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A straight talking introduction to psychiatric drugs
- Author:
- MONCRIEFF Joanna
- Publisher:
- PCCS Books
- Publication year:
- 2009
- Pagination:
- 150p.
- Place of publication:
- Ross-on-Wye
This book is intended for anyone currently taking, or thinking about taking, a psychotropic drug, anyone prescribing them and anyone party to their use. The author provides a simple guide to how psychiatric drugs work, and discusses whether they are effective and how to understand the evidence. The competing theories of drug action are also explained in easy-to-understand terms. There are separate chapters for neuroleptic drugs, antidepressants, lithium and other drugs used for manic depression, stimulants, and benzodiazepines. The book concludes with practical advice on the questions to ask if you are prescribed medication for mental health problems and what happens on withdrawal of medication. In the book the author argues that the current assumptions about how psychiatric drugs work and what they do are erroneous. It is suggested that psychiatric drugs do not reverse an underlying biological abnormality, as suggested by the orthodox ‘disease-centred’ view of what they do; they in fact create one. The appendix gives sources and information about stopping and reducing psychiatric drugs.
Mood switch in bipolar depression: comparison of adjunctive venlafaxine, bupropion and sertraline
- Authors:
- POST R. M., et al
- Journal article citation:
- British Journal of Psychiatry, 189(2), August 2006, pp.124-131.
- Publisher:
- Cambridge University Press
Few studies have examined the relative risks of switching into hypomania or mania associated with second-generation antidepressant drugs in bipolar depression. The aim was to examine the relative acute effects of bupropion, sertraline and venlafaxine as adjuncts to mood stabilisers. In a 10-week trial, participants receiving out-patient treatment for bipolar disorder (stratified for rapid cycling) were randomly treated with a flexible dose of one of the antidepressants, or their respective matching placebos, as adjuncts to mood stabilisers. A total of 174 adults with bipolar disorder I, II or not otherwise specified, currently in the depressed phase, were included. All three antidepressants were associated with a similar range of acute response (49-53%) and remission (34-41%). There was a significantly increased risk of switches into hypomania or mania in participants treated with venlafaxine compared with bupropion or sertraline. More caution appears indicated in the use of venlafaxine rather than bupropion or sertraline in the adjunctive treatment of bipolar depression, especially if there is a prior history of rapid cycling
Cost-effectiveness of relapse-prevention cognitive therapy for bipolar disorder: 30-month study
- Authors:
- LAM Dominique H., et al
- Journal article citation:
- British Journal of Psychiatry, 186(6), June 2005, pp.500-506.
- Publisher:
- Cambridge University Press
This article reports the advantageous clinical outcome of adding cognitive therapy to medication in the prevention of relapse of bipolar disorder. This 30-month study compares the cost-effectiveness of cognitive therapy with standard care. The authors randomly allocated 103 individuals with bipolar 1 disorder to standard treatment and cognitive therapy plus standard treatment. Service use and costs were measured at 3-month intervals and cost-effectiveness was assessed using the net-benefit approach. The group receiving cognitive therapy had significantly better clinical outcomes. The extra costs were offset by reduced service use elsewhere. The probability of cognitive therapy being cost-effective was high and robust to different therapy prices. Combination of cognitive therapy and mood stabilisers was superior to mood stabilisers alone in terms of clinical outcome and cost-effectiveness for those with frequent relapses of bipolar disorder.
The relevance of guidelines for treatment mania in old age
- Author:
- SNOWDON John
- Journal article citation:
- International Journal of Geriatric Psychiatry, 15(9), September 2000, pp.779-783.
- Publisher:
- Wiley
Reviews three sets of guidelines for the treatment of patients with bipolar disorder, in order to assess their adequacy in relation to treatment of older persons with mania. One of the three referred to differences encountered when treating elderly people, but none gave adequate attention to age-related changes in pharmacokinetics and whether it is appropriate to prescribe lithium as a first-line mood stabiliser for older persons. Concludes that the guidelines do not give clear guidance on initial management of acutely manic patients who refuse medication. Nor do they give consideration to secondary mania. Recommended that evidence be gathered in order to develop guidelines specifically for management of mental disorders presenting in old age.
