A study of previous data suggests the commonly used antidepressant paroxetine may increase the risk of defects by around a quarter.
The researchers pooled data from 23 studies which compared women who took paroxetine during the first three months of their pregnancy, with women who did not. It found that the small overall risk of birth defects was 23% higher. This takes the overall risk to approximately 3.69% for women who had taken paroxetine at this time.
Based on the type of studies included, we cannot be sure the effect was due to the drug or other factors, such as the woman's depression or other factors linked to it.
ABSTRACT FROM: Shin JY, Park MJ, Lee SH, et al. Risk of intracranial haemorrhage in antidepressant users with concurrent use of non-steroidal anti-inflammatory drugs: nationwide propensity score matched study. BMJ 2015;351:h3517. To read the full commentary, log in using your NHS OpenAthens details
Open access. Epilepsy is a serious condition which can profoundly affect an individual’s life. While there is some evidence to suggest an association between antidepressant use and epilepsy and seizures it is conflicting and not conclusive. Antidepressant prescribing is rising in the UK so it is important to quantify absolute risks with individual antidepressants to enable shared decision making with patients. In this study we assess and quantify the association between antidepressant treatment and the risk of epilepsy and seizures in a large cohort of patients diagnosed with depression aged between 20 and 64 years.
Antipsychotic medications, especially second-generation antipsychotics, have increasingly been prescribed to children under age 18 in the United States. They are approved to treat pediatric bipolar and psychotic disorders and aggressive behaviors among patients with autism, but they are often used off label to control disruptive behaviors of children without autism and treat mood problems of children without bipolar disorder.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
Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
There have been hints from previous literature that antidepressants taken by pregnant women may have an effect on fetal brain development, and specifically may predispose to autistic spectrum disorder (ASD). Researchers in Quebec used a registry covering the Province's entire population to try and establish whether such a link exists (Boukhris T, et al. JAMA Peds 2015. doi:10.1001/jamapediatrics.2015.3356). They identified over 145 000 infants born between 1998 and 2009, in whom they could analyse data on prescribing antidepressant drugs immediately before or during pregnancy. …..To read the full article, log in using your NHS OpenAthens details
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
19 January, 2016: The number of prescriptions dispensed in England for approved medicines (2) to treat Alzheimer's increased from 502,000 (3) in 2004 to 3.0 million in 2014. The cost to the NHS of prescriptions (4) for Alzheimer's disease medicines dispensed in primary care stood at £45.7m in 2014. This was up from £42.8m in 2004, but down from the high point it reached in 2011 of £110.8m (5).
The Cochrane Collaboration, known for their high-quality reviews and meta-analyses, recently published a systematic review of the efficacy of lithium as used to treat schizophrenia (Leucht et al, 2015).
Open access. Conclusion: The results clearly show that after one year of treatment with risperidone LAI, RSWG-remitted patients have a high level of global functioning, which is significantly higher than in stable, non-remitted patients. Social functioning was also higher in remitted patients as compared with stable, non-remitted patients.
Medication reconciliation (‘med rec’, as it is often called) refers to the ‘process of identifying the most accurate list of all medications a patient is taking … and using this list to provide correct medications for patients anywhere within the health system’.1 Two recent systematic reviews summarised the evidence for med rec interventions, finding that several med rec interventions reduced medication history errors and errors in patients’ admission and discharge medication regimens.2 ,3.....To read the full article, log in using your NHS OpenAthens details
A review of clinical study reports compiled by drug companies also suggests that risks may have been under-reported. Clinical study reports usually have more detail than the summaries of published trial results.
Researchers analysed 70 studies which looked at five antidepressants.
They looked specifically at the reports of deaths, suicides, suicidal thinking or suicide attempts, aggression, and a type of extreme restlessness called akathisia.
The results showed that children taking antidepressants had a higher chance of suicidal thoughts or suicide attempts, and of aggression. None of the children in the studied died. Adults in the studies did not have an increased risk of these problems.
