Featured Publications
Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta‐analysis
Farhat LC, Olfson E, Nasir M, Levine JLS, Li F, Miguel EC, Bloch MH. Pharmacological and behavioral treatment for trichotillomania: An updated systematic review with meta‐analysis. Depression And Anxiety 2020, 37: 715-727. PMID: 32390221, DOI: 10.1002/da.23028.Peer-Reviewed Original ResearchMeSH KeywordsAcetylcysteineBehavior TherapyClomipramineHumansSelective Serotonin Reuptake InhibitorsTrichotillomaniaConceptsClinical trialsSingle randomized clinical trialTTM symptomsFirst-line medicationRandomized clinical trialsStrong evidence baseLarge treatment effectsHair pulling disorderEffective medicationsAvailable agentsPharmacological agentsAdditional trialsDrug AdministrationPsychiatric conditionsSystematic reviewN-acetylcysteineBehavioral treatmentBehavioral therapyEvidence baseTrichotillomaniaTrialsRelative efficacyTreatment effectsMedicationsSymptomsAnnual Research Review: Defining and treating pediatric treatment‐resistant depression
Dwyer JB, Stringaris A, Brent DA, Bloch MH. Annual Research Review: Defining and treating pediatric treatment‐resistant depression. Journal Of Child Psychology And Psychiatry 2020, 61: 312-332. PMID: 32020643, PMCID: PMC8314167, DOI: 10.1111/jcpp.13202.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAntidepressive AgentsCombined Modality TherapyDepressive Disorder, MajorDepressive Disorder, Treatment-ResistantDrug Therapy, CombinationHumansPsychotherapySelective Serotonin Reuptake InhibitorsConceptsTreatment-resistant depressionMajor depressive disorderAdolescent treatment-resistant depressionRisk factorsAdolescent major depressive disorderPsychotherapy treatment trialSecond-line treatmentSignificant risk factorsPediatric clinical trialsSecond leading causeSignificant health problemEvidence-based psychotherapiesCent of adolescentsMedication switchAdequate medicationSubstantial morbiditySymptom improvementInterventional treatmentMedication augmentationTreatment trialsCare treatmentClinical trialsDepressive disorderDiagnostic difficultiesLeading causeMeta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder
Bloch MH, McGuire J, Landeros-Weisenberger A, Leckman JF, Pittenger C. Meta-analysis of the dose-response relationship of SSRI in obsessive-compulsive disorder. Molecular Psychiatry 2009, 15: 850-855. PMID: 19468281, PMCID: PMC2888928, DOI: 10.1038/mp.2009.50.Peer-Reviewed Original ResearchMeSH KeywordsAnalysis of VarianceDose-Response Relationship, DrugDouble-Blind MethodFemaleHumansMaleObsessive-Compulsive DisorderOutcome Assessment, Health CareRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsY-BOCS scoresSerotonin reuptake inhibitorsObsessive-compulsive disorderHigh dosesReuptake inhibitorsTreatment respondersDose of SSRIsTreatment efficacyDouble-blind placebo-controlled clinical trialGreater side effect burdenPlacebo-controlled clinical trialSide effect burdenAbsolute risk differenceTreatment of adultsGreater treatment efficacyMajor depressive disorderImproved treatment efficacyTreatment of OCDDose-response relationshipRevMan 4.2.8Clinical trialsDepressive disorderCause dropoutsMean changeA systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder
Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF. A systematic review: antipsychotic augmentation with treatment refractory obsessive-compulsive disorder. Molecular Psychiatry 2006, 11: 622-632. PMID: 16585942, DOI: 10.1038/sj.mp.4001823.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAntipsychotic AgentsBasal Ganglia DiseasesBenzodiazepinesComorbidityDepressive DisorderDibenzothiazepinesDouble-Blind MethodDrug ResistanceDrug Therapy, CombinationHaloperidolHumansMiddle AgedObsessive-Compulsive DisorderOlanzapinePatient DropoutsQuetiapine FumarateRandomized Controlled Trials as TopicRisperidoneSelective Serotonin Reuptake InhibitorsTic DisordersTreatment OutcomeConceptsSerotonin reuptake inhibitorsAntipsychotic augmentationAbsolute risk differenceObsessive-compulsive disorderComorbid ticsOCD patientsTreatment responseSystematic reviewTreatment-refractory obsessive-compulsive disorderTreatment-refractory OCD patientsRefractory obsessive-compulsive disorderDouble-blind trialEfficacy of quetiapineTreatment-refractory OCDCochrane Central RegisterMeaningful treatment responseProportion of subjectsEfficacy of haloperidolRandomized control trialObsessive-compulsive disorder patientsSRI monotherapyAdequate trialCentral RegisterControlled TrialsReuptake inhibitors
