Commonly prescribed psychiatric drugs: do they work?

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John Baker summarises a review of commonly prescribed medication that covers seven psychiatric drugs, including antidepressants, antipsychotics, benzodiazepines, amphetamines, methylphenidate and cholinesterase inhibitors.

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

This trial suggests that antipsychotic use can be effectively reduced in nursing homes by using a review protocol.

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

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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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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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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…]

The cardiovascular safety of dementia medications: a cross national study

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Two of the most widely available medicines for dementia in the UK are cholinesterase inhibitors and a N-methyl-D-aspartate (NMDA) receptor antagonists (NHS, 2013).  Both drugs are popular because they have been found to lead to improvements in dementia symptoms (Raina 2008). However, some have raised concerns about the safety for patients. These concerns are partly [read the full story…]

Scotland sees increase in prescribing rates for mental health drugs

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The Scottish Government have published their annual summary of prescribing statistics for mental health drugs. The report shows increases in the prescribing rates for all groups of drugs over the last 12 months. The prescribing costs of some groups of drugs have also risen (ADHD, dementia, depression) although other groups have seen a decline (insomnia [read the full story…]

Cholinesterase inhibitors should not be recommended for mild cognitive impairment, says Cochrane review

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Early diagnosis and effective treatment of dementia will help large numbers of the population remain independent for longer. Cholinesterase inhibitors are one of the anti-dementia drugs that are used to treat Alzheimer’s disease, and they are often used immediately after diagnosis. This new systematic review from the Cochrane Dementia and Cognitive Improvement Group, looks at [read the full story…]

Cholinesterase inhibitors are an effective treatment for patients with Parkinson’s disease with dementia

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People with Alzheimer’s disease experience a loss of nerve cells that use a chemical called acetylcholine as a chemical messenger. Dementia symptoms become more severe as more nerve cells are lost. Cholinesterase inhibitors are a group of drugs (including donepezil, rivastigmine and galantamine) that prevent the enzyme acetylcholinesterase from breaking down acetylcholine in the brain. [read the full story…]

Memantine may reduce fractures and cholinesterase inhibitors may increase syncope in dementia: new systematic review

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Last week I blogged about a study that showed how some dementia drugs may help reduce the progression of the disease and delay admission to care homes for people with the condition. This new systematic review carried out by a research team from Harvard Medical School investigates the potential side effects of two dementia drugs: [read the full story…]