A private member’s bill that would encourage UK doctors to try innovative treatments and consider the off-label use of drugs has passed its Commons stages with government support, and will go to the House of Lords. To read the full article, log in using your NHS Athens
Nearly one in 10 younger adults given antidepressants for depression or anxiety may have unrecognised bipolar disorder, a UK primary care study has shown. To read the full article, log in using your NHS Athens
Objective To explore medication-related burden (MRB) and patients’ lived experience with medicines (PLEM) without regard to particular medication therapies or medical conditions. Open Access Article
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Editorial. 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
Editorial. 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
Previous trials have shown that in patients that do not improve, adjunctive treatment with aripiprazole (an atypical antipsychotic) is more effective than stand-alone treatment with antidepressants (Steffens D, 2011). There is a gap in the information available regarding augmentation in late life depression in older adults (Dew M. et al, 2007).
Owing to this lack of evidence for clinicians, Lenze and colleagues (2015) developed a randomised, double blind, placebo-controlled trial (the first of its kind) that proposed the addition of aripiprazole would:
Be associated with higher remission probability rate than placebo
Greater improvement of depressive symptoms
Resolution of suicidal ideation
Better stability than placebo
But may lead to increased risk of akathisia
Nursing and medical staff recorded the time it took to prescribe and administer medication electronically and in paper form. A structured questionnaire was used to assess staff experience and attitudes to e-prescribing after the pilot had ended. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
Two £25 vouchers are up for grabs in the library’s ‘Making the Most of Information’ survey.
To take part, just visit http://goo.gl/AdN4ok by Friday 19th February.
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
Library Services do not currently have access to this journal, but you can request a copy of the article online and we will try to get a copy to you: http://bit.ly/1Xyazai
Major depressive disorder has been associated with dysregulation of the endogenous opioid system. The authors sought to determine whether opioid modulation achieved through administration of ALKS 5461, a combination of a μ- and κ-opioid partial agonist, buprenorphine, and a μ-opioid antagonist, samidorphan, would exhibit antidepressant activity in patients with major depression. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
In February 2016, we updated this guideline to link to the Medicines and Healthcare Products Regulatory Agency’s (MHRA) toolkit to ensure female patients are better informed about the risks of taking valproate during pregnancy.
This important paper (Sharma et al, 2016) has rightly made the headlines. Dedicated work by a team of committed researchers overcame resistance from the European Medicines Agency and pharmaceutical companies. There are numerous concerns about the safety of antidepressants particularly in children and young people.
Key results
We found no evidence of benefit of the interventions with respect to reducing adverse drug events (harmful effects caused by medicines) or death. One study led to residents having fewer days in hospital; however, the majority of studies did not show a benefit in relation to reducing hospital admissions. One study led to a slower decline in health-related quality of life. Problems relating to medicines were found and addressed through the interventions used in the studies. Prescribing was improved based on criteria used to assess the appropriateness of prescribing in five studies.
An international consortium of scientists has identified a stretch of chromosome that is associated with responsiveness to the mood-stabilizing medication lithium among patients with bipolar disorder. While the finding won’t have an immediate clinical application, it is a groundbreaking demonstration of the potential for identifying genetic information that can be used to inform personalized treatment decisions, even in genetically complex disorders. The genes identified are also an avenue for understanding the biology of the lithium response.
There have been hints from previous literature that antidepressants taken by pregnant women may have an effect on fetal brain development, and specifically may predispose to autistic spectrum disorder (ASD). Researchers in Quebec used a registry covering the Province's entire population to try and establish whether such a link exists (Boukhris T, et al. JAMA Peds 2015. doi:10.1001/jamapediatrics.2015.3356). To read the full article, log in using your NHS Athens
What are the implications for practice?
We think our study highlights the complicated internal struggles that people with first episode psychosis have with medication.