2020
Meta-analysis: Pharmacologic Treatment of Restricted and Repetitive Behaviors in Autism Spectrum Disorders
Zhou MS, Nasir M, Farhat LC, Kook M, Artukoglu BB, Bloch MH. Meta-analysis: Pharmacologic Treatment of Restricted and Repetitive Behaviors in Autism Spectrum Disorders. Journal Of The American Academy Of Child & Adolescent Psychiatry 2020, 60: 35-45. PMID: 32387445, DOI: 10.1016/j.jaac.2020.03.007.Peer-Reviewed Original ResearchMeSH KeywordsAntipsychotic AgentsAutism Spectrum DisorderDouble-Blind MethodHumansMethylphenidateRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsPlacebo-controlled trialPharmacological treatmentPharmacological agentsAvailable pharmacological agentsAutism spectrum disorderSerotonin reuptake inhibitorsStandardized mean differenceStandardized study designsTreatment of ASDPharmacologic treatmentPrimary outcomeReuptake inhibitorsAntipsychotic medicationSpecific assessment toolsFolinic acidSpectrum disorderModest benefitRepetitive behaviorsMean differenceStudy designSmall effect sizesIndividual studiesTrialsPlacebo
2019
Selective Serotonin Reuptake Inhibitor Use During Pregnancy—Associated With but Not Causative of Autism in Offspring
Flores JM, Avila-Quintero VJ, Bloch MH. Selective Serotonin Reuptake Inhibitor Use During Pregnancy—Associated With but Not Causative of Autism in Offspring. JAMA Psychiatry 2019, 76: 1225-1227. PMID: 31577332, DOI: 10.1001/jamapsychiatry.2019.2193.Commentaries, Editorials and LettersMeSH KeywordsAntidepressive AgentsAutistic DisorderFemaleHumansPregnancyPregnancy ComplicationsSelective Serotonin Reuptake Inhibitors
2018
Systematic review and meta‐analysis: Dose–response curve of SSRIs and SNRIs in anxiety disorders
Jakubovski E, Johnson JA, Nasir M, Müller‐Vahl K, Bloch MH. Systematic review and meta‐analysis: Dose–response curve of SSRIs and SNRIs in anxiety disorders. Depression And Anxiety 2018, 36: 198-212. PMID: 30479005, DOI: 10.1002/da.22854.Peer-Reviewed Original ResearchMeSH KeywordsAnxiety DisordersHumansNorepinephrinePhobia, SocialSelective Serotonin Reuptake InhibitorsSerotoninSerotonin and Noradrenaline Reuptake InhibitorsConceptsSerotonin-norepinephrine reuptake inhibitorsSelective serotonin reuptake inhibitorsGreater treatment benefitHigh dosesTreatment responseAnxiety disordersReuptake inhibitorsSymptom improvementTreatment benefitPharmacological agentsRandomized placebo-controlled clinical trialSSRIs/serotonin-norepinephrine reuptake inhibitorsPlacebo-controlled clinical trialIndividual pharmacological agentsCochrane Central RegisterNorepinephrine reuptake inhibitorsSerotonin reuptake inhibitorsOverall symptom improvementGreater symptom improvementDose-response curveLinear mixed model analysisCentral RegisterMedication classesAdult patientsControlled TrialsMeta-analysis: Second generation antidepressants and headache
Telang S, Walton C, Olten B, Bloch MH. Meta-analysis: Second generation antidepressants and headache. Journal Of Affective Disorders 2018, 236: 60-68. PMID: 29715610, DOI: 10.1016/j.jad.2018.04.047.Peer-Reviewed Original ResearchConceptsRisk of headacheSecond-generation antidepressantsAntidepressant medicationGeneration antidepressantsSide effectsTreatment-emergent side effectsPlacebo-controlled trialPooled risk ratioFixed-dose trialStratified subgroup analysisTreatment of adultsDosage of medicationReceptor affinity profileSignificant differencesMeta-analysis resultsOnly antidepressantsMedication classesMedication dosingMedication typeObsessive-compulsive disorderSubgroup analysisRisk ratioRelative riskHeadacheMedications
2017
Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder.
