Rivastigmine for Alzheimer’s: is a small cognitive ‘improvement’ worth the risk of feeling physically unwell?


Rosalyn Nelson presents the latest Cochrane systematic review of Rivastigmine for Alzheimer’s disease, which brings together the results of 7 industry sponsored or funded trials, and concludes that Rivastigmine may be of benefit to people with Alzheimer’s disease.

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What impact are psychotropic drugs having on our physical health?


John Baker summarises the findings of a recent review of people with schizophrenia, bipolar disorder and depression. The study looks at the adverse effects on physical health of psychotropic drugs (antipsychotics, antidepressants and mood stabilisers).

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Combined methylphenidate and citalopram may help older people with depression recover faster

Depressed older man

Lisa Burscheidt summarises a recent randomised controlled trial of combined methylphenidate and citalopram for depression in older people, which presents promising but limited findings.

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The antipsychotic drugs don’t work for anorexia nervosa

Refusing pills

Helen Bould appraises a recent meta-analysis of second-generation antipsychotics for anorexia nervosa, which finds that the drugs don’t lead to weight gain or improve eating disorder symptoms. So why are antipsychotics being used in this group of patients?

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ECT for depression in the elderly

Depression and anxiety are quite common in people with dementia and mild cognitive impairment.

Andrew Shepherd reports on a post-hoc analysis of pre-existing trial data, which does little to convince him that ECT is a safe and effective treatment option for older people with severe depression.

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Anti-inflammatory drugs for depression: new review points to benefits, but more research needed


Helge Hasselmann highlights a recent systematic review of anti-inflammatory drugs for depression, which concludes that NSAIDs, in particular celecoxib, decreases depressive symptoms without increased risk of adverse effects. However, the meta-analysis has a number of draw-backs, which make the study findings far from convincing.

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Medication in advanced dementia: how can we judge what is appropriate?


Caroline Struthers appraises a recent US cross-sectional study of the use of medications of “questionable benefit” in nursing home residents with advanced dementia. She concludes that all medications are of questionable value if they have side effects which might have a negative impact on quality of life or are likely to cause harm.

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Reducing benzodiazepine prescribing in primary care


Liz Hughes summarises two recent studies (1 systematic review and 1 RCT) that both investigate brief interventions for reducing the use of benzodiazepines in primary care.

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Efficacy of high vs. low-potency first-generation antipsychotics for schizophrenia

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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.

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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.

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