Bipolar disorder: the assessment and management of bipolar disorder in adults, children and young people in primary and secondary care: CG185
- Author:
- NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
- Publisher:
- National Institute for Health and Care Excellence
- Publication year:
- 2014
- Place of publication:
- Manchester
This guideline covers the recognition, assessment and management of bipolar disorder in children, young people and adults. It includes specific recommendations for diagnosis in children and young people because presentation in these age groups can be complicated by other conditions such as ADHD. The recommendations apply to people with bipolar I, bipolar II, mixed affective and rapid cycling disorders. The guideline highlights the key priorities for implementation in relation to: care across all phases of bipolar disorder; recognising and managing bipolar disorder in adults in primary care; managing mania or hypomania in adults in secondary care; managing bipolar depression in adults in secondary care; managing bipolar disorder in adults in the longer term in secondary care; and recognising, diagnosing and managing bipolar disorder in children and young people. (Edited publisher abstract)
The pathology and pharmacology of mental illness
- Authors:
- WILBOURN Mark, PROSSER Sylvia
- Publisher:
- Nelson Thornes
- Publication year:
- 2003
- Pagination:
- 238p.,bibliog.
- Place of publication:
- Cheltenham
The book lays the foundation for learning by introducing the principles of pharmacology and how the body deals with drugs, followed by practice-focused chapters that follow ICD-10 diagnostic group criteria. The book provides an insight into the physical basis of mental illness and the pharmacological treatments available.
Antidepressant-associated mania in late life
- Authors:
- YOUNG R. C., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(5), May 2003, pp.421-424.
- Publisher:
- Wiley
Elderly patients can present with mania for the first time late in life, and some elders treated with antidepressants can present with mania. Clinical characteristics of antidepressant-associated mania (AAM) in late life have not been examined. The aims of the study were to identify elders with AAM and to compare selected clinical characteristics to those of manic elders who had not been treated with an antidepressant. The authors hypothesized that AAM patients would have later age at presentation of bipolar disorder. The authors retrospectively reviewed inpatients with manic disorder who were aged 60 years. The sample was selected from admissions prior to 1990. AAM patients (n = 11) were more often experiencing first manic episode, and they had later age at onset of first manic episode, compared to non-AAM patients (n = 46). Most of the AAM patients had been treated with tricyclic agents. These preliminary findings invite further investigation. Related studies may contribute to risk-benefit analyses for the use of particular antidepressants in the elderly. Also, first episode mania in late life may prove to be a useful model of vulnerability to AAM.
Psychopharmacological treatment of bipolar disorder
- Author:
- WALSH Joseph
- Journal article citation:
- Research on Social Work Practice, 8(4), July 1998, pp.406-425.
- Publisher:
- Sage
The purpose of this article is to provide social workers with an overview of the pharmacological treatment of bipolar disorder so that they can carry out their roles more effectively. This overview includes information about types of appropriate medication and their dosages, short and long-term efficacy, and other relevant considerations for social workers.
Recent advances in understanding mental illness and psychotic experiences: a report by The British Psychological Society Division of Clinical Psychology
- Author:
- BRITISH PSYCHOLOGICAL SOCIETY
- Publisher:
- British Psychological Society
- Publication year:
- 2000
- Pagination:
- 82p.
- Place of publication:
- Leicester
The report is divided into three parts, covering understanding of mental illness, causes, and help and treatment. The scope includes diagnoses of schizophrenia, paranoid schizophrenia, psychosis, manic depression and bipolar affective disorder. Incidence, prognosis, the continuum with mental health, biological, life circumstance and psychological causes, medication, intervention, risks and consequent social exclusion are all covered.