They used a commercial insurance database and the study was done by Donovan-Moust and colleagues

in JAMA Open Network. The risks with benzos are well known, and they get worse with age,

balls, car accidents, memory problems, pneumonia, and other respiratory disorders.

And we're especially worried about combining benzos with opioids

because both drugs suppress breathing in different ways, and their

combination has fueled an epidemic of drug overdose deaths that has shown no signs of slowing

down over the past two decades.

So when this team from the University of Michigan analyzed outcomes on 353,000 patients who either stayed on or came off

a benzodiazepine, they expected to see change in mortality rates with benzodiazepine

discontinuation. And they did, but not in the direction that they expected. The risk of death over a year of follow-up

was slightly greater for those who came off their benzodiazepines versus those who stayed on.

...