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Polypharmacy common in MS patients


A single-centre analysis in Germany has found that polypharmacy is common among MS patients, with 56.5% of patients reporting use of 5 or more medications (Frahm et al. Sci Rep 2019;9:3743; free full text at Most patients were currently taking a disease-modifying therapy (DMT) for MS. Other medications commonly used were gastrointestinal drugs, thrombosis prophylaxis drugs, osteoporosis drugs, antihypertensives and sedatives. Read More


Benefits to early switching in MS: MSBase analysis


The most recent analysis from the MSBase Study Group has examined how treatment decision-making affects the risk of conversion to secondary-progressive multiple sclerosis (SPMS) (Brown et al. JAMA 2019;321:175-187). The results indicate that starting with a higher-efficacy disease-modifying therapy (DMT) or switching earlier can substantially reduce the risk of SPMS. Read More


FDA advisors recommend intranasal ketamine in depression


Two FDA advisory committees have voted 14-2 in favour of the use of esketamine for treatment-resistant depression (TRD). The advisors found that the intranasal drug is effective in TRD, and that the benefits outweigh the risks. The esketamine program received a Breakthrough Therapy Designation (BTD) in 2013 based on a phase II study of an intravenous formulation in treatment-resistant depression (Singh et al. Biol Psychiatry 2016;80:424-431). Read More

Always online: problem or addiction?


“Internet addiction” was first described in the dial-up era (Young KS. Psychol Rep 1996;79:899-902), with the prevalence steadily increasing with more widespread internet access. Five years ago, a meta-analysis reported a global prevalence of 6.0% (Cheng et al. Cyberpsychol Behav Soc Netw 2014;17:755-760). More recent estimates have found a prevalence of 17.7% among adolescents in rural Japan (Kojima et al. Psychiatry Clin Neurosci 2019;73:20-26), and 38.2% among university students in Japan (Kitazawa et al. Psychiatry Clin Neurosci 2018;72:531-539). The range in prevalence is largely due to a lack of consensus on diagnostic criteria, which in itself is a reflection of a more fundamental controversy: is Internet overuse an “addiction” or only problematic? Read More