Combining antidepressants (ADs) for therapy of acute depression is frequently employed, but randomized studies have yielded conflicting results. We conducted a systematic review and meta-analysis aimed at determining efficacy and tolerability of combination therapy. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
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Attention deficit hyperactivity disorder (ADHD) can be treated with stimulant medication such as methylphenidate. Although effective, methylphenidate can cause serious side-effects, including suppressed appetite, growth retardation and sleep problems. A drug holiday is a deliberate interruption of pharmacotherapy for a defined period of time and for a specific clinical purpose, for example for appeasing side-effects. While some international guidelines recommend introducing drug holidays in ADHD treatment, this is not practised routinely. Our aim was to examine the views and experiences of planned drug holidays from methylphenidate with adults who have responsibility for treatment decisions in children and adolescents with ADHD. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Approximately 6.2 % of women in the USA and 3.7 % of women in the UK, use Selective Serotonin Reuptake Inhibitors (SSRIs) during their pregnancies because of depression and/or anxiety. In the Netherlands, this prevalence is around 2 %. Nonetheless, SSRI use during pregnancy is still controversial. On the one hand SSRIs may be toxic to the intrauterine developing child, while on the other hand relapse or recurrence of depression during pregnancy poses risks for both mother and child. Among patients and professionals there is an urgent need for evidence from randomized studies to make rational decisions regarding continuation or tapering of SSRIs during pregnancy. At present, no such studies exist.
Aims and method To identify training needs of the next generation of psychiatrists and barriers in prescribing first-generation antipsychotics (FGAs). We have surveyed psychiatry trainees in East Anglia with regard to their training experience, knowledge and attitudes to the use of oral FGAs as regular medication.
two recent Cochrane reviews (Storebo et al, 2015; Punja et al, 2016a) questioned the quality of the evidence from available RCTs (see also a previous Mental Elf blog by Chris Hollis on this review).
Whilst meta-analyses of interventions (such as the available ones on ADHD drugs) often include parallel RCTs, no meta-analysis so far had pooled n-of-1 trials, defined as multiple crossover trials performed in a single participant, often with randomisation and blinding. Meta-analysing data from n-of-1 trials would allow aggregating data on individual response to treatment.
Punja and colleagues (Punja et al, 2016b) performed the first meta-analysis of n-of-1 trials, focusing on psychostimulants (methylphenidate and amphetamine derivatives) for ADHD, for which numerous N-of-1 trials have been published.
In May 2016, a new recommendation was added on providing information about olanzapine when choosing antipsychotic medication for children and young people with a first episode of psychosis.
Schizophrenia is not a taboo topic anymore. Some aspects of the illness, like hearing voices and delusions (‘positive symptoms’), are increasingly spoken and written about by laypeople. But ‘negative symptoms’ (lack of thought content, motivation, meaningful pleasure and sociability) and the predisposition for people with schizophrenia to get depressed, are still commonly under-appreciated.
Both these domains are often treated by adding an antidepressant to an already-prescribed antipsychotic, but the evidence for this isn’t as comprehensive as we’d like. There have been multiple small studies, but there is little consensus and some subsidiary questions (like whether antidepressants might worsen positive symptoms) remain unanswered. Fortunately for us, a team based in Munich have recently published a systematic review and meta-analysis in the American Journal of Psychiatry, to pull together all of the data in this broad area (Helfer et al, 2016).
Despite significant advances in medication safety, errors related to confusion between drug names are a cause of preventable adverse events and serious harm,1 and remain a patient safety priority.2 ,3 Although drug name confusion is recognised as a factor contributing to error, its minimisation or elimination is a prevailing challenge.4 ,5 In this issue, Schroeder et al6 postulate that despite industry's efforts to follow regulators' guidance7 on how to review drug names, more objective evidence, in a standardised format, is needed to improve decision-making about the acceptability of a name. To address this concern, the authors assessed the association between error rates in laboratory-based tests of drug name memory and perception and rates of real-world errors related to drug name confusion. To read the full article, log in using your NHS OpenAthens details.
In a pragmatic clinical trial, this study sought to compare relapses among patients receiving either long-acting injectable or oral second-generation antipsychotics.
There is increasing evidence that some glutamatergic drugs could have antidepressant effects. Ketamine as a promising prototype for novel glutamatergic antidepressants has a much faster onset of action and is possibly more efficacious than standard antidepressants.1 Two recent systematic reviews and meta-analyses assessed the antidepressant efficacy (including modes of administration, duration of effect and adverse effects) of ketamine and other glutamate receptor modulators in the treatment of unipolar depression (Caddy et al,2 in the Cochrane Database of Systematic Reviews), and, more generally, in mood disorders (Newport et al,3 in the American Journal of Psychiatry). To read the full article, log in using your NHS OpenAthens details
The authors sought to determine the relative morbidity and mortality associated with drugs used to treat depression and to examine specific clinical effects associated with serious outcomes. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
A new study funded by the MRC and Wellcome, and published today in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, has found that the wakefulness-promoting drug modafinil improves memory functions in people recovering from depression.
to compare drug use among persons with Alzheimer's disease (AD) aged ≥90 years to persons without AD with similar age and to younger persons with AD. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
There are huge volumes of drug trials published, and for clinicians it’s clearly difficult to keep up to date with the latest evidence.
It is also clear that huge volumes of medicines are routinely prescribed, at a considerable cost to health services worldwide. For example, in the UK we spend £14.4bn per year on prescriptions, and most of this spend focuses on common conditions.
The aim of this recent meta-analysis by Leucht and colleagues (2015) was to explore the efficacy of 20 commonly prescribed medicines.
Opioid antagonists (eg, naltrexone) and positive modulators of γ-aminobutyric acid type A receptors (eg, alprazolam) each modestly attenuate the abuse-related effects of stimulants. A previous study demonstrated that acute pretreatment with the combination of naltrexone and alprazolam attenuated a greater number of the subject-rated effects of D-amphetamine than the constituent drugs alone. This study tested the hypothesis that maintenance on the combination of naltrexone and alprazolam XR would attenuate the reinforcing and “positive” subject-rated effects of methamphetamine to a greater extent than the constituent drugs alone. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Lysergic acid diethylamide (LSD) is a potent serotonergic hallucinogen or psychedelic that modulates consciousness in a marked and novel way. This study sought to examine the acute and mid-term psychological effects of LSD in a controlled study. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai