The edition · Psychiatry
Open Dialogue cut inpatient use without delaying relapse; connectivity-guided theta-burst shows early promise
A cluster-randomised trial of Open Dialogue in crisis care missed its primary relapse endpoint but reduced admissions, a small trial favours connectivity-guided theta-burst targeting, and a Danish registry study looks at psychotropic use after abortion.
The edition in brief
In ODDESSI, a cluster-randomised trial of 494 adults presenting in crisis to English community mental health services, Open Dialogue did not delay time to first relapse (marginal hazard ratio 0.95, 95% CI 0.67 to 1.32) but was associated with fewer psychiatric admissions and re-referrals and better self-rated recovery and satisfaction. A single-centre trial of 119 adults with treatment-resistant depression found that structural-connectivity-guided theta-burst stimulation gave a larger Hamilton score reduction than the 5-cm rule at weeks 2 and 6 (8.79 and 12.87 percentage points), with no difference by week 12. A Danish registry cohort of 67,390 women found small increases in first psychotropic prescriptions in the year after abortion (incidence rate ratio about 1.1) that did not survive multiple-testing correction, and lower rates beyond five years. The FDA recorded a supplemental approval for a generic clozapine product on 2 October; the notice carries no detail on what changed.
FDA records a supplement for a generic clozapine product
No action is needed from this notice alone; look at the updated label if you use this specific product.
Psychotropic prescriptions after abortion: small early rise that did not hold up to correction
Check on mood and sleep at follow-up after a termination as you would after any stressful event, and avoid attributing symptoms to the procedure itself.
Connectivity-guided theta-burst stimulation beat 5-cm targeting in early weeks
Consider this as early evidence for targeting research, not yet a reason to alter the stimulation protocol you use.
Ask about bowel habit at every clozapine review
Include a direct bowel question in every clozapine review.
Open Dialogue in crisis care: no effect on relapse, fewer admissions
Consider network-based, continuity-focused crisis care as a model worth piloting where admission rates are a concern, recognising that relapse was not reduced.
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