Costa DLC, Diniz JB, Requena G, Joaquim MA, Pittenger C, Bloch MH, Miguel EC, Shavitt RG. Randomized, Double-Blind, Placebo-Controlled Trial of N-Acetylcysteine Augmentation for Treatment-Resistant Obsessive-Compulsive Disorder. The Journal Of Clinical Psychiatry 2017, 78: e766-e773. PMID: 28617566, DOI: 10.4088/jcp.16m11101.Peer-Reviewed Original ResearchMeSH KeywordsAcetylcysteineAdolescentAdultAgedAnxiety DisordersComorbidityDepressive DisorderDouble-Blind MethodDrug ResistanceDrug Therapy, CombinationFemaleHumansMaleMiddle AgedObsessive-Compulsive DisorderPsychiatric Status Rating ScalesPsychometricsSelective Serotonin Reuptake InhibitorsYoung AdultConceptsTreatment-resistant obsessive-compulsive disorderObsessive-compulsive disorderY-BOCS scoresN-acetylcysteineNAC groupYale-Brown Obsessive Compulsive Scale scoresTreatment-resistant OCD patientsBaseline Y-BOCS scoresTreatment-Resistant ObsessivePrimary outcome measureAnxiety symptomsDSM-IV criteriaSymptom dimensionsCompulsive Scale scoresSpecific OCD symptom dimensionsOCD symptom dimensionsAntioxidant medicationsAbdominal painPlacebo groupGlutamate modulatorsSecondary outcomesTertiary hospitalOutpatient clinicSeverity scoreWeek 16Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment
Hirschtritt ME, Bloch MH, Mathews CA. Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. JAMA 2017, 317: 1358-1367. PMID: 28384832, DOI: 10.1001/jama.2017.2200.Peer-Reviewed Original ResearchMeSH KeywordsAntipsychotic AgentsDeep Brain StimulationDiagnostic and Statistical Manual of Mental DisordersHumansMeta-Analysis as TopicObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsSerotonin reuptake inhibitorsObsessive-compulsive disorderCognitive behavioral therapyTreatment of OCDReuptake inhibitorsBehavioral therapySystematic reviewFirst-line pharmacologic interventionPreferred initial treatment strategyTreatment-resistant obsessive-compulsive disorderInitial treatment strategyPrimary care settingTreatment-resistant casesDiagnosis of OCDFirst-line interventionEfficacy of neurolepticsDeep brain stimulationComputer-based cognitive behavioral therapyCase seriesPharmacologic interventionsAdjunctive useTreatment optionsTreatment advancesNeuromodulatory approaches
2016
Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors and Clomipramine in Pediatric Obsessive-Compulsive Disorder
Varigonda AL, Jakubovski E, Bloch MH. Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors and Clomipramine in Pediatric Obsessive-Compulsive Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry 2016, 55: 851-859.e2. PMID: 27663940, PMCID: PMC6944467, DOI: 10.1016/j.jaac.2016.07.768.Peer-Reviewed Original ResearchMeSH KeywordsChildClomipramineHumansObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsSelective serotonin reuptake inhibitorsPediatric obsessive-compulsive disorderSerotonin reuptake inhibitorsObsessive-compulsive disorderYale-Brown ObsessiveReuptake inhibitorsTime courseEarly treatment responseTreatment effectsChildren's Yale-Brown ObsessiveSSRI agentsPlacebo groupSSRI treatmentAdult patientsTreatment responsePooled estimatesPharmacological responseHigh dosesMeta-AnalysisSystematic reviewClomipramineSymptom dataMagnitude of responseMean differenceCompulsive ScaleAddressing Difficulties in the Study of Dose-Response Relationships of SSRIs in Depression: Response to Hieronymus and Eriksson
Jakubovski E, Bloch MH. Addressing Difficulties in the Study of Dose-Response Relationships of SSRIs in Depression: Response to Hieronymus and Eriksson. American Journal Of Psychiatry 2016, 173: 836-838. PMID: 27477138, DOI: 10.1176/appi.ajp.2016.16030304r.Peer-Reviewed Original ResearchEarly onset of response with selective serotonin reuptake inhibitors in obsessive-compulsive disorder: a meta-analysis.