Our study highlights how Nurses and Doctors need to try and better understand what it is like to take these drugs and work collaboratively with patients to support them to make informed choices about treatment. Login using your SSSFT NHS Athens for full text. SSOTP - request a copy of the article from the library http://www.sssft.nhs.uk/library
In this article, we focus on the emerging evidence in pharmacogenetics and biomarkers for assessing individual response and tolerability of antipsychotic medication in schizophrenia. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
The objectives of this study were to describe the use of psychotropic drugs among home-dwelling people with mild dementia, to identify potentially inappropriate medications (PIM) and drug–drug interactions (DDI), and to analyze potential variables associated with having PIM and DDI. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - www.sssft.nhs.uk/library
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.
To evaluate the risk of suicide attempts by antidepressant drug class and the presence or absence of depression. Library Services do not currently have access to this journal through this site, but you can request a copy of the article online and we will get a copy to you: http://bit.ly/1Xyazai
potentially inappropriate prescribing (PIP) in older hospitalised patients, and in particular those with dementia, is associated with poorer health outcomes. PIP reduction is therefore essential in this population. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Adherence to medicines has been identified as a key issue by the Royal Pharmaceutical Society of Great Britain,1 the WHO2 and, most recently, by the UK Academy of Medical Sciences.3 Estimates of adherence vary widely but are often reported to be as low as 50%.4 When a patient does not take their prescribed medicines as intended, they may not derive the expected outcomes. As well as implications for the individual patient, this can result in increased costs associated with patient hospitalisations or avoidable escalation in other costs of care.3 It may also result in unused medicines, the cost of which is estimated at £300 million per year in England alone.3 To read the full article, log in using your NHS OpenAthens details
NHS England has today launched the world’s largest healthcare incentive scheme for hospitals, family doctors and other health service providers to prevent the growing problem of antibiotic resistance.
Launched against the backdrop of the International Patient Safety Conference taking place at Lancaster House in London today, funding will be made available to hospitals and other providers that reduce the inappropriate use of antibiotics.
Open access. Safe and effective paediatric pharmacotherapy requires careful evaluation of the type of drug substance, the necessary dose and the age-appropriateness of the formulation. Generally, the younger the child, the more the attention that is required. For decades, there has been a general lack of (authorised) formulations that children are able to and willing to take. Moreover, little was known on the impact of pharmaceutical aspects on the age-appropriateness of a paediatric medicine. As a result of legislative incentives, such knowledge is increasingly becoming available
Debate surrounding assisted outpatient treatment has mostly focused on issues of due process, cost-effectiveness, and efficacy as measured by readmission and incarceration rates. Less attention has been paid to whether long-term use of antipsychotic treatment is supported by sufficient evidence to warrant its compulsory use in assisted outpatient treatment programs. The authors examine the rationale and evidence for long-term use of antipsychotics, noting the pervasive belief within the psychiatric community that psychotic illness, especially schizophrenia, requires lifelong medication. They argue that although antipsychotics are clearly indicated for patients in the acute phase of psychotic illness, the evidence for long-term use is less convincing and may not justify compulsory long-term use. 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://bit.ly/1Xyazai
The term “deprescribing,” initially coined in geriatric medicine, describes a process of pharmacologic regimen optimization through reduction or cessation of medications for which benefits no longer outweigh risks. Burgeoning rates of polypharmacy, growing appreciation of long-term adverse effects, and a focus on patient-centered practice present specific indications for deprescribing in psychiatry. A strong therapeutic alliance, appropriate timing, and consideration of the meaning of medication for the patient must accompany the following established elements: review of all medications, identification of medications that could be ceased or reduced, collaborative planning of the deprescribing regimen, and provision of review and support to the patient and caregivers. The authors discuss how deprescribing might be adapted for and implemented in psychiatry, identify potential barriers, and make recommendations for future directions. 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://bit.ly/1Xyazai
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.
