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NEWS - Psychiatry

Antidepressants for treating depression in dementia – Cochrane Library (free for a limited period)

Summary: Antidepressants for treating depression in dementia – Cochrane Library (free)

“On the only measure of efficacy for which we had high-quality evidence (depression rating scale scores), antidepressants showed little or no effect.”

 


Antidepressant Withdrawal Syndrome – Therapeutics Initiative (free)

Related Perspective: Many People Taking Antidepressants Discover They Cannot Quit – The New York Times (10 articles per month are free)

“Antidepressants should be added to the list of drugs associated with tolerance, dependence and a withdrawal syndrome.”

“Withdrawal symptoms occur in at least one-third of patients who stop.”

 


Opinion: Endless Gaming May Be a Bad Habit. That Doesn’t Make It a Mental Illness – The New York Times (10 articles per month are free)

Related: Gaming addiction as a mental disorder: it’s premature to pathologise players – The Conversation (free)

“The World Health Organization has made “internet gaming” a diagnosable disorder. But many experts aren’t even sure it exists”.

 


Association of Antidepressant Use With Drug-Related Extrapyramidal Symptoms: A Pharmacoepidemiological Study – Journal of Clinical Psychopharmacology (link to abstract – $ for full-text)

Commentaries: Incidence of Extrapyramidal Symptoms Higher With Certain Antidepressants – MPR (free) AND Antidepressants tied to Parkinson’s-like symptoms – Univadis (free registration required)

“Observational study: Incidence of EPSs with antidepressants. RRs: duloxetine, 5.68; mirtazapine, 3.78; citalopram, 3.47; escitalopram, 3.23; paroxetine, 3.07; sertraline, 2.57; venlafaxine, 2.37; bupropion, 2.31; and fluoxetine, 2.03 (all significant)” (via @psychopharmacol see Tweet)

 


Association of Hypertensive Disorders of Pregnancy With Risk of Neurodevelopmental Disorders in Offspring: A Systematic Review and Meta-analysis – JAMA Psychiatry (free for a limited period)

Commentary: Hypertension in Pregnancy Tied to Autism, ADHD – MedPage Today (free registration required)

“Researchers call for greater pediatric surveillance of infants in hypertensive moms” (from MedPage Today)

 


Mental Health ATLAS 2017 – World Health Organization (free PDF)

News Release: Mental health: massive scale-up of resources needed if global targets are to be met (free)

See also: WHO Campaign on Mental Health (free resources)

“Every US$ 1 invested in scaling up treatment for common mental illnesses such as depression and anxiety leads to a return of US$ 4 in better health and ability to work” (via @WHO see Tweet)

 


Stimulants for ADHD in children: Revisited – Therapeutics Initiative (via @AllenFrancesMD)

“There is convincing evidence that a proportion of boys and girls treated with stimulants in BC and around the world are simply the youngest in their class”

 


Dose Increase Versus Unchanged Continuation of Antidepressants After Initial Antidepressant Treatment Failure in Patients With Major Depressive Disorder: A Systematic Review and Meta-Analysis of Randomized, Double-Blind Trials – The Journal of Clinical Psychiatry (link to abstract – $ for full-text)

Commentary: Depression: boosting SSRIs doesn’t work – Univadis (free registration required)

“Meta-analysis: there is evidence from RCTs against increasing the dose of SSRIs (with the possible exception of citalopram) in adult patients with major depression and antidepressant treatment failure” (via @psychopharmacol see Tweet)

 


Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of adverse events in non-randomised studies – Cochrane Library (link to abstract – $ for full-text)

Summary: Methylphenidate for attention deficit hyperactivity disorder (ADHD) in children and adolescents – assessment of harmful effects – Cochrane Library (free)

“Our findings suggest that methylphenidate may be associated with a number of serious adverse events as well as a large number of non-serious adverse events in children and adolescents, which often lead to withdrawal of methylphenidate”.

 


Support for midlife anxiety diagnosis as an independent risk factor for dementia: a systematic review – BMJ Open (free)

Commentaries: Moderate to severe mid-life anxiety may be linked to later life dementia – BMJ Open Blog (free) AND Anxiety in middle age linked to dementia later – Reuters (free) AND Expert reaction to a review of the association between mid-life anxiety and later life dementia – Science Media Centre (free)

“The current study isn’t designed to explain how anxiety and dementia might be connected, Iadecola added.

“We cannot say with confidence that anxiety is a cause (risk factor), an early manifestation of the dementia, or only coincidentally associated with it,”” (from Reuters)

 


Anticholinergic drugs and risk of dementia: case-control study – The BMJ (free)

Editorial: Anticholinergic drugs and dementia in older adults (free)

Commentaries: Expert reaction to study investigating the association between different types of anticholinergic drugs and risk of dementia – Science Media Centre (free) AND Anticholinergic drugs may be linked to increased risk of dementia – OnMedica (free)

“The effect of anticholinergic therapy is relatively small (odds ratio 1.1 – 1.2) and establishing an association does not prove a causal link. Nevertheless, the paper may act as a useful guide for future research and clinical practice”. (by Prof Les Iversen, in Science Media Centre)

 


Non-invasive brain stimulation techniques for chronic pain – Cochrane Library (free)

