Aleksi Hamina
LightNews LightNews
banner
aleksihamina.bsky.social
Aleksi Hamina
@aleksihamina.bsky.social
38 followers 79 following 30 posts
Pharmacist and reseacher with an interest in all things science 🧪 #medsky #episky #psychiatry

Investigating substance use disorders, severe mental health disorders, opioid analgesics, and epidemiology of medication use with Nordic healthcare data.
Posts Replies Media Videos
aleksihamina.bsky.social
New study out in @thelancetpsych.bsky.social!

Clozapine was associated with reduced psychiatric hospitalisations compared with other oral antipsychotics across several psychotic and affective disorders, but not borderline personality disorder.

Free access!
authors.elsevier.com/c/1m2747tf1d...
A forest plot figure of the risk of the primary outcome, hospitalisation for any psychiatric reason, in people with schizophrenia, schizoaffective disorder, bipolar disorder, depression, psychotic depression, delusional disorder, and borderline personality disorder in the Finnish and Swedish cohorts and meta-analysis of these cohorts. Figure shows decreased risk for clozapine compared to other oral antipsychotics as a group for all other studied disorders, but not for borderline personality disorder.
November 3, 2025 at 7:41 AM
aleksihamina.bsky.social
Interesting new analysis of ADHD meds in schizophrenia-spectrum disorders: reduced risk of psychosis with atomoxetine and reduced risk for somatic hospitalizations with lisdexamphetamine.

Higher somatic hospitalization with polytherapy, no other negative safety signals. #psychiatry #medsky
July 5, 2025 at 8:11 AM
aleksihamina.bsky.social
Yes! This is actually discussed as one mechanism that might contribute to lithium's disease-modifying effects!
June 12, 2025 at 1:33 PM
aleksihamina.bsky.social
Small (N=31) but important phase 2 trial in @thelancetpsych.bsky.social indicates semaglutide is safe and effective in people with schizophrenia on clozapine: 13.9% mean weight loss in 3 years with no difference in PANSS scores or clozapine levels. doi.org/10.1016/S221... #medsky #psychiatry
Percentage weight change in participants up to 36 weeks. A line chart showing significant weight loss in the semaglutide group and no change in the placebo group.
June 12, 2025 at 10:23 AM
aleksihamina.bsky.social
Extremely interesting narrative review on lithium's potential as a disease-modifying drug in bipolar disorder published in @thelancetpsych.bsky.social #medsky #psychiatry
Abstract of the article "Lithium as a disease-modifying drug for bipolar disorder": Lithium is a classic, primary treatment for bipolar disorder that has paradoxically been used less over time, especially in North America, which goes against the accumulating evidence for its efficacy. Bipolar disorder is increasingly conceptualised as a chronic, potentially progressive condition worsened and accelerated by each mood episode, which might resemble multiple sclerosis or rheumatoid arthritis as a condition that requires disease-modifying treatments to change illness trajectory. In this Personal View, we argue that lithium acts like a disease-modifying drug in bipolar disorder. Although the pathophysiology of bipolar disorder remains unclear, many of the mechanisms implicated in bipolar disorder, and the surrogate markers associated with this condition, are uniquely affected by lithium treatment from the DNA and cellular levels to the structure and function of the brain and other body systems. Clinical trial and cohort study evidence shows that lithium is effective and probably superior to other medications used to treat bipolar disorder, and that long-term outcomes are better with lithium than non-lithium regimens. Conceptualisation of lithium as a disease-modifying agent might help to increase clinical use by doctors, especially early in the disease course to better serve our patients.
June 12, 2025 at 8:06 AM
aleksihamina.bsky.social
Our new study, published in PAIN, analyzed age-standardized mortality in 116,006 non-cancer long-term users of opioids. Multifold risk of mortality vs the general population, especially due to suicide, accidents, and accidental poisoning.
www.doi.org/10.1097/j.pain.0000000000003653
#medsky 🧪 #episky
Table on Standardized Mortality Ratios for all-cause and cause-specific mortality in noncancer patients with long-term prescription opioid use. Results show multifold risk for unnatural causes of death, especially suicide, accidents, and accidental poisoning.
May 16, 2025 at 7:11 AM
aleksihamina.bsky.social
New study on 3357 Canadian hypertension patients (followed on median 4.6 years) showed no difference between morning vs. bedtime dosing for CV outcomes, casting further doubt on the dramatic results of the MAPEC and Hygia trials.

www.doi.org/10.1001/jama.2025.4390
#medsky 🧪
Graphical abstract of the study, explaining randomization of 1677 patients to bedtime, 1680 patients to morning dosing. Findings were 2.3 cardiovascular events per 100 py with bedtime dosing and 2.4 with morning dosing (adjusted hazard ratio 0.96, 95% CI 0.77-1.19), ie, no difference.
May 13, 2025 at 7:02 AM
aleksihamina.bsky.social
New study from our group! In a Swedish cohort of 1772 individuals with cannabis-induced psychosis, antipsychotics and especially LAIs, were effective in preventing re-hospitalization.

