Commentary on the Finnish analysis of first episode schizophrenia outcomes

A recent study by a Finnish group declares that discontinuing antipsychotics following a first episode of schizophrenia causes higher risk of death or rehospitalisation. The study is based on an observational analysis of routinely collected data, and these analyses can be seriously misleading. It also prioritises short-term outcomes. The study highlights the need for randomised…

Royal College of Psychiatrists still not interested in discussing important evidence on long-term antipsychotic treatment

The annual meeting of the UK’s Royal College of Psychiatrists is in full swing at the moment in London. The conference will again not be debating important new findings about antipsychotic drug treatment. Two years ago the conference organising committee rejected a suggestion to discuss this issue. This year I proposed a similar symposium, which…

Lithium and suicide: what does the evidence show?

There appears to be increasing acceptance of the idea that lithium prevents suicide, and even that it can reduce mortality rates. For a toxic drug that makes most people feel rather depressed, this seems curious. I did wonder whether it might be having this effect on suicide by sapping people of the will to act, but…

NICE guidelines for bipolar disorder- a missed opportunity

There are some things to applaud about the recently released update of the NICE bipolar guidelines (1,2), not least the recognition that the diagnosis has been inappropriately applied to children with behavioural problems. Hopefully this will help curtail the worrying trend of using toxic bipolar drugs in this age group. As usual, however, the Guidelines…