How consistent are international treatment guidelines for bipolar disorder?

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Steven Marwaha publishes his debut blog on a review article that asks if there is consensus across international evidence-based guidelines for the management of bipolar disorder.

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Depot antipsychotics: If you pay me, you can keep injecting me

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John Baker looks at the 2-year follow-up results of a cluster RCT on the effectiveness of financial incentives to improve adherence to maintenance treatment with depot antipsychotics.

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Mindfulness-based cognitive therapy cannot substitute maintenance antidepressants for preventing depression relapse

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Ioana Cristea takes a closer look at a recent non-inferiority RCT, which compares mindfulness-based cognitive therapy (MBCT) plus discontinued antidepressants versus MBCT and maintenance antidepressants.

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Mindfulness-based cognitive therapy to prevent depression

In April 2015 we blogged PREVENT and concluded that mindfulness based cognitive therapy is a promising intervention for preventing depression.

André Tomlin presents the results of the PREVENT RCT published today in The Lancet, which investigates the effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence.

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Medication for the maintenance treatment of bipolar disorder

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Elena Marcus summarises a recent network meta-analysis published in The Lancet of the comparative efficacy and tolerability of medication for the maintenance treatment of bipolar disorder.

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How does buprenorphine fair as an alternative to methadone for treating opioid dependence?

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Meg Fluharty summarises a recent Cochrane review, which tells us that high-dose buprenorphine is an effective maintenance treatment for heroin compared to placebo, but fixed flexible-dosing methadone is superior to buprenorphine at participant retention.

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Extended therapy with varenicline reduces rates of smoking relapse in people with serious mental health issues

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People with serious mental health issues such as schizophrenia have higher rates of cigarette smoking than the general population, with estimates suggesting more than 50% are current smokers. When people in this population do manage to quit during treatment we then see particularly high rates of relapse after treatment ends. A new randomised control trial (Evins [read the full story…]

Long term maintenance treatment with antipsychotics: a cautionary note from recent research

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The support of individuals with experience of psychosis is complex and relies on a combination of psychopharmacology (antipsychotic drugs), psychological therapies and social interventions. Antipsychotics will often be the first line treatment offered, with the intention of reducing psychotic symptom burden. Following the resolution of immediate symptoms the role of antipsychotics becomes less clear; should [read the full story…]

Cochrane review finds limited evidence to support valproate as a maintenance treatment for bipolar disorder

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Bipolar disorder is an affective disorder marked by cycles between mania and depression. It has an early onset, with mean age ranging from 19 to 29 (Offord, 2012) and a prevalence of 0.5% – 4.3% in primary care alone, stretching to 9.3% in some settings (Cerimele, Chwastiak, Dodson, & Katon, 2013). With its problematic recurring [read the full story…]

If I pay you, will you have your injection?

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Getting patients to take their medication as prescribed is notoriously difficult. Regardless of condition only about 50% of patients adhere to prescribed regimes. This is particularly the case in chronic or complex conditions worldwide and improving this problem has the potential to save considerable health burden and costs. Adherence in mental health is no different. [read the full story…]