Open access! Published in the British Journal of Psychiatry
www.doi.org/10.1192/bjp.2025.72
A forest plot graph on the association of antipsychotic use with hospital admission caused by psychotic relapse, compared to periods of non-use. Graph shows lowered adjusted hazard ratios for any antipsychotic, but also especially for long-acting injectable antipsychotics (LAIs).
May 7, 2025 at 8:16 AM
aleksihamina.bsky.social
Super interesting (but preliminary) study published in Neuron, indicating:
-Transplanting gut microbiota from women with
fibromyalgia into mice induces pain
-Replacing fibromyalgia microbiota with healthy microbiota alleviated pain both in mice and humans
doi.org/10.1016/j.ne...
#medsky 🧪
The results of an open-label pilot study to investigate the effects of fecal microbiota transplantation from healthy female donors on fibromyalgia symptoms in 14 women with severe, refractory fibromyalgia. Figure showing statistically significant (positive) effects on pain intensity, Fibromyalgia Impact Questionnaire results, anxiety, depression, sleep disturance, and physical quality of life.
April 30, 2025 at 7:28 AM
aleksihamina.bsky.social
Study in BC 🇨🇦 sees no change in opioid or stimulant harms 1 year after decriminalization. "The findings do not support decriminalization in isolation as an effective policy at reducing drug overdose harms."

Keep an eye on that opioid hospitalization trend, though

www.doi.org/10.1001/jama.2025.3006
Changes in opioid and stimulant deaths and hospitalizations two years before and one year after decriminalization in British Columbia.
April 15, 2025 at 8:30 AM
aleksihamina.bsky.social
New short report in the American Journal of Psychiatry indicates that self-reported non-medical use of prescription stimulants, opioids, and benzodiazepines in adolescents decreased notably between 2009 and 2022 in US adolescents:
www.doi.org/10.1176/appi.ajp.20240674 🧪
Trend lines (2009-2022) of nonmedical use of prescription benzodiazepines, opioids, and stimulants showing decreases in past-year nonmedical use, lifetime medical use and adolescents reporting these drugs are "very easy to get. Simultaneously increases in adolescents reporting that these drugs are "probably impossible to get".
April 9, 2025 at 11:20 AM
aleksihamina.bsky.social
New meta-analysis finds co-occurring psychotic disorders are negatively associated with OAT retention, but no evidence of association between co-occurring psychotic disorders and illicit drug use (in OAT).

doi.org/10.1007/s404...
Forest plot of comparison: patients with psychotic versus patients with non-psychotic OUD receiving opioid agonist therapy, outcome: treatment retention. Pooled OR 0.65 (95% CI: 0.57–0.74; P < 0.05), suggesting significantly poorer OAT retention among patients with OUD and psychotic disorders.
March 25, 2025 at 7:41 AM
aleksihamina.bsky.social
New study!

Despite continuous use of LAI D2 blockers, 45% of first-episode schizophrenia patients relapsed in 10 years, suggesting non-dopaminergic pathophysiology. Risk of breakthrough psychosis decreased over time, opposing dopamine supersensitivity theory. dx.doi.org/10.1176/appi.ajp.20240321
Kaplan-Meier graphs of cumulative probability of relapse among patients on continuous long-acting injectable (LAI) antipsychotic treatment (N=305) and all other patients during the first year and across 10 years (N=4,483). The figures show lower risk with LAI, but progressively cumulating relapses over time.
February 20, 2025 at 1:23 PM
aleksihamina.bsky.social
Prior research from our team also showed a smaller risk for AUD hospitalization with GLP-1 agonists. www.doi.org/10.1001/jamapsychiatry.2024.3599
Risk of hospitalization due to AUD and SUD, showing association with decreased risk with semaglutide and liraglutide.
February 13, 2025 at 8:10 AM
aleksihamina.bsky.social
Prospective self-measured outcomes paint a messier picture, but I will be waiting for phase 3 with great interest.
February 13, 2025 at 8:10 AM
aleksihamina.bsky.social
New evidence for treating AUD with semaglutide: phase 2 RCT including 48 participants showed a decrease in laboratory alcohol self-administration (and some self-measured outcomes). www.doi.org/10.1001/jamapsychiatry.2024.4789
Visual abstract of the RCT "Once-weekly semaglutide in adults with alcohol use disorder".
February 13, 2025 at 8:10 AM
aleksihamina.bsky.social
New Lancet Psychiatry study on 105,495 individuals with bipolar disorder in Sweden: lithium reduces the risk of hospitalisation for depression (aHR 0·75, 95% CI 0·67–0·85) mania (0·61, 0·54–0·68), and somatic hospitalisation (0·86, 0·80–0·93), unlike any other drug.

doi.org/10.1016/S221...
Risk of depression-related hospitalisation associated with drugs for bipolar disease in a within-individual model compared to non-use. Only lithium is associated with a decreased risk (aHR 0.75, 95% CI 0.67-0.85).
February 7, 2025 at 8:30 AM
aleksihamina.bsky.social
We published our analysis on the fatal overdose risk associated with pregabalin and gabapentin as a Letter to the Editor in PAIN. I believe the title wraps it up nicely: Pregabalin is associated with a higher overdose risk but the risk with gabapentin is not negligible.

dx.doi.org/10.1097/j.pa...
January 15, 2025 at 9:21 AM
aleksihamina.bsky.social
Time to activate Bluesky with some blue skies.
Dog on a rock beside a blue lake and a blue sky.
December 3, 2024 at 4:12 PM