Self-harm in primary care: more prescribing than referrals

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Olivia Kirtley and Alys Cole-King present a major new cohort study, which includes worrying evidence about the clinical management of patients in primary care following self-harm.

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Prescribing antipsychotics in primary care: new study highlights frequent off-label use


Josephine Neale reports on a recent cohort study that finds less than half of UK prescriptions for antipsychotics are issued for main licensed conditions (e.g. psychosis or bipolar disorder). The research provides a reminder about the dangers of prescribing antipsychotics to people with dementia.

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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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Shared decision making in antipsychotic prescribing: the perspective of psychiatrists


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


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?


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

medicine in blisterpack

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

Older man

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


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…]