Thomas A. Ban: Psychiatry for Neuropsychopharmacologists

Peter R. Martin’s comment on Carlos Morra’s comment on Thomas Ban’s reply to Peter Martin’s comment on Ban’s essay

I am very pleased that our observations (Rich and Martin, 2014) derived from many years of providing addiction psychiatric care to patients with alcohol and/or drug use disorders resonates with others as reflected by the comments of both Ban and Morra. The idea of heuristic investigations of fundamental questions in nosology and therapeutics by a network of investigators (INHN) provides a unique opportunity, one based on identification and analysis of the clinical experiences of many to seek enhanced understanding.  This harkens back to the origins of our field when expert clinicians followed patient populations for long periods (throughout their own lifetimes) and thus developed insights into the important clinical questions (e.g., Kraepelin, Schneider, Leonhard, Schou, Grof and others).  I am very enthusiastic about Carlos Morra’s proposal to launch INHN research with projects designed to establish the proportion of patients with MDP that have an alcohol and/or drug use disorder and to test the hypothesis that MDP patients with alcohol and/or drug use disorder are more responsive to anticonvulsants than to lithium whereas MDP patients without alcohol and/or drug use disorder are more responsive to lithium than anticonvulsants.  I would add the importance also of clarifying the psychopathological characteristics of the MDP observed in alcohol and/or drug use disorder patients compared to those who do not have alcohol and/or drug use disorders.

Reference:

Rich SJ, Martin PR (2014). Co-occurring psychiatric disorders and alcoholism. In: Sullivan EV, Pfefferbaum A (eds) Handbook of Clinical Neurology Alcohol and the Nervous System. Elsevier, pp 573-588.

Peter R. Martin

September 22, 2016