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…]
Functional analysis may be a promising alternative treatment for challenging behaviour in dementia
Mood, memory and behaviour are all affected by dementia and it is not unusual for behaviour to become ‘challenging’. People with dementia may become agitated or aggressive and this can be extremely difficult and stressful for family members and carers. Challenging behaviour has traditionally been managed with antipsychotic drugs, despite the fact that they do [read the full story…]
When is it appropriate to prescribe antipsychotics to treat the behavioural and psychological symptoms of dementia?
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…]
No evidence for the use of aspirin, steroids or NSAIDs for the treatment of Alzheimer’s disease
Alzheimer’s disease affects 1-2% of people aged 65-70 and approximately 20% of those over 80 years. As our population ages, the condition is on the increase and it’s estimated that 2030, an estimated 7.7 million Americans aged 65 and older will have Alzheimer’s disease. We do not yet know exactly how and why Alzheimer’s disease [read the full story…]
No good quality research to guide the treatment of late-onset schizophrenia
Late-onset schizophrenia is relatively common. Onset after the age of 40 years is reported in 23% of patients hospitalised with schizophrenia. The condition is different from early-onset schizophrenia on a number of counts, including the response to antipsychotic drugs. This Cochrane review set out to assess the effects of antipsychotic drugs for elderly people with [read the full story…]
New guides to help GPs commission mental health services
The Joint Commissioning Panel for Mental Health (JCP-MH) have published the first of their guides aimed at GPs who will soon be commissioning mental health services. Each of the guides provide a description of what a ‘good’ service configuration should look like, and brings together scientific evidence, service user and carer experience, and case studies [read the full story…]
Antidepressants may be less effective in older patients with depression, according to new meta-analysis
Following on from my post yesterday about screening tools for depression in later life, here is a new meta-analysis that explores the efficacy of antidepressants for the treatment of major depressive disorder (MDD) in patients aged ≥ 55 years. The researchers from the University of Modena and Reggio Emilia in Italy just searched PubMed for [read the full story…]
The Geriatric Depression Scale is the best screening tool for depression in older people in acute hospital settings
Depression often occurs in later life and people in poor physical condition tend to be more susceptible than others. Older people in hospital who get depressed have poorer outcomes, so it’s important that we know how to detect depression and manage it in the acute setting. This systematic review conducted by researchers in Swansea set [read the full story…]
Memantine is not an effective treatment for dementia in people with Down’s syndrome, according to new RCT
People with Down’s syndrome are more likely to develop dementia than others and one in three will have the illness as early as in their 50s. Despite this high prevalence, there is very little reliable research about drug treatments for this population. This small randomised controlled trial (funded by the drug company Lundbeck) aimed to [read the full story…]
New report from the Alzheimer’s Society makes recommendations for the commissioning of dementia services
Mental health commissioners will be interested in this new report from the Alzheimer’s Society and MHP Health Mandate, that was published just before Christmas. It follows on from the publication of the Department of Health’s Dementia Commissioning Pack back in July 2011. The report looks at the current policy landscape and how it relates to [read the full story…]