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

Tightrope walker

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...]

NICE publish first clinical guideline on social anxiety disorder

Social humiliation

I wonder if the timing of this publication was planned to be so close to the release of DSM-5, but this debut guidance on social phobia (now known as social anxiety disorder) is certainly going to ruffle some feathers. It fuels the discussion about the medicalisation of human personality traits and some will see it [read the full story...]

New guideline says lithium still appears to have the most robust evidence base as a long-term treatment for bipolar disorder

Bipolar

Bipolar disorder features as one of the top ten disabling disorders for working age adults. There are numerous risks including suicide, increased mortality and reduced social functioning associated with the disorder. Key to enabling recovery is preventing acute episodes from occurring, with each episode increasing the risk of future ones. Therefore ensuring long-term maintenance treatment [read the full story...]

CBT is better than nothing for older adults with depression, but so is any form of active support

Old man stretching

Depression is such a widely known issue now that it barely needs introduction. It’s something we Elves have covered with interest, looking at the effectiveness of various treatments, like psychotherapy, medication and exercise. For older adults though, there remains a somewhat hazy picture of what treatments work best. Most of the evidence base for the [read the full story...]

New RCT says antidepressants should not be used when treating depression in dementia

Senior woman taking pill

Dementia is one of the most common and serious disorders in later life. It places a considerable burden on the health care system, individuals and especially unpaid carers. Depression is common among people with dementia and causes additional distress to affected individuals and their social circle. Research into the treatment of depression in dementia is [read the full story...]

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

Hand holding pill

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...]

Meta-analysis shows a small increased risk of brain haemorrhage in people taking SSRIs

Bleeding brain

Depression is a serious mental health threat proclaimed to be the greatest disease burden in the industrialised world by 2020 (Simon, 2003). In the pharmaceutical combat against depression, selective serotonin reuptake inhibitors (SSRIs) are the current treatment of choice. Indeed, SSRIs are the most prescribed antidepressant medicine (Helms & Eric, 2006). As the name suggests, they increase [read the full story...]

Cochrane review finds bupropion is the best treatment to help people with schizophrenia give up smoking

Woman breaking cigarette

People with schizophrenia are 2-3 times more likely to smoke tobacco than the rest of the population, so helping them quit is a significant public health issue. The evidence for smoking cessation interventions in the general population is fairly well defined. We know quite a bit about what works and we have a range of [read the full story...]

SSRI use in pregnancy does not increase the risk of stillbirth, neonatal mortality or post-neonatal mortality

Newborn baby and mother

Studies have shown that the prevalence of depression in pregnant women is 7-19%. Being depressed during pregnancy can result in preterm delivery, which can in turn lead to illness and even death of the newborn child. Researchers have struggled to single out the causes of these risks. Is it the depression, the medical treatment being [read the full story...]

New RCT shows that adding CBT to usual care helps people with treatment resistant depression

shutterstock_117069988

The CoBalT trial was published last week in the Lancet. This important randomised controlled trial (RCT) examined the effectiveness of cognitive behavioural therapy (CBT) as an add-on treatment to usual care for people with treatment resistant depression. Previous studies have shown that only around one third of people with depression respond well to treatment with [read the full story...]