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 www.ncbi.nlm.nih.gov/pmc/articles/PMC6403326/pdf/41598_2019_Article_40283.pdf). 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
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Benefits to early switching in MS: MSBase analysis
February 27, 2019The 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
February 20, 2019Two 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?
February 13, 2019“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