Laurence Palfreyman summarises 3 recent Cochrane reviews, which investigate high-potency versus low-potency first-generation antipsychotic drugs for schizophrenia. The reviews find little difference in efficacy between the high-potency antipsychotics Trifluoperazine, Haloperidol, Fluphenazine, and low-potency typical antipsychotics.
[read the full story...]Statins have no beneficial effect on cognition in dementia, but can cause serious side-effects
This updated Cochrane review on statins for the treatment of dementia contains worrying adverse effects data, but Caroline Struthers has to do a significant amount of digging to root it all out.
[read the full story...]The adverse effects of psychiatric drugs and emergency department visits
A new study finds that psychiatric medications are implicated in many adverse drug events treated in US emergency departments. Nearly 1 in 10 of all adverse drug event visits to emergency departments are due to psychiatric drugs, including antidepressants, antipsychotics, lithium salts, sedatives, anxiolytics and stimulants.
[read the full story...]Psychotherapy trials should report the side effects of treatment
If a treatment is powerful enough to have a good effect, then it’s powerful enough to have a bad effect. This is well recognised when it comes to medication, with strict regulations in place to ensure adverse outcomes are monitored and measured. By contrast, psychotherapy has never been as readily associated with the potential to [read the full story…]
Ketamine for severe depression: what can we conclude from a small open label study?
Last week the media reported widely on a study of ketamine for depression (McShane et al, 2014). As usual the headlines made bold assertions, the Telegraph running with “Horse tranquilliser Ketamine could cure severe depression” (Knapton, 2014). But what did the paper authored by an Oxford group and published in the Journal of Psychopharmacology really [read the full story…]
Little differences among antidepressants regarding sexual dysfunction, but bupropion performs best
Antidepressant treatment is associated with a variety of side effects, including emotional changes, weight gain or fatigue. As pharmaceutical treatment has evolved, clinicians have become increasingly aware of another major adverse effect of modern antidepressants: sexual dysfunction. Current figures estimate that up to every second patient will, at some stage, experience reduced sexual function, which [read the full story…]
Cochrane review finds that haloperidol is an effective antipsychotic, but its side effects can be problematic
Schizophrenia is a serious disorder characterised by delusions (including paranoid beliefs and hallucinations) and other symptoms such as blunted affect and reduced motivation. While relatively uncommon (lifetime prevalence is less than 1%), it is associated with serious social impairment (e.g., unemployment, homelessness), which in turn can result in physical health problems. As a result, the [read the full story…]
Atypical antipsychotics no better than typicals for adolescents with psychosis, but atypicals may have fewer short-term side effects
Schizophrenia is a serious neurodevelopmental disorder that often starts during adolescence. Current treatment guidelines (NICE, 2013) recommend atypical antipsychotics for adolescents with this condition, but this is based largely on studies of adults with the condition. The Cochrane Schizophrenia Group conducted this systematic review to synthesise the current evidence base for atypical antipsychotic medication in [read the full story…]
Varenicline, smoking cessation and neuropsychiatric adverse events
Varenicline is a prescription drug to help people stop smoking that works by stimulating the nicotine receptors in the brain to reduce cravings and decrease the pleasure that results from smoking. Quit attempts aided by varenicline are up to 2-3 times more successful than those without (Cahill et al 2009 and 2012). However, following the [read the full story…]
Atomoxetine for adult ADHD: the harms outweigh the benefits, according to new systematic review
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental neurological condition affecting functioning in a number of domains, but in particular, the ability to focus and concentrate, and regulate activity levels. This is a common disorder with 2.5-4.0% of adults meeting diagnostic criteria for ADHD (Fayyad et al, 2007), and this condition has significant impact on a persons [read the full story…]