Issari Y, Jakubovski E, Bartley CA, Pittenger C, Bloch MH. Early onset of response with selective serotonin reuptake inhibitors in obsessive-compulsive disorder: a meta-analysis. The Journal Of Clinical Psychiatry 2016, 77: e605-11. PMID: 27249090, DOI: 10.4088/jcp.14r09758.Peer-Reviewed Original ResearchMeSH KeywordsAdultCognitive Behavioral TherapyCombined Modality TherapyDose-Response Relationship, DrugHumansObsessive-Compulsive DisorderRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsSelective serotonin reuptake inhibitorsYale-Brown Obsessive Compulsive ScalePlacebo-controlled trialSerotonin reuptake inhibitorsTreatment of adultsObsessive-compulsive disorderSSRI responseSSRI treatmentReuptake inhibitorsSymptom improvementEfficacy of SSRIsTrials of SSRIsFirst-line pharmacologic treatmentCochrane Central RegisterStart of treatmentMajor depressive disorderEffect of doseObsessive Compulsive ScaleSSRI actionCentral RegisterPharmacologic treatmentPrimary outcomeControlled TrialsSSRI trialDepressive disorderSystematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder
Schumer MC, Bartley CA, Bloch MH. Systematic Review of Pharmacological and Behavioral Treatments for Skin Picking Disorder. Journal Of Clinical Psychopharmacology 2016, 36: 147-152. PMID: 26872117, PMCID: PMC4930073, DOI: 10.1097/jcp.0000000000000462.Peer-Reviewed Original ResearchMeSH KeywordsBehavior TherapyDisruptive, Impulse Control, and Conduct DisordersHumansMental DisordersRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsSelf-Injurious BehaviorSkin DiseasesTreatment OutcomeConceptsInactive control conditionsUncontrolled trialsBehavioral treatmentSystematic reviewLarger placebo-controlled RCTsSelective serotonin reuptake inhibitorsShort-term clinical trialsBehavioral interventionsPlacebo-controlled RCTsSerotonin reuptake inhibitorsSkin picking disorderEfficacy of treatmentNovel pharmacological agentsShort-term trialsReuptake inhibitorsTreatment armsControl conditionClinical trialsDemonstrated efficacyPsychiatric disordersPharmacological agentsSignificant improvementElectronic databasesRCTsMeta-Analysis
2015
Systematic Review and Meta-Analysis: Dose-Response Relationship of Selective Serotonin Reuptake Inhibitors in Major Depressive Disorder
Jakubovski E, Varigonda AL, Freemantle N, Taylor MJ, Bloch MH. Systematic Review and Meta-Analysis: Dose-Response Relationship of Selective Serotonin Reuptake Inhibitors in Major Depressive Disorder. American Journal Of Psychiatry 2015, 173: 174-183. PMID: 26552940, PMCID: PMC4975858, DOI: 10.1176/appi.ajp.2015.15030331.Peer-Reviewed Original ResearchMeSH KeywordsCitalopramDepressive Disorder, MajorDose-Response Relationship, DrugFluoxetineFluvoxamineHumansParoxetineSelective Serotonin Reuptake InhibitorsSertralineTreatment OutcomeConceptsSelective serotonin reuptake inhibitorsMajor depressive disorderSerotonin reuptake inhibitorsDepressive disorderHigh dosesTreatment responseReuptake inhibitorsBenefit of SSRIsEfficacy of SSRIsTolerability of SSRIsEffects of SSRIsRandomized placebo-controlled trialPlacebo-controlled trialStratified subgroup analysisTherapeutic dose rangeDose-response relationshipSSRI doseTolerability analysisMedication dosesSignificant positive associationSubgroup analysisMultiple time pointsDose categoriesMixed regression modelsCause dropoutsRiluzole augmentation in treatment-refractory obsessive-compulsive disorder: a pilot randomized placebo-controlled trial.
