Escitalopram, The Most Effective New SSRI
Major depressive disorder (MDD) is a chronic, recurrent mental disease with disability characterised by both symptomatic and functional impairment. A variety of randomised, placebo-controlled trials have shown that escitalopram is effective for MDD and its efficacy and tolerability are superior to other SSRIs and other antidepressants.
Modern Medicine â Issue 6 2021
Could it be ADHD? Recognising ADHD in youth and adults
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts in childhood and continues into adulthood in most cases. Many young people and adults with ADHD remain undiagnosed and significantly impaired by their symptoms, particularly problems with day-to-day responsibilities. GPs are well placed to identify patients with ADHD and refer for specialist treatment. Effective treatment can be life-changing.
Modern Medicine â Issue 1 2021
Aripiprazole for the Treatment of Adult Bipolar Disorder
Bipolar disorder is characterised by exacerbations of opposite mood polarity, ranging from manic to major depressive episodes. Treatment of all phases of this disorder is primarily with mood stabilisers. Aripiprazole is a novel antipsychotic initially approved for the treatment of schizophrenia but soon found to be effective in bipolar disorder. This drug is well studied, as randomised controlled trials have been conducted in various phases of bipolar disorders. Aripiprazole exhibits the pharmacodynamic properties of partial agonism, functional selectivity and serotonin-dopamine activity modulation.
Modern Medicine â Issue 4 2020
Schizophrenia The GPâs crucial management role
Early recognition and referral are key in managing schizophrenia and related psychoses. Management should occur within a framework of autonomy and self-determination and, where possible, with family or carer inclusion. Pharmacological and psychosocial treatments improve outcomes, including quality of life, for people affected by schizophrenia. Antipsychotic, mood stabiliser and antidepressant medications may all be indicated in treating psychoses.
Modern Medicine â Issue 3 2020
When Treating Depression and Insomnia, Consider the Gut-brain Axis
Major depressive disorder is one of the leading causes of disability, morbidity and mortality worldwide. The disorder affects approximately one in five people at any stage of their lifespan. It is generally agreed upon that depression is induced by the cumulative effect of genetic information and environmental stresses. Certain genes and psychological features might predispose some people to depression and stressful life events including early-life stress are important inducements of depression. Research has indicated that the gut microbiota also play a crucial part in the pathophysiology of depression.
Modern Medicine â Issue 4 2019
Dual Diagnosis of Bipolar and Substance Use Disorders
Substance use disorders (SUD) and mental illnesses have many of the same symptoms. Additionally, having a substance use disorder may predispose someone to develop a mental illness and vice versa. Further, those with BD (Bipolar Disorder) and SUD are at increased risk for non-medical use of prescription opioids.
Modern Medicine â Issue 4 2019
Cognitive Tests Predict Antidepressant Response â MM1610
Major depressive disorder (MDD) is a prevalent and disabling condition with
a high frequency of non-recovery and recurrence, leading to substantial
mortality and morbidity. Only a subset of individuals with MDD (30-40%)
reaches symptomatic remission after adequate treatment with a first-line
antidepressant. Many do not reach premorbid levels of psychosocial functioning and a significant proportion present with residual symptoms.
More recent findings have raised hopes for identifying cognitive tests for predicting antidepressant clinical response, which would have the distinct advantage of being quick and easy to administer in a doctorâs office.
Modern Medicine â October 2016
Adult Depression A step-by-step guide to treatment â MM1605
A stepwise approach to the early detection and management of depression, guided by severity of presentation and treatment response, encourages more timely access to evidence-based treatments, including easily accessed and destigmatising e-mental health interventions. Evidence-based treatments range from e-mental health apps, psychological therapy and medication to neurostimulation.
With the overall similarities in efficacy of antidepressants, the most important considerations when initiating pharmacotherapy are tolerability and safety. For patients with difficult-to-treat depression, an algorithmic management approach with steps that include increasing the antidepressant dose, switching antidepressants, augmenting with a non-antidepressant treatment and combining antidepressants improves the chance of patient recovery. Neurostimulatory treatments such as electroconvulsive therapy and repetitive transcranial magnetic stimulation have an expanding role in the evidence based treatment of severe depression.
Modern Medicine â May 2016
Levetiracetam: Effective Adjunct Epileptic Therapy in Kids â MM1601
Epilepsy is a common chronic disorder that requires long-term antiepileptic drug therapy. Approximately one half of patients fail the initial antiepileptic drug and about 35% are refractory to medical therapy, highlighting the continued need for more effective and better tolerated drugs.
Modern Medicine â January 2016
Bupropion for Depression Improves Day-to-day Functioning â MM1511
Bupropion is a dopamineânorepinephrine reuptake inhibitor that is effective not only for depressive disorders but also for nicotine dependence. Due to the lack of serotonergic activity, it has less propensity to induce sexual dysfunction, weight gain and a psychological side effect of apathy syndrome than selective serotonin reuptake inhibitors (SSRIs). These adverse events are important because they are the primary reasons of SSRI discontinuation.
Modern Medicine â November 2015
