Chris Aiken, MD
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chrisaikenmd.bsky.social
Chris Aiken, MD
@chrisaikenmd.bsky.social
Editor, Carlat Psychiatry Report.
Assist Prof, NYU & WFU medical schools.
www.chrisaikenmd.com
Posting daily updates on all things psychiatric
New data on Acetaminophen (Tylenol) --> #Autism/#ADHD:

▪ No evidence of causal link in analysis of 9 systemic reviews
▪ When compared to outcomes in unexposed siblings, the small associations disappeared, suggesting other (eg, genetic) factors explain it:

www.bmj.com/content/391/...
November 11, 2025 at 1:01 PM
Keto and Mediterranean diets compared for mood in health subjects:
▪ Medit better for #depression
#Keto better for impulsivity, weight
www.ncbi.nlm.nih.gov/pubmed/41197...

How to use Medit for mood:
chrisaikenmd.com/antidepressa...

Evidence: Low (small, high drop-out, not blinded, 3-mth RCT)
November 10, 2025 at 1:17 PM
"How to get the best night's #sleep: What the science says" a nice podcast from Nature journal:
cms-resources.apps.public.k8s.springernature.io/springer-cms...

They focus on light at night. These blue-light blockers improved sleep quality in two RCTs:
chrisaikenmd.com/darktherapy

#therapy
November 9, 2025 at 1:00 PM
Saffron improved premenstrual syndrome with a moderate effect size (0.4-0.8) in meta-analysis of 7 randomized trials:
pubmed.ncbi.nlm.nih.gov/41151539

Saffron also improved #depression and #sleep quality in recent large trials.

How to use it:
chrisaikenmd.com/supplements

#naturalhealth
November 8, 2025 at 1:00 PM
FDA approved lumateperone (Caplyta) aug in #major depression:
▪ 42 mg qhs
▪ Effect size 0.6 (good for class)
▪ Lower risk of EPS, akathisia, and metabolic risks within class, but sedating

I'll need to update this table from my book, Difficult to Treat Depression, about to go to press.

#psychiatry
November 7, 2025 at 1:01 PM
From ChatGPT's internal audit. Each week
▪ 1.2 million (0.15%) express suicidal intent
▪ 560,000 (0.07%) have signs of emergency mania/psychosis

New algorithm performs better those who use it for therapy, but still veers off in suicide conversations 1 in 10 times:
pubmed.ncbi.nlm.nih.gov/41167716
November 6, 2025 at 1:02 PM
Probiotics may help #autism, from meta-analysis of 8 small RCTs:
pubmed.ncbi.nlm.nih.gov/41139591

Bigger impact over > 3 mth and in younger children.

(Gut health is implicated in autism, but confidence limits in analysis barely positive)

How to use them:
chrisaikenmd.com/supplements

#therapy
November 5, 2025 at 1:01 PM
#Sleep deprivation linked to worse outcomes in this first-of-its kind study of surgeons:
pubmed.ncbi.nlm.nih.gov/41117395

Evidence grade low (4/10):
chrisaikenmd.com/ebm

Photo: Weird Al. #psychiatry #surgery #medicine
November 4, 2025 at 1:02 PM
Night owls procrastinate more in college, and have more #depression/anxiety, concludes new cross-sectional study:
www.ncbi.nlm.nih.gov/pubmed/41140...

Evidence grade low (3/10)

They benefit from blue-light blockers glasses and dawn simulators; how to use them: chrisaikenmd.com/darktherapy
November 3, 2025 at 1:01 PM
New #therapy for #depression, Dynamic Interpersonal Therapy, had better long-term effects than CBT or med:
pubmed.ncbi.nlm.nih.gov/41135204

Focuses on attachment, mentalization, and recurring patterns in relationships.

Evidence grade moderate 7/10
chrisaikenmd.com/ebm

#psychology #psychiatry
November 2, 2025 at 1:01 PM
Daylight savings changes worsen sleep, especially in the Spring and for night owls, concludes new analysis:
pubmed.ncbi.nlm.nih.gov/41110263

Dawn simulators help adjust to these changes and improve winter #depression:
chrisaikenmd.com/dawnsimulator
November 1, 2025 at 12:01 PM
Camouflaging is when people on the #autism spectrum mask their symptoms or imitate normal interactions to avoid standing out.

It can work, but it's also a cause of distress, as new study finds:
pubmed.ncbi.nlm.nih.gov/41120451

How do you manage this potential side effect of social skills training?
October 31, 2025 at 12:27 PM
Is "warm milk before bed" more than just a folk remedy?

