The last placebo-controlled ECT trial for depression occurred in 1985. While awaiting trials that meet today's standards of evidence-based medicine, this paper presents the responses, to an online su...

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Schizophrenia-spectrum disorders (SSD) are characterized by interruptions in one's sense of self, cognitive dysfunction, disorganized thinking, belief inflexibility, and unusual experiences such ...

This randomized clinical trial compares early dose reduction or discontinuation vs maintenance treatment of antipsychotic medication for patients remitted from first-episode psychosis in the Netherlan...

The study shows that tapering can be successfully and relatively safely done by most people after first-episode psychosis.

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Background The implementation of electronic patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in community mental healthcare is a complex experience for both t...

Patients with deficit schizophrenia (DS) have been reported to have lower levels of insight than those with non-deficit schizophrenia (NDS). However, …

The World Psychiatric Association (WPA) advocates for a practical approach to implementing alternatives to coercion in mental health care. It adopted a Position Statement and Call to Action in 2020 th...

We must educate judges so they can rule in lawsuits related to psychiatry. Judge Picard’s biases in this verdict were one of factors.

Background: Norwegian health authorities have implemented treatment units devoted to medication-free mental health treatment in all health regions to improve people’s freedom of choice. This article e...

Stadig flere har forstått at psykiatriens fortelling om psykiske vansker ikke holder mål. Likevel er media restriktive med å omtale funn som slår beina under den sykdomsmodellen.

Frykt for søksmål, frykt for tap av annonseinntekter og journalister som mangler kompetanse til å vurdere faglig kvalitet. Det er momenter psykolog og seniorforsker Geir Smedslund trekker fram som mul...

Stakeholders worldwide increasingly acknowledge the need to address coercive practices in mental healthcare. Options have been described and evaluated in several countries, as noted recently in major ...

Objective: Relapse prevention is a major goal of schizophrenia treatment. However, there is no standard definition of relapse. To address this, the authors reviewed recent approaches and developed con...

- Skal du bare lese én bok om helse i den nærmeste fremtid, så anbefaler jeg deg å velge denne. Hilde Marie Rekstad lot seg imponere av en «brutalt opprørende og samtidig fantastisk håpefull og innsik...

Cognitive behavioral therapy for insomnia (CBT-I) is the first-line treatment for insomnia in general population, but only recently has it begun to be…

Antipsychotic medications (APs) are pivotal in treating schizophrenia, alleviating symptoms like delusions, hallucinations, and disorganized behavior. APs can induce extrapyramidal symptoms and sedation, complicating chronic use but aiding in acute management. AP-induced metabolic syndrome, a primary factor in reduced life expectancy, is not a major concern during short-term treatment. Studies on APs efficacy yield mixed results, leading to trial-and-error prescribing practices. Meta-analyses indicate clozapine, amisulpride, olanzapine, and risperidone as effective in acute settings, with olanzapine and haloperidol beneficial for SZ-related agitation. Empirical observations suggest higher potency APs, like olanzapine and haloperidol, are more effective in acute psychosis, with zuclopenthixol also advantageous for its sedative properties. Cariprazine, lurasidone, low-dose amisulpride, brexpiprazole and aripiprazole showed a favorable side effects profile and a potential benefit on negative symptoms. My proposal in this perspective paper is to consider schizophrenia as a relapsing–remitting disorder, requiring a different pharmacological approach in the acute and maintenance phases. In the initial phase a high-dose, high-potency and fast-titrating AP should be used, for rapid symptoms’ control (i.e. haloperidol, olanzapine, risperidone, high-dose amisulpride, zuchlopenthixol), defined as a tactic AP. Once the acute phase resolved, patients should be gradually switched towards a medication with fewer side effects (i.e. metabolic syndrome, extrapyramidal symptoms, hyperprolactinemia) and a potential efficacy on negative symptoms and personal functioning (i.e. cariprazine, low-dose amisulpride, lurasidone, aripiprazole, brexpiprazole), to be continued in the long term, defined as a strategic AP. This approach aligns with empirical observations and aims to refine schizophrenia care through phase-specific APs use, necessitating further studies to validate its efficacy.

Mental disorders represent a worldwide public health concern. Psychotherapies and pharmacotherapies are recommended as first line treatments. However, evidence has emerged that their efficacy may be o...

Når så mange liv verden over har blitt ødelagt over så mange år for at en gruppe mennesker skal få høyere status og tjene mer penger, kan det med rette kalles for den største skandalen i medisinens hi...