“There is a lack of high-quality evidence to support or refute the effectiveness of non-invasive brain stimulation techniques for chronic pain”

 


Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study – BMC Medicine (free)

Commentary: Sleep deficiency increases risk of a motor vehicle crash – Brigham and Women’s Hospital, via ScienceDaily (free)

“Study finds that sleep deficiency due to either sleep apnea or insufficient sleep duration is strongly associated with motor vehicle crashes, regardless of one’s self-reported sleepiness level” (from ScienceDaily)

 


Suicide After Deliberate Self-Harm in Adolescents and Young Adults – Pediatrics (free)

Commentary: Young People Who Self-Harm Face Striking Increase in Suicide Risk – Physician’s First Watch (free)

“Teens who self-harm are nearly 50 times more likely to commit suicide in the next year compared with their non-self-harming peers” (via @Physns1stWatch see Tweet)

 


A Quiet Drug Problem Among the Elderly – The New York Times (free)

Related: Our Other Prescription Drug Problem – New England Journal of Medicine (free) AND Benzodiazepines: our other prescription drug epidemic – STAT (free)

“Despite warnings from experts, older people are using more anti-anxiety and sleep medications, putting them at risk of serious side effects and even overdoses”.

 


Do Antidepressants Work? – The New York Times (10 articles per month are free)

“The most comprehensive study on them has recently been published, showing mostly modest effects”.

See related meta-analysis and commentaries in our February 23rd issue (see #3)

 


Effectiveness of brief alcohol interventions in primary care populations – Cochrane Library (free)

In general practice or emergency care settings, brief alcohol interventions can reduce alcohol consumption and related harm.

 


Guidelines for Adolescent Depression in Primary Care – American Academy of Pediatrics

Part I. Practice Preparation, Identification, Assessment, and Initial Management (free)

Part II. Treatment and Ongoing Management (free)

Commentary: Pediatricians Call For Universal Depression Screening For Teens – NPR (free)

 


Comparative Effectiveness and Safety of Cognitive Enhancers for Treating Alzheimer’s Disease: Systematic Review and Network Meta-analysis – Journal of the American Geriatrics Society (free)

Source: Medscape (free registration required)

“Cognitive enhancers in general have minimal effects on cognition according to minimal clinically important difference and global ratings. The drugs appear safe, but this must be interpreted cautiously because trial participants may have less comorbidity and fewer adverse effects than those treated with these drugs in clinical practice”.

 


Electroconvulsive therapy and age: Age-related clinical features and effectiveness in treatment resistant major depressive episode – Journal of Affective Disorders (link to abstract – $ for full-text)

“Short-term ECT outcome in the treatment of depression in elderly is equivalent to that of young patients in efficacy and tolerability. Old patients reported faster ECT response than younger ones and required less sessions to achieve response and remission” (via @psychopharmacol see Tweet)

 


Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies – Progress in Neuro-Psychopharmacology and Biological Psychiatry (link to abstract – $ for full-text) (via @psychopharmacol see Tweet)

“These findings provide preliminary evidence that atypical antipsychotics cause insulin resistance and weight gain directly, independent of psychiatric disease and may be associated with length of treatment”.

 


Postsurgical prescriptions for opioid naive patients and association with overdose and misuse: retrospective cohort study – The BMJ (free)

“The duration of treatment rather than dose is more strongly associated with opioid misuse after surgery, concludes this study” (via @bmj_latest see Tweet)

 


Editorial: Children and social media – The Lancet (free)

Original report: Life in ‘likes’ – Children’s Commissioner (free)

See also a recent Pediatrics supplement: Children, Adolescents and Screens: What We Know and What We Need To Learn (series of free articles) and related articles on Social Media and Mental Health

 


The role of selective serotonin reuptake inhibitors in preventing relapse of major depressive disorder – Therapeutic Advances in Psychotherapy (free PDF)

“Review: The relapse risk during 1 year in adults with MDD was lower when SSRIs were combined with psychotherapy. Results comparing SSRIs and SNRIs were inconclusive. TCAs may be equally as effective as SSRIs” (via @psychopharmacol see Tweet)

 


Practice guideline update summary: Mild cognitive impairment – American Academy of Neurology (free PDF)

Commentary: Mild cognitive impairment: a practice guideline update – Clinical Advisor (free)

“For patients diagnosed with MCI, clinicians may choose NOT to offer cholinesterase inhibitors”.

“If clinicians choose to offer cholinesterase inhibitors, they must first discuss with patients the fact that this is an off-label prescription not currently backed by empirical evidence”.

 


Efficacy and Safety of Transcranial Direct Current Stimulation as an Add-on Treatment for Bipolar Depression: A Randomized Clinical Trial – JAMA Psychiatry (link to abstract – $ for full-text)

Commentary: Electrical Stimulation Works as Add-On in Bipolar Depression – MedPage Today (free registration required)

“Small RCT in BD I and II (n=59): active tDCS showed superior improvement versus sham in change in HDRS-17 scores at week 6 (βint = −1.68; NNT = 5.8; 3.3-25.8) and response rates (67.6% vs 30.4%; NNT = 2.69; 1.84-4.99)” (RT @psychopharmacol see Tweet)

 


Treating Anxiety in Children – The New York Times (10 articles per month are free)

 


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