Alex Langford

Alex Langford
I am a psychiatrist (now an SpR) based in Oxford after 3 years working in South East London. Before I went into psychiatry, I used to be a general medical doctor, and I also have a BSc in psychology.

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Adding antidepressants to antipsychotics in schizophrenia: do they work, for what, and are they safe?

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Alex Langford explores the emerging findings from a recent meta-analysis looking at the efficacy and safety of antidepressants added to antipsychotics for people with schizophrenia and schizophrenia-like psychosis.

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Integrated treatment for first episode psychosis: media hype versus reality

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Alex Langford reflects on the media hype surrounding a new RCT of the NAVIGATE intervention; a comprehensive, multidisciplinary, team-based treatment approach for first episode psychosis.

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Antidepressant meta-analyses: big business and bias

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Alex Langford reflects on the findings of a recent study that looks at 185 meta-analyses of antidepressants. It finds that industry involvement in research can lead to biased studies that under-report negative aspects of antidepressants for depression.

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Understanding Psychosis and Schizophrenia: a critique by Laws, Langford and Huda

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Keith Laws, Alex Langford and Samei Huda provide a critique of the British Psychological Society Division of Clinical Psychology report published today.

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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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Psychotherapy trials should report the side effects of treatment

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If a treatment is powerful enough to have a good effect, then it’s powerful enough to have a bad effect. This is well recognised when it comes to medication, with strict regulations in place to ensure adverse outcomes are monitored and measured. By contrast, psychotherapy has never been as readily associated with the potential to [read the full story…]

Ketamine for severe depression: what can we conclude from a small open label study?

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Last week the media reported widely on a study of ketamine for depression (McShane et al, 2014). As usual the headlines made bold assertions, the Telegraph running with “Horse tranquilliser Ketamine could cure severe depression” (Knapton, 2014). But what did the paper authored by an Oxford group and published in the Journal of Psychopharmacology really [read the full story…]

What impact do guidelines actually have on patient outcomes for people with schizophrenia?

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Using research findings to improve care in mental health should be easy. Notice an understudied area, do a study on it, write a guideline based on your results and watch mental health professionals modify their practice accordingly. Hooray for science. But in reality, this process is convoluted and murky. Though we’re fairly good at churning out [read the full story…]

Can assessing and acting on quality of life scores improve patient satisfaction? New study concludes yes, but the results actually say no

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For mental health patients, quality of life (QoL) can include many things like self-esteem, autonomy, satisfaction with the care they’re receiving and the staff who are caring from them, reduced symptoms, minimal side-effects from treatment and good overall functioning. Measuring QoL can pick up on difficulties a patient is having that wouldn’t have otherwise come [read the full story…]

Transcranial magnetic stimulation (rTMS) enhances response to antidepressants: a rather flawed meta-analysis

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It’s a well-known fact that elves are allergic to unhappiness, so the fact that there are at least 350 million sufferers of depression worldwide1 is quite a problem. That’s before we’ve even mentioned the crippling mortality, morbidity and economic impact that depression causes. The trouble is, our treatments for depression aren’t perfect. Less than a [read the full story…]