Long-term antidepressant treatment in general practice: changes in body mass index.

To discern changes in body mass index (BMI) in patients on long-term antidepressant treatment in a general practice population and establish BMI changes in patients with and without a diagnosis of diabetes. We used a retrospective observational method and identified patients on four antidepressants of interest. We excluded those who did not have start and current BMI readings within the past 3 years and noted whether or not patients had a diagnosis of diabetes.

Body mass index and blood glucose in psychiatric and general practice populations.

Aims and method Using a retrospective observational approach, we aimed to discern whether there was a difference in metabolic parameters between psychiatric and general practice populations in the same locality. Second, we aimed to establish differences in metabolic parameters of patients taking olanzapine, clozapine or aripiprazole. Results Patients with psychiatric illness had a body mass index (BMI) comparable to that of the general practice population (28.

Effectiveness of long-acting antipsychotics in clinical practice: 2. Effects of antipsychotic polypharmacy on risperidone long-acting injection and zuclopenthixol decanoate.

Objectives: Antipsychotic polypharmacy (APP) is common clinical practice. Theoretically, APP runs the risk of additional side effects, drug interactions, adherence and cost. A limited evidence base is emerging to support the effectiveness of APP in clinical practice.

Effectiveness of long-acting antipsychotics in clinical practice : 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate.

Objectives: In the UK, nine different compounds are available as long-acting antipsychotic injections (LAIs). There are few clinical guidelines for determining which LAIs are most effective in specific patient groups. To measure the clinical effectiveness of LAIs we aimed to determine the now-established concept of antipsychotic discontinuation rates and measure Clinical Global Impression (CGI) outcomes.

Antipsychotic dose escalation as a trigger for neuroleptic malignant syndrome (NMS): literature review and case series report.

Background: "Neuroleptic malignant syndrome" (NMS) is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition.

Agomelatine in unipolar depression in clinical practice: a retrospective chart review.

Agomelatine (Valdoxan), a synthetic melatonergic receptor agonist at the MT1 and MT2 receptors, was first used in the management of sleep disorder. Its 5HT2C receptor antagonistic properties support its antidepressant potential. It is currently licensed in the UK, Europe and USA for the treatment of major depressive disorder.

Comparing the effectiveness of aripiprazole and quetiapine in schizophrenia and related psychoses: a naturalistic, retrospective chart review study.

Background: Naturalistic studies offer advantages over randomized clinical trials by including patients seen in routine practice. Aripiprazole and quetiapine are the most recent second-generation antipsychotics available in the United Kingdom. We aimed to study all patients who were prescribed these medications in a defined geographic area in order to identify and compare those who had a good clinical response.

Comparing the use and discontinuation of antipsychotics in clinical practice: an observational study.

Background: There are few independent studies comparing atypical or second-generation antipsychotics (SGAs).

Objective: To compare the patterns of use and discontinuation of commonly used SGAs.

Method: Retrospective review of 11,250 case records (2002-2005) of all mental health care contacts in a discrete geographical setting in Scotland.

Optimum number of sessions for depression and anxiety.

Aim: To examine the relationship between the number of psychological treatment sessions completed by patients (1-5 sessions, 6-8 sessions, >8 sessions) and the change in self-rated depressive and anxiety symptoms using the Hospital Anxiety and Depression Scale (HADS).

Method: Recording demographic characteristics and various clinical outcome measures for all referrals to the service and examining the relationship between changes in self-reported anxiety and depression symptoms.

Results: For depression, the study shows that having 6-8 sessions offers more benefit than 1-5 sessions.

Left dorso-lateral repetitive transcranial magnetic stimulation affects cortical excitability and functional connectivity, but does not impair cognition in major depression.

Purpose: Transcranial magnetic stimulation (TMS) has been used for over a decade to investigate cortical function. More recently, it has been employed to treat conditions such as major depression. This study was designed to explore the effects of differential treatment parameters, such as stimulation frequency.

The effects of noradrenergic re-uptake inhibition on memory encoding in man.

Rationale: Animal and human evidence implicate the central noradrenergic system in the process of memory modulation for emotional material. Blockade of the beta-adrenergic system in humans has been shown to result in decreased recall and recognition memory performance, relative to placebo, for the emotional elements of a series of slides accompanied by a narrative. Stimulation of the noradrenergic system with yohimbine has also been shown to result in increased recall and recognition performance relative to placebo for the same stimulus materials.

Right and left prefrontal transcranial magnetic stimulation at 1 Hz does not affect mood in healthy volunteers.

Background: Prefrontal repetitive transcranial magnetic stimulation (rTMS) has been used to induce side-specific mood changes in volunteers and patients. To clarify inconsistencies between reports that used different stimulation frequencies, we conducted a controlled study with a low (1 Hz) frequency, comparing left with right-sided stimulation

Methods: Nineteen healthy volunteers received randomised left or right prefrontal rTMS at a frequency of 1 Hz and 100% of motor threshold in two sessions two weeks apart.

Results: There were significant improvements with TMS for performance in the digit symbol substitution and verbal fluency tests, but no change of mood on a number of measures.