A new systematic review published last week in BMJ Open by Eiring and colleagues aimed to investigate patients’ preferences for outcomes associated with psychoactive medications.
This study is a useful summary of which nutrients have been tested as an add-on to antidepressants, and an overall indication of what the studies found. It shows that, for most of these nutrients, the evidence comes from small studies of varying quality and length, and that we need bigger, better studies to get a true picture of their effects.
For the nutrients where there was sufficient evidence to carry out a meta-analysis, the difficulty is that the way the results are presented makes it hard to tell how much of an effect the nutrients actually had on people's depression.
The study was a randomised trial to see if clonidine decouples stress-related cocaine and heroin administration in patients maintained on buprenorphine. To read the full article, log in using your NHS OpenAthens details
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
Open access. The predictable pharmacokinetic drug interaction between clozapine and rifampicin is listed in most standard reference texts but little detail is given or emphasis on its clinical significance. The interaction is based on theoretical knowledge of both drugs; to date just two case reports have been published. This article describes a third case demonstrating the significance of this interaction. This was potentially devastating for the patient who required an extended psychiatric admission. The enzyme induction was so potent that the dose of clozapine had to be increased approximately sixfold. Careful management of this significant interaction is essential for effective patient care.
Antipsychotic drug treatment can potentially lead to adverse events such as leukopenia and neutropenia. Although these events are rare, they represent serious and life-threatening hematological side effects.
To compare objective and subjective weight gain of second-generation antipsychotics in schizophrenia and bipolar disorder. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The primary objective of this study was to investigate whether the choice and dosage of antipsychotic medication differ between patients with schizophrenia starting treatment in an inpatient or outpatient unit. In addition, we investigated whether the reason for the introduction of new antipsychotic medication had an impact on the treatment setting and whether the use of benzodiazepines differed between inpatients and outpatients. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Second-generation antipsychotics are commonly prescribed for pediatric patients with schizophrenia and schizophrenia spectrum disorders despite their lack of approval for use in children. Although considered a safer alternative to first-generation antipsychotics, there is evidence to suggest that second-generation antipsychotics may be associated with some adverse events as well as an increase in prolactin levels. The purpose of this review is to examine the risk of prolactin-related adverse events in pediatric patients using antipsychotics and to quantify changes in prolactin for this population.
This study aimed to compare (1) the detection rates of antipsychotic-associated side effects between clinician and patient ratings and (2) differences as a function of change and absolute score definitions. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Pain is a common symptom in patients with depressive disorders, which, if present, worsens the prognosis. However, there is little empirical knowledge of the therapeutic effects of antidepressants on painful physical symptoms of patients with depressive disorders. Furthermore, tricyclic/tetracyclic antidepressants (TCAs) have not yet been included in existing meta-analyses. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Although the precise drug mechanism of action of acamprosate remains unclear, its antidipsotropic effect is mediated in part through glutamatergic neurotransmission. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Letter. Prevalence of Selective Serotonin Reuptake Inhibitor–Related Apathy in Patients With Obsessive Compulsive Disorder. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Suzanne Dash on a meta-analysis of CBT and antidepressants for depression that looked at negative & positive responses and what predicted different outcomes
Many patients with bipolar disorder are reaching old age, but whether they are receiving evidence-based psychotropic treatment remains unclear. Our objective was to describe current psychotropic prescribing patterns in a large Canadian late-life bipolar sample. 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.
We found 115 studies through surveillance of this guideline.
This included new evidence on patient involvement in decisions about medicines, supporting adherence and reviewing medicines that supports current recommendations. We asked topic experts whether this new evidence would affect current recommendations on NICE guideline CG76. Generally, the topic experts thought that an update was not needed.
We did not find any new evidence on communication between health professionals.
None of the new evidence considered in surveillance of this guideline was thought to have an effect on current recommendations.
In addition, no major ongoing studies or research due to be published in the next 3–5 years was identified.
Our study confirms an association between aripiprazole, pramipexole, or ropinirole and impulse control disorder and gambling disorder. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Recently, clinical guidelines about treatment of mania have been published by important scientific societies.1 Atypical antipsychotic adjunctive therapy to lithium or valproate is effective in treating acute mania; however, antipsychotics should not be continued unless the benefits of reducing relapse outweigh the risks such as weight gain and metabolic syndrome.2 So far, there is no high-quality evidence for such beneficial duration of the therapy. The study by Yatham and colleagues aimed to determine the efficacy of different durations (24 and 52 weeks) of atypical antipsychotic adjunctive therapy to mood stabiliser versus discontinuing the atypical antipsychotic at study entry, in the prevention … To read the full article, log in using your NHS OpenAthens details.
Open-label trials suggest that escitalopram (up to 20 mg/d) is an effective treatment for some, but not all posttraumatic stress disorder (PTSD) patients. Higher doses of escitalopram effectively reduced major depression symptoms in patients who had not responded to regular doses. The current study examines the efficacy, tolerability, and adherence to high-dose escitalopram in PTSD. SSSFT staff can use the OVID link, or you can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Pharmacological treatments for agitation and aggression in patients with Alzheimer’s disease have shown limited efficacy. The authors assessed the heterogeneity of response to citalopram in the Citalopram for Agitation in Alzheimer Disease (CitAD) study to identify individuals who may be helped or harmed. Login at top right hand side of page using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library