The Canadian Network for Mood and Anxiety Disorders (CANMAT) has produced an update of its guidelines for the management of patients with bipolar disorder (Yatham et al. Bipolar Disord 2013;15:1-44). The guidelines were produced in conjunction with the International Society for Bipolar Disorders. Read More
Psychiatry
What is the minimum clinically important change in PANSS?
July 17, 2013An analysis has been conducted to determine the minimum clinically important difference in the positive and negative syndrome scale (PANSS) during antipsychotic treatment based on data from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study (Hermes et al. J Clin Psychiatry 2012;73:526-532). Data were available for 1,442 patients to link PANSS scores and clinician/patient ratings on the Clinical Global Impressions (CGI) scale.
First-episode schizophrenia: two reports from the EUFEST study
May 8, 2013The European First Episode Schizophrenia Trial (EUFEST) was initiated in 2005 as a multicentre open-label trial comparing treatment with amisulpride, quetiapine, olanzapine or ziprasidone to low-dose haloperidol in patients with schizophrenia who had minimal prior exposure to antipsychotics (Fleischhacker et al. Schizophr Res 2005;78:147-156).
The EUFEST group reported that 12-month remission rates were higher with second-generation antipsychotics (amisulpride 40%; olanzapine 41%; quetiapine 24%, ziprasidone 28%) compared to haloperidol (17%) (Boter et al. Schizophr Res 2009;115:97-103). A subsequent finding was that the likelihood of remission at 12 months was correctly predicted at the week 2 assessment in 61% of cases (positive predictive power 0.61, negative predictive power 0.58), although accuracy was improved with the addition of 4-week (63%; PPP 0.67, NPP 0.55) and 6-week assessments (68%; PPP 0.73, NPP 0.61) (Derks et al. J Clin Psychopharmacol 2010;30:176-180).
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Web-based CBT effective for depression, QOL
May 8, 2013The Australian National University, Canberra, reports that a web-based cognitive-behavioural therapy (CBT) program can be an effective tool in improving depression and quality of life. Callers to a national helpline with moderate to high psychological distress were randomized to an Internet CBT program, weekly telephone follow-ups, Internet CBT plus weekly telephone follow-up, or usual care (Farrer et al. PLoS One 2011;6:e28099; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3227639/pdf/pone.0028099.pdf).
Mean patient age was 37-43 years, 82% of participants were female and 53% were not employed. Most (93%) had a history of depression, 60% had a history of social phobia, and 74% had experienced a panic attack in the preceding four weeks.
Lower zolpidem dosing advised
April 10, 2013The U.S. FDA has issued an advisory recommending a lower dose for products containing the hypnotic zolpidem, such as Ambien, Ambien CR, Edluar, and Zolpimist. In Canada, zolpidem is sold under the trade name Sublinox. Dosing for Intermezzo, a zolpidem formulation for middle-of-the-night awakening, is unaffected.