Substitute consent for nursing home residents prescribed psychotropic medication.

Background: Prescribing psychotropic medications for persons with dementia who lack capacity to give informed consent requires proxy consent under NSW Guardianship legislation.

Objective: To survey current practice in complying with legislation and regulations in prescribing psychotropic medications for nursing home residents.

Method: In three Sydney nursing homes, the files of 77 residents identified as having dementia, being on a psychotropic medication and not having capacity to give informed consent, were audited.

Atypical antipsychotics in bipolar depression: neurobiological basis and clinical implications.

The use of atypical antipsychotics is rapidly expanding in the management of bipolar disorder. This therapeutic class appears to have benefits across the spectrum of moods found in bipolar disorder, and a re-examination of the monoamine hypothesis is required. This paper reviews the evidence for the role of monoamines, and particularly dopamine, in bipolar depression and its implications in the treatment of patients, focusing upon the response to atypical antipsychotics.

Neuropsychological disturbances and cerebral blood flow in bipolar disorder.

Objective: To determine and correlate alterations in neuropsychological function and cerebral blood flow in bipolar patients.

Method: Assessments included the Positive and Negative Symptom Scale, Global Assessment Functioning, Wechsler Adult Intelligence Scale (WAIS), Wisconsin Card Sorting Test (WCST), Stroop test, Trail Making Test (TMT), California Verbal Learning Test (CVLT), Wechsler Memory Scale (WMS) and phonetic verbal fluency/controlled oral word association tests. Single photon emission computed tomography (SPECT) was carried out with the administration of 99mTc-HMPAO.

Effects on weight and outcome of long-term olanzapine-topiramate combination treatment in bipolar disorder.

Olanzapine is an effective drug for the long-term treatment of bipolar disorder but is associated with burdensome weight gain. Topiramate is a novel anticonvulsant that may induce weight loss in some patients. This is the first study to address the long-term efficacy and impact on weight of the combination of olanzapine and topiramate in bipolar patients.

Acute and continuation risperidone monotherapy in mania.

Background: The aim of this study was to assess the effectiveness and safety of risperidone monotherapy for acute and continuation treatment of mania.

Method: Ninety-six DSM-IV acutely manic bipolar patients with a Young mania rating score (YMRS) of 20 or more entered this open, multicentre, 6-month study. Efficacy was assessed with the YMRS, the positive and negative syndrome scale (PANSS) and the clinical global impressions scale (CGI).