Cutting across diagnostic categories: Does stimulant medication improve ADHD symptoms in children with autism spectrum disorder?

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Until fairly recently, it was thought that autism spectrum disorder (ASD; previously known as PDD or pervasive developmental disorder) and attention deficit hyperactivity disorder (ADHD) were two entirely separate childhood-onset conditions and that they could not both be diagnosed in one individual. Numerous studies in the last decade have shown that, in reality, a number of [read the full story…]

Do antipsychotics cause progressive brain changes in schizophrenia?

People with schizophrenia taking antipsychotics saw a reduction in grey matter

For over 30 years researchers have found that people with a diagnosis of schizophrenia have, on average, differences on brain scans compared to people without.  Not everybody with a diagnosis of schizophrenia will have these differences and it has not yet been possible to use brain scanning as a test to work out whether someone [read the full story…]

Cochrane review says there’s insufficient evidence to tell whether fluoxetine is better or worse than other treatments for depression

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Depression is common in primary care and associated with a substantial personal, social and societal burden. There is considerable ongoing controversy regarding whether antidepressant pharmacotherapy works and, in particular, for whom. One widely-prescribed antidepressant is fluoxetine (Prozac), an antidepressant of the selective serotonin reuptake inhibitors (SSRI) class. Although a number of more recent antidepressants are [read the full story…]

Atypical antipsychotics can lead to weight gain in children and adolescents, but more evidence needed about metabolic side effects

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Atypical (second-generation) antipsychotics are used to treat a variety of psychiatric conditions. Although they have fewer side effects than first-generation antipsychotics, weight gain and other metabolic problems (such as high blood pressure and diabetes) remain common side effects of taking atypical antipsychotic medication (Mind, 2012). The Mental Elf has previously blogged about a Canadian report [read the full story…]

Tricyclic antidepressants are associated with higher risk of bone fracture

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While most people would likely associate tricyclic antidepressants (TCAs) with more common adverse effects such as dry mouth, sedation and constipation, there is some evidence to suggest increased occurrence of bone fractures (Vestergaard, Rejnmark, & Mosekilde, 2006). However, the topic remains controversial and conflicting results about the association of TCAs and fracture risk abound (e.g. [read the full story…]

New Cochrane review provides strategies for managing sexual dysfunction brought on by antidepressants

Sexual dysfunction

One of the major complaints of people on antidepressant medication is the effect it has on their sex lives. It does this in three main ways – it affects sexual desire, the ability to achieve and sustain an erection in men and alters the sensation of orgasms and ejaculation. These side effects are one of [read the full story…]

Cochrane review finds quetiapine is equivalent in efficacy to typical antipsychotics and possibly causes fewer side effects

Antipsychotic medication is the standard treatment for schizophrenia and psychosis in the UK.  Given that psychosis is commonly a chronic condition and therefore that medication used to treat it often needs to be taken for several years, getting the medication “right” is important. As I mentioned in my first blog post for the Mental Elf, [read the full story…]

SSRIs and TCAs are equally effective at treating chronic depression, but SSRIs have fewer side effects

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Major depression all too often develops a chronic course, with every episode making future relapse more likely (Gilmer et al., 2005). Dysthymic disorders represent a less severe, but more persistent form of depression lasting for at least two years. In the affective disorder spectrum, chronic forms are unsurprisingly associated with greater functional impairment and overall [read the full story…]

Atypical antipsychotics don’t improve quality of life in treatment-resistant depression

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SSRIs are usually considered first-line treatment against major depression and approximately 50% of patients achieve remission with the drug they try first (Steffens, Krishnan, & Helms, 1997). However, every eighth case proves to be treatment-resistant and does not respond to standard antidepressant treatment at all. As a last resort, second-generation antipsychotics (SGAs) effective in schizophreniform [read the full story…]

Old side effects and old drugs; old side effects and new drugs

Pill

People using antipsychotic drugs like chlorpromazine and haloperidol get [anticholinergic] side effects such as blurred vision, dry mouth and constipation but the proportion of people experiencing these is not clear. Past surveys are very old indeed, small and not really proper surveys at all. Their results had been perpetuated for decades without verification. They were [read the full story…]