Antipsychotics continue to be used for challenging behaviour in learning disabilities with poor monitoring of side effects

Medication

People with learning disabilities are often prescribed anti-psychotic medication, whether or not there has been a diagnosis of psychiatric disorder. There continues to be some concern about the evidence base to support this. The most recent Cochrane review which looked at the issue in relation to people with learning disabilities and schizophrenia found that there is [read the full story…]

Paliperidone palmitate injections for schizophrenia: new Cochrane systematic review

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We know that people with schizophrenia who adhere to their treatment are more likely to experience sustained periods of time without psychotic symptoms. However, lots of patients find it hard to stick to the prescribed medication, so doctors sometimes recommend alternative treatments to try and encourage adherence. Long-acting intramuscular injections are one option available to [read the full story…]

Drug and talking treatments can reduce violent behaviour in mental health and criminal populations, but more research is needed

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Studies show that over 1.6 million people are killed as a result of violence each year and it is thought that this estimate is considerably less than the actual number who die from assaults. Violence in inpatient hospital settings and emergency departments is the subject of a NICE guideline that is currently being updated. A [read the full story…]

Extrapyramidal side effects from second-generation antipsychotic drugs: new systematic review

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The newer second-generation antipsychotic drugs (Risperidone, Quetiapine, Amisulpride, Aripiprazole, Clozapine, Olanzapine) are promoted because they have a lower risk of extrapyramidal side effects than older drugs. Drug companies often promote these newer drugs as virtually free from extrapyramidal side effects, but the patients who take them and the clinicians who prescribe them often don’t agree. [read the full story…]

Antipsychotic drugs reduce the rate of relapse in patients with schizophrenia at 1 year, according to new systematic review

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There is an enormous body of research concerned with schizophrenia and the use of antipsychotic drugs. A quick search on PubMed for ‘schizophrenia, antipsychotics and randomised controlled trials’ brings back nearly 2,000 articles! The authors of a new systematic review and meta analysis published today in the Lancet, suggest that one area that has not [read the full story…]

Young people with psychotic symptoms should be offered CBT before antipsychotics, according to new RCT

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Antipsychotic drugs are currently prescribed to a significant proportion of young people who are diagnosed with psychosis. Past research has estimated that up to half of people at risk of developing psychosis at a young age will progress to a full blown psychotic illness such as schizophrenia. A new landmark randomised controlled trial has been [read the full story…]

Comparative risks of antipsychotics amongst nursing home residents with dementia

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Regular readers may recall previous blogs where I have written about the dangers associated with antipsychotic drugs in elderly patients. Many of you have responded simply and emotionally on Twitter by saying: “Stop prescribing these drugs!” Others have recognised that the issue is far from clear cut as a fair proportion of patients do have [read the full story…]

Well conducted studies are urgently needed to assess the adverse effects of antipsychotics in children and young people

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There is a great deal of debate about prescribing antipsychotics to children and young people. Prescription rates of these drugs has risen sharply over the last few years, but there remains only limited evidence about the safety and efficacy of these medicines. The second-generation antipsychotics (SGAs) have become more popular and this is partly due [read the full story…]

Preventing and managing violence in mental health and criminal justice populations: results of a new systematic review

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The public perception of mental health and violent behaviour has often been influenced by poor media coverage and a focus on specific crimes committed by people with psychosis. There’s a nice summary of work in this area on the Mind website, which includes a number of enlightening stats, including this one: The fear of random [read the full story…]

When is it appropriate to prescribe antipsychotics to treat the behavioural and psychological symptoms of dementia?

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This topic has been well publicised in recent years and for good reason. We know that there is a huge disparity between the number of people with dementia who are prescribed antipsychotics (180,000 in England each year) and the number who may derive some benefit from the treatment (36,000). We also know that dangerous side [read the full story…]