This newsletter summarizes the recent findings of kisspeptin, a promising neuropeptide for hypoactive sexual desire disorder.
We also discuss practical aspects for treating OCD in children and adolescents, key points from a presentation on the role of psychopharmacology in ASD, and our practical research summaries of adult, child, and adolescent psychiatry (Quick Takes and CAP Smart Takes).
Kisspeptin for Hypoactive Sexual Desire Disorder
On February 3, 2023, an RCT was published in the JAMA Network Open, which suggested that kisspeptin has potential as the first pharmacologic treatment for men with low sexual desire.
- What is kisspeptin?
- Kisspeptin is a neuropeptide with a critical role in the function of the hypothalamic–pituitary–gonadal (HPG) axis. It is produced in the hypothalamus and stimulates the secretion of GnRH.
- How can kisspeptin help in hypoactive sexual desire disorder (HSDD)?
- Evidence from animal models suggests that kisspeptin signaling has key roles in modulating reproductive behavior, including sexual motivation and erections. Thus, kisspeptin administration could enhance limbic activity in response to sexual stimuli.
- What participants were included?
- Heterosexual men diagnosed with HSDD and without depression, anxiety traits, and underlying erectile dysfunction
- How was kisspeptin administered and how often?
- Participants received a 75-minute infusion of kisspeptin in 2 study visits at least 7 days apart.
- What were the findings?
- Kisspeptin significantly increased penile tumescence by up to 56% and increased participant-reported happiness about sex compared with placebo.
- What were kisspeptin’s side effects?
- Kisspeptin was well tolerated, with no side effects or adverse events reported. Additionally, kisspeptin did not have any effects on general mood and anxiety.
- How could this change clinical practice?
- Preliminary results from an RCT show positive outcomes in women as well. However, to assess the efficacy and safety of this potential treatment, we need to carry out additional trials with larger sample sizes, different delivery methods, and long-term follow-up.
- Kisspeptin seems to be a promising alternative for low HSDD. If positive trials continue, kisspeptin-based treatments may be available in 5–10 years. Read more here.
OCD in Children and Adolescents, With David Rosenberg, M.D.
In this interview, Dr. David Rosenberg reviews essential principles in the assessment and management of obsessive-compulsive disorder (OCD) in children and adolescents. Dosing strategies and the use of adjunctive medications for the management of OCD in this special population are likewise discussed.
Interview highlights include the following:
- Antipsychotic agents can be used as an augmenting strategy in patients who are partially responding or even nonresponding to other psychotropic medications.
- Although TMS is a promising strategy for the management of treatment-resistant pediatric OCD, more research needs to be done to demonstrate its efficacy and safety in this population.
Learn more and earn 0.5 CME credits here.
The Role of Psychopharmacology in Autism Spectrum Disorder
In this video lecture, Dr. Christopher Keary addresses essential concepts regarding the role of psychopharmacology in ASD. He includes valuable clinical pearls about the use of medications in this particular population and discusses treatment strategies for co-occurring symptoms, such as motor hyperactivity, irritability, and sleep disturbances. Additionally, he reviews nonmedication-based treatments and provides numerous sample cases to highlight clinical learning.
Treatment of Sleep Disturbances in ASD: Melatonin and Other Strategies
- There are many RCTs of melatonin for treating insomnia in ASD.
- These RCTs attest to the effectiveness and excellent tolerability of melatonin.
- Diphenhydramine and benzodiazepines have a higher risk for paradoxical reactions in patients with developmental disabilities.
Learn more and earn 1.25 CME credits here.
Quick Takes: Research, Digested
Sublingual Dexmedetomidine for the Treatment of Acute Agitation in Adults With Schizophrenia or Schizoaffective Disorder
- Sublingual dexmedetomidine was superior to placebo in a randomized trial for the treatment of acute agitation.
- Was the difference clinically significant? That appears unlikely when you look at all the reported data, at least for effects within the first 30 minutes after administration. Learn more.
Listen to or read the full volume, and earn 0.5 CME credits here.
CAP Smart Takes: Research, Digested
Efficacy and Safety of Lisdexamfetamine in Preschool Children with ADHD
- Whereas most psychotropic medications for ADHD are not FDA approved in preschool children, pharmacotherapy is increasingly being used to treat preschool children with ADHD.
- Lisdexamfetamine appears to be another option; it was effective and well tolerated in preschool children 4–5 years old, with no new safety signals.
- However, CGI-I improvement scores did not reach statistical significance. Learn more.
Listen to or read the full volume, and earn 0.5 CME credits here.
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References
- Mills, E. G., Ertl, N., Wall, M. B., Thurston, L., Yang, L., Suladze, S., Hunjan, T., Phylactou, M., Patel, B., Muzi, B., Ettehad, D., Bassett, P. A., Howard, J., Rabiner, E. A., Bech, P., Abbara, A., Goldmeier, D., Comninos, A. N., & Dhillo, W. S. (2023). Effects of Kisspeptin on sexual brain processing and penile tumescence in men with hypoactive sexual desire disorder. JAMA Network Open, 6(2), e2254313.
