The adverse effects of psychiatric drugs and emergency department visits

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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.

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Shared decision making in antipsychotic prescribing: the perspective of psychiatrists

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Shared decision making is now commonplace, but will this approach ever be fully embraced in relation to antipsychotic prescribing? Liz Hughes reports on a recent qualitative study of consultant psychiatrists’ experiences that sheds some light on the issue.

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What should we prescribe for neuropsychiatric symptoms in Alzheimer’s disease?

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Psychiatrist Andrés Fonseca considers how his clinical practice should change, after reading a systematic review and meta-analysis of drug treatment for neuropsychiatric symptoms in Alzheimer’s disease

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Antipsychotics and mood stabilisers may reduce violent crime

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John Baker reports on the first population based report of the positive effects of antipsychotic medication and mood stabilisers on reducing the risk of a conviction for violent crime, published in the Lancet in May.

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Paliperidone Palmitate is no better than Haloperidol Decanoate at preventing relapse or controlling psychotic symptoms

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Alex Langford summarises a relatively large and pragmatic study, which provides firm evidence that the newer antipsychotic, Paliperidone, is no better at preventing relapse or controlling psychotic symptoms than its decades-old comparator, Haloperidol.

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Which (if any) drugs should we use for agitated or aggressive behaviour in dementia?

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This is a dilemma I frequently face when I am called out to see someone with dementia on the ward or living in a nursing home. On the one hand I am thinking that anything I use can potentially have serious side-effects and will probably lead to increased health risks and increased mortality. On the [read the full story...]

A new model for schizophrenia?

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Schizophrenia is a complex disorder (or, more likely, group of disorders) that has reality distortion at its core. Efforts to establish the cause of schizophrenia have been ongoing for more than a century, and many models have come and gone in that time (not for nothing has schizophrenia been called ‘the graveyard of neuropathologists’ (Plum, [read the full story...]

Spoilt for choice? Four new Cochrane reviews on antipsychotics for schizophrenia

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Schizophrenia is a crippling condition characterised by psychotic experiences such as delusions and hallucinations. It can be hugely debilitating for the patient and their family and it can also be an enormous challenge for psychiatrists and other health and social care professionals who are responsible for providing care and support to the service user. Currently, [read the full story...]

Drug treatment of refractory schizophrenia remains a major challenge, but clozapine continues to be gold standard

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Schizophrenia is a crippling condition that often (in about 20-30% of patients) shows an inadequate response to first-line antipsychotic drugs. Because it is associated with significant, often devastating reductions in quality of life, the management of refractory cases of schizophrenia represents a major challenge to psychiatry. As pharmacotherapy is the treatment of choice, stringent guidelines [read the full story...]

New study demonstrates effectiveness of antipsychotic Pimavanserin for Parkinson’s disease psychosis

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When we think of Parkinson’s disease (PD), hallucinations and delusions are probably not the first symptoms that come to mind. And yet, it is estimated that nearly half of all patients with PD experience psychotic symptoms at one time or another. Although deficits in motor function are seen as the hallmark of PD, it is [read the full story...]