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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Why do GPs over prescribe benzodiazepines? Synthesis of qualitative studies

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Benzodiazepines are used to treat insomnia, anxiety and chronic back pain due to their sedative and muscle relaxing effects. They’ve got a sting in the tail though and can cause memory disruption, loss of coordination and dependence if used long term. It’s therefore recommended that other treatments, such as psychological interventions, are tried first and [read the full story…]

Moderators of outcome in late-life depression: should we be prescribing antidepressants to older people?

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Meta-analyses are an incredibly useful tool for synthesising evidence. However, such analyses typically use aggregate data, meaning the average scores or outcomes for treatment groups, which can cause problems if we’re trying to dig a little deeper into the question of ‘what works’ to answer ‘what works, and for whom?’ The ‘for whom?’ question is [read the full story…]

35% of people with learning disabilities in Australian city prescribed psychotropic medications

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It is estimated that in UK, up to 200,000 people with learning disabilities are given anti-psychotic drugs, which can have powerful side effects, like risk of weight gain, impotence and strain to the cardiovascular system, and with little evidence of their efficacy in treating challenging behaviour. There are equal concerns about the use of anti-convulsant [read the full story…]

Reducing variation in prescribing activities in primary care

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  Introduction This study, carried out in Scotland, is relevant to commissioners and general practitioners, as it demonstrates why there are variations in prescribing practice, and how these can be managed. The authors have noticed that there is “significant variation in the quality of prescribing” and they have carried out an ethnographic study into why [read the full story…]

Inappropriate use of antipsychotics to treat behavioural and psychological symptoms of dementia is likely to be more prevalent in care homes and low-income households

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Antipsychotics were discovered as an effective treatment for schizophrenia in the 1950s, but their use was expanded despite lack of supporting evidence, to treat other patient groups.  This included treating aggression, agitation and other behavioural and psychological symptoms of dementia (BPSD). There is evidence that these distressing symptoms can often be prevented or managed without [read the full story…]

People with mental illness are prescribed fewer drugs for physical disorders than the rest of the population

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A year ago this week I blogged about a study in the British Journal of Psychiatry that showed the dramatically reduced life expectancy of people with severe mental illness, who on average live 15-20 years less than the rest of the population. Twelve months on and a new study published in the same journal paints an equally [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…]

Guest blog: Antidepressants and the Long Shadow of Stigma

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Following the media coverage of the NHS statistics published last week that reported a large rise in antidepressant prescribing, Martin Brunet (a GP from Surrey and author of the excellent Binscombe Doctor Blog) has written an opinion piece that explores the positive and negative aspects of this complex story: “Are GPs prescribing antidepressants too readily?” [read the full story…]

The cost of antidepressant prescribing has risen by nearly a quarter in the last year, according to new NHS figures

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The largest annual rise in prescriptions was seen in antidepressants according to figures published this week by the NHS Information Centre. 46.7 million prescriptions for antidepressants were dispensed in 2011, a rise of 3.9 million on 2010. This equates to a rise of 9.1% in the 12 month period, which is similar to that seen [read the full story…]