The Cochrane Schizophrenia Group

Prescribing as a junior doctor: do we know what we think we know?

Generic

Generic (Photo credit: Kraemer Family Library)

By Jennifer Nelson, Junior Doctor

“Evidence-based medicine” (EBM) is a term that is familiar to all junior doctors. But how often do we really consider EBM in our everyday practice? Are our decisions on how to treat patients made after careful consideration of the evidence, or do we simply follow trust protocols, or, more likely, go with a sort of “gut-feeling” about which treatment to offer?

Recently,  I was asked to review a patient with paranoid schizophrenia who is currently relapsing. He had been restarted on the antipsychotic Aripiprazole two weeks prior to me seeing him. He was starting to show signs of improvement; the voices were diminishing and he was gaining partial insight into the fact that the “pills” might be helping him. At the end of the interview, I decided to suggest an increase in the dose of Aripiprazole from 15mg to 20mg.  Read the rest of this entry »

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Old side effects and old drugs; old side effects and new drugs

silence the voices - still the visions

silence the voices – still the visions (Photo credit: Jackal1)

By Clive Adams

People using antipsychotic drugs like chlorpromazine and haloperidol get [anticholinergic] side effects such as blurred vision, dry mouth and constipation but the proportion of people experiencing these is not clear.

Past surveys are very old indeed, small and not really proper surveys at all. Their results had been perpetuated for decades without verification. They were undertaken so long ago that they were only about older drugs – so the lack of verification had resulted in bias as the older drugs held their reputation of causing these effects and the newer ones never gathered it in the same way. Read the rest of this entry »

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