Ageing—along with its associated physiological and pathological changes—places individuals at a higher risk of multimorbidity and treatment-related complications. Today, polypharmacy, a common and important problem related to drug use, occurs subsequent to this multimorbidity in the elderly in all populations. In recent decades, several scientific investigations have studied polypharmacy and its correlates, using different approaches and definitions, and their results have been inconclusive. Differences in definitions and approaches in these studies form a barrier against reaching a conclusion regarding the risk factors and consequences of polypharmacy. It is therefore imperative to establish an appropriate definition of polypharmacy. To read the full article, log in using your NHS OpenAthens details
This review found no difference in effectiveness or drop-out rates between antidepressants and cognitive behavioural therapy for adults recently diagnosed with major depressive disorder. Both treatments should be offered, as recommended by NICE, either alone or possibly in combination, and the final decision will rely heavily on the patient’s preference.
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.
Ketamine, an N-methyl-d-aspartate glutamate receptor antagonist, has demonstrated a rapid-onset antidepressant effect in patients with treatment-resistant depression. This study evaluated the efficacy of twice- and thrice-weekly intravenous administration of ketamine in sustaining initial antidepressant effects in patients with treatment-resistant depression. 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://bit.ly/1Xyazai
The effectiveness, side-effect profiles, and numerous other characteristics of antipsychotic medications have been extensively studied. However, the majority of publications do not address the many potential sex differences in efficacy and doses of medications, as well as other sex-specific considerations. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Poor adherence to medication in schizophrenia spectrum disorders leads to inadequate symptom control. Adherence therapy (AT) is an intervention that seeks to reduce patients’ psychiatric symptoms by enhancing treatment adherence. We aimed to systematically review the trial evidence of the effectiveness of AT on improving clinical outcomes in these patients.
This guideline covers systems and processes for using and managing controlled drugs safely in all NHS settings except care homes. It aims to improve working practices to comply with legislation and have robust governance arrangements. It also aims to reduce the safety risks associated with controlled drugs.
Despite evidence for their comparable efficacy, psychotherapy faces a dramatic decline relative to pharmacotherapy in psychiatry. A deep ideological reason for this decline centres on the belief that psychotherapy is a psychosocial treatment whereas pharmacotherapy is a biological treatment. Modern cognitive neuroscience demonstrates that this distinction is a myth.Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
To compare the safety and effectiveness of antidepressant v. mood stabiliser monotherapy for bipolar type II major depressive episodes. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
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.
People with intellectual disability experience high rates of mental disorders and challenging behaviour, but representative data are hard to obtain for this population. Concerns have previously been raised about the difficulty this group experience in accessing quality mental health services1 and the morbidity associated with high rates of psychotropic drug prescription.2 General practitioners (GPs) are pivotal in provision of mental healthcare and representative data from this setting has the capacity to inform the epidemiology of mental disorders and the psychotropic drug burden for people with intellectual disability. To read the full article, log in using your NHS OpenAthens details
Despite the availability of different antipsychotics for the treatment of schizophrenia, in clinical practice it is somewhat of a struggle to identify an antipsychotic medication for individual patients that they are willing to adhere to. Brexpiprazole is a new molecular entity that is a dopamine receptor partial agonist that differs from aripiprazole in terms of greater potency at serotonin 5-HT1A receptors and less intrinsic activity at dopamine D2 receptors.1 Brexpiprazole received approval in the USA for the treatment of schizophrenia in July 2015......To read the full article, log in using your NHS OpenAthens details
Several strategies have been proposed for patients with treatment-resistant depression (TRD), including dose optimisation, switching to another therapeutic class or combination/augmentation regimens,1 however, it is still not known how the different strategies compare with each other. Zhou and colleagues specifically examined augmentation strategies for efficacy and acceptability in a network meta-analysis of randomised controlled trials (RCTs). To read the full article, log in using your NHS OpenAthens details
Appropriate use of antipsychotic medications for people experiencing early episode psychosis is critical for symptom control and for shaping attitudes towards medication as a support to recovery.1 Risperidone is an effective medication in treating early episode psychosis2 and long-acting injectable risperidone may increase early (12-week) adherence rates.3 However, long-acting medications are rarely used following a first episode of schizophrenia4 and the aim of the present study was to compare the clinical efficacy of the long-acting injectable formulation of risperidone with the oral formulation in the early course of schizophrenia. To read the full article, log in using your NHS OpenAthens details