Pittenger C, Bloch MH, Wasylink S, Billingslea E, Simpson R, Jakubovski E, Kelmendi B, Sanacora G, Coric V. Riluzole augmentation in treatment-refractory obsessive-compulsive disorder: a pilot randomized placebo-controlled trial. The Journal Of Clinical Psychiatry 2015, 76: 1075-84. PMID: 26214725, PMCID: PMC4560666, DOI: 10.4088/jcp.14m09123.Peer-Reviewed Original ResearchMeSH KeywordsAdultDrug SynergismDrug Therapy, CombinationExcitatory Amino Acid AntagonistsFemaleHumansMaleMiddle AgedObsessive-Compulsive DisorderPilot ProjectsRiluzoleSelective Serotonin Reuptake InhibitorsTreatment OutcomeConceptsPlacebo-controlled trialObsessive-compulsive disorderSmall open-label trialsTreatment-refractory obsessive-compulsive disorderGlutamate modulator riluzoleSignificant residual symptomsOpen-label trialSubset of patientsDSM-IV obsessive-compulsive disorderBest available treatmentsPlacebo leadRiluzole groupRefractory symptomsPartial responseSignificant morbidityResidual symptomsModerate nauseaAvailable treatmentsStandard interventionGlutamate homeostasisRiluzoleSide effectsSRI treatmentPatientsSecondary analysisSystematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors in Pediatric Major Depressive Disorder
Varigonda AL, Jakubovski E, Taylor MJ, Freemantle N, Coughlin C, Bloch MH. Systematic Review and Meta-Analysis: Early Treatment Responses of Selective Serotonin Reuptake Inhibitors in Pediatric Major Depressive Disorder. Journal Of The American Academy Of Child & Adolescent Psychiatry 2015, 54: 557-564. PMID: 26088660, DOI: 10.1016/j.jaac.2015.05.004.Peer-Reviewed Original ResearchMeSH KeywordsChildDepressive Disorder, MajorEarly Medical InterventionHumansPediatricsRandomized Controlled Trials as TopicSelective Serotonin Reuptake InhibitorsConceptsSelective serotonin reuptake inhibitorsPediatric major depressive disorderMajor depressive disorderSerotonin reuptake inhibitorsSSRI agentsReuptake inhibitorsPediatric depressionDepressive disorderAdult major depressive disorderFirst-line pharmacological treatmentEarly treatment responseIndividual patient dataStandardized mean differenceMDD trialsSSRI doseSSRI pharmacotherapyPlacebo groupAdult patientsSSRI responsePharmacological treatmentPharmacological trialsTreatment responsePooled estimatesPharmacological responseHigh dosesMr Jakubovski and Dr Bloch reply.
Jakubovski E, Bloch MH. Mr Jakubovski and Dr Bloch reply. The Journal Of Clinical Psychiatry 2015, 76: 327-8. PMID: 25830452, DOI: 10.4088/jcp.14lr09483a.Peer-Reviewed Original ResearchCitalopramDepressive Disorder, MajorFemaleHumansMaleOutcome Assessment, Health CareSelective Serotonin Reuptake InhibitorsAssessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children
Bloch MH, Storch EA. Assessment and Management of Treatment-Refractory Obsessive-Compulsive Disorder in Children. Journal Of The American Academy Of Child & Adolescent Psychiatry 2015, 54: 251-262. PMID: 25791142, PMCID: PMC4460245, DOI: 10.1016/j.jaac.2015.01.011.Peer-Reviewed Original ResearchConceptsTreatment-refractory obsessive-compulsive disorderPediatric obsessive-compulsive disorderSelective serotonin reuptake inhibitorsObsessive-compulsive disorderCognitive behavioral therapyTreatment-Refractory ObsessivePharmacological treatment optionsSide effect profileSerotonin reuptake inhibitorsTreatment of adultsGlutamate-modulating agentsLittle evidence-based dataEvidence of efficacyEvidence-based dataPediatric OCD patientsOCD symptomsAntipsychotic augmentationSSRI dosagesPediatric patientsReuptake inhibitorsEffect profilePediatric populationTreatment optionsPractice guidelinesEffective treatment
2014
Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial.
Kelly JM, Jakubovski E, Bloch MH. Prognostic subgroups for remission and response in the Coordinated Anxiety Learning and Management (CALM) trial. The Journal Of Clinical Psychiatry 2014, 76: 267-78. PMID: 25562579, PMCID: PMC4930076, DOI: 10.4088/jcp.13m08922.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdrenergic Uptake InhibitorsAdultAgedAnti-Anxiety AgentsAnxiety DisordersBenzodiazepinesCognitive Behavioral TherapyCombined Modality TherapyDepressive Disorder, MajorFemaleHumansMaleMiddle AgedOutcome Assessment, Health CarePanic DisorderPhobic DisordersPrognosisRemission InductionSelective Serotonin Reuptake InhibitorsSeverity of Illness IndexSex FactorsSocial ClassSocial SupportStress Disorders, Post-TraumaticYoung AdultConceptsLow socioeconomic statusCoordinated Anxiety LearningUsual careGeneralized anxiety disorderPosttraumatic stress disorderAnxiety disordersBaseline characteristicsPatient characteristicsPrognostic subgroupsAnxiety LearningSocioeconomic statusBaseline patient characteristicsCollaborative care interventionPrimary care settingPoor treatment outcomesCommunity treatment centersDSM-IV criteriaManagement trialsCognitive behavioral therapyLimited social supportExploratory moderator analysesMost patientsRemission criteriaComorbid depressionPrognostic outcomes