Milk/dairy improved sleep quality in new analysis of 8 RCTs and 6 other studies, whether in day or night:
pmc.ncbi.nlm.nih.gov/articles/PMC...

Likely through tryptophan/probiotics.

#psychiatry #psychology #nutrition #taylorswift
October 30, 2025 at 3:48 PM
FDA approved folinic acid (Leucovorin) for #autism, a controversial move based on 2 small RCTs and the endorsement of a Florida man.

Folate is impaired in autism, 84% have genetic problems in its metabolism:
pubmed.ncbi.nlm.nih.gov/41112632

Can also use methylfolate:
chrisaikenmd.com/supplements
October 29, 2025 at 4:07 PM
Here's why you need to know about white matter hyperintensities. They are linked to...
#Depression in elderly (vascular type)
▪ Antidepressant non-response
▪ 3x risk of stroke
▪ 2x risk of dementia
▪ 2x risk of suicide in new analysis of mood disorders:
www.ncbi.nlm.nih.gov/pubmed/41107...
October 28, 2025 at 12:03 PM
Shift work causes insomnia, particularly after 24 hours of shift work per week, concludes prospective observational study of nurses:
www.ncbi.nlm.nih.gov/pubmed/41063...

Shift work also contributes to #depression, obesity, heart disease, cancer.

How to manage:
chrisaikenmd.com/darkbedroom
October 27, 2025 at 12:04 PM
Is #autism linked to dark triad traits of:
1. Machiavellianism (cunning, manipulative)
2. Narcissism
3. Sociopathy

No, concludes new study, which finds low levels of the first two and no increase of #3.

www.ncbi.nlm.nih.gov/pubmed/41090...

Good to hear positive news about mental differences.
October 26, 2025 at 12:01 PM
Trazodone is very effective at improving sleep quality in #depression, concludes new review:
www.ncbi.nlm.nih.gov/pubmed/41081...

That’s something we can’t say for most antidepressants (serotonergics can make sleep worse), nor for most sleep meds (orexins are an exception).

#psychiatry #pmhnp
October 25, 2025 at 12:02 PM
Ketamine failed against midazolam (IV) in new trial of inpatient #depression:
pubmed.ncbi.nlm.nih.gov/41123905

Was earlier success (against IV saline) due to unblinding? Or is it that benzos are well-established rapid-acting antidepressants (they just don't last).

Evidence grade: Moderate (8/10)
October 24, 2025 at 12:32 PM
Antioxidants for #autism? Trials are small, but systematic review highlights NAC, l-carnosine, omega-3, sulforaphane (from brocolli), CoQ10 as the best of the lot
www.ncbi.nlm.nih.gov/pubmed/41071...

Evidence moderate (~6/10)
chrisaikenmd.com/ebm

How to use them:
chrisaikenmd.com/supplements/
October 23, 2025 at 12:04 PM
The diet for #depression recommends 6 eggs/wk:
chrisaikenmd.com/antidepressa...

Same number may prevent cognitive decline (but more harms vascular health):
ncbi.nlm.nih.gov/pubmed/41061...

How? Choline, omega-3, D/B-vitamins, antioxidants

Evidence = Moderate 4/10
October 22, 2025 at 12:50 PM
Light #therapy treats perinatal #depression, and new trial shows sustained benefits 7 months later (even though the light was only used for 5 weeks):
www.ncbi.nlm.nih.gov/pubmed/41070...

Evidence: Moderate (6/10)

How to use light therapy (new recs for LED boxes):
chrisaikenmd.com/lighttherapy
October 21, 2025 at 12:02 PM
A common med hair-loss med (finasteride) causes #depression and #suicide, concludes 8 studies in this report that examines why this signal was suppressed for 20 years

Likely mechanism = lowers allopregnanolone, neurosteroid that modulates GABA (benzo) receptors
pubmed.ncbi.nlm.nih.gov/41004169
October 20, 2025 at 12:02 PM
Does response to the first stimulant dose predict later response in #ADHD?

It did in new study of methylphenidate, using Qb test to compare immediate and 2-month response:
www.ncbi.nlm.nih.gov/pubmed/41053...

Art: Grace Venditti

#psychiatry #pmhnp
October 19, 2025 at 12:01 PM
Do GLP-1s treat #alcohol use d/o?

Belief is high, evidence is thin, so take it with a grain of salt when this case-control study of diabetes looks for the GLP most effective against alcohol.

Winners = Tirzepatide, semaglutide:
www.ncbi.nlm.nih.gov/pubmed/41058...

Evidence: Low 3/10
October 18, 2025 at 12:03 PM