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
Approximately one-third of patients with major depressive disorder (MDD) do not respond to existing antidepressants, and those who do generally take weeks to months to achieve a significant effect. There is a clear unmet need for rapidly acting and more efficacious treatments. We will review recent developments in the study of ketamine, an old anaesthetic agent which has shown significant promise as a rapidly acting antidepressant in treatment-resistant patients with unipolar MDD, focusing on clinically important aspects such as dose, route of administration and duration of effect. To read the full article, log in using your NHS OpenAthens details
Several observational studies have been conducted on the use of selective serotonin reuptake inhibitors (SSRIs) in pregnancy and the risk of congenital malformations, providing conflicting results.1 Conflicting results among studies can be easily explained by methodological shortcomings that are often inherent to the clinical setting.2 For instance, since the outcomes are very rare, aggregate end points (ie, clusters of birth defects that may affect different organs and systems) are usually employed when the sample does not have sufficient power to detect an association. Likewise, aggregate exposures (ie, an entire drug class, such as SSRIs) can be adopted.............To read the full article, log in using your NHS OpenAthens details
To investigate whether psychotropics are associated with an increased risk of fall injuries, hospitalizations, and mortality in a large general population of older adults. Login using your SSSFT NHS OpenAthens for full text. SSOTP - request a copy of the article from the library - http://bit.ly/1Xyazai
Hypersalivation is a frequent, disturbing, and uncomfortable adverse effect of clozapine therapy that frequently leads to noncompliance. The aim of this study was to examine the efficacy of metoclopramide (dopamine D2 antagonist, antiemetic medication) as an option for management of hypersalivation associated with clozapine (HAC). Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Oral and long-acting injectable second-generation antipsychotics are known to be associated with a high risk of metabolic adverse effects. Together with other drug treatments, poor lifestyle choices, and genetic liability, they contribute to development of metabolic syndrome (MetS), which occurs in nearly one third of patients with schizophrenia.
The primary objective of this multicenter prospective observational study was to explore the prevalence of MetS in a sample of 60 real-world patients treated with paliperidone palmitate (PP) over a period of 12 months. The secondary objectives were to assess other tolerability aspects and the efficacy of PP on schizophrenic symptoms. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
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
Adherence to treatment is one of the most consistent factors associated with a favorable addiction treatment outcome. Little is known about factors associated with treatment adherence in individuals affected with comorbid attention-deficit/hyperactivity disorder and substance use disorders (SUD). This study aimed to explore whether treatment-associated factors, such as the prescribing physician's (sub)specialty and methylphenidate (MPH) dose, or patient-related factors, such as sex, age, SUD subtype, and psychiatric comorbidity, were associated with adherence to MPH treatment.
This review examined the safety of second-generation antipsychotics (SGAs) in exposed breastfed infants. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Patients with schizophrenia experience higher rates of obesity and related morbidity and mortality than the general population does. Given preclinical studies revealing the role of histamine H1 receptor in human eating behavior, and the potential of olanzapine to block with this system, we hypothesized that histamine H1 receptor agonists may be beneficial in reducing antipsychotic-associated weight gain. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
This prospective 12-week open-label trial evaluates the tolerability and efficacy of memantine hydrochloride for the treatment of core social and cognitive deficits in adults with high-functioning autism spectrum disorder (ASD). Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
The aim of this study was to conduct a systematic review of literature to retrieve all randomized controlled trials that evaluated the efficacy of tamoxifen on manic mood episodes and meta-analyze their quantitative results. Please contact the library to receive a copy of this article - http://bit.ly/1Xyazai
Most depression among older adults is treated in primary care, and many patients do not adhere to medication treatment. The U.S. Department of Veterans Affairs (VA) has recently introduced initiatives to address such treatment gaps. This study examined patient-reported antidepressant nonadherence during the acute treatment period (first four months after a prescription) and identified predictors of nonadherence in a sample of older veterans. 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://bit.ly/1Xyazai