Author | Lightnews

Reposted by Aleksi Hamina

The Mental Elf @thementalelf.bsky.social · 4d

🧪 Weighing the risks: new review ranks antidepressants by their physical health side effects

Antidepressants help many, but how do they affect heart health, weight, blood pressure, or glucose?

New Lancet review (out today!) compared 30 meds across 58k ppl.

🧵 THREAD

#Antidepressants #SideEffects

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Reposted by Aleksi Hamina

The Mental Elf @thementalelf.bsky.social · 20d

🧠 Treating ADHD in psychosis: What does the evidence say about safety?

New research tracked over 9,000 people with schizophrenia spectrum disorders over 9 years.

What happened when they were prescribed ADHD medication? 🧵

#ADHD #Psychosis #MentalHealthResearch #Schizophrenia

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Reposted by Aleksi Hamina

Tapio Määttä @tapiomaatta.bsky.social · 24d

Olisiko hyvä idea, jos yliopistolla aloittava uusi professori saisi miljoonan euron aloituspaketin voidakseen rakentaa omaa tutkimusryhmäänsä?

Jos hyvällä aloituspaketilla tuettu professuuri Itä-Suomen yliopistossa kiinnostaa, ks. toimintaohjeet uutisestamme.

www.uef.fi/fi/artikkeli...

Itä-Suomen yliopistolta 4 miljoonaa euroa kansainvälisten huippuprofessoreiden rekrytointeihin

Itä-Suomen yliopisto tavoittelee korkean kansainvälisen tason tutkijoita vakituisiin ja kokoaikaisiin professuureihin uusilla ja mittavilla rekrytointipaketeilla.

www.uef.fi

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Reposted by Aleksi Hamina

Chris Aiken, MD @chrisaikenmd.bsky.social · Sep 19

Should we start meds for #opioid use disorder like buprenorphine in jail?

Yes. Associated with 50% lower overdose risk and lower risk of reincarnation:
www.ncbi.nlm.nih.gov/pubmed/40929...

Evidence grade: Moderate (5/10)
chrisaikenmd.com/ebm/

▪ 13% of US jails provide it
Art: Van Gogh

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Chris Aiken, MD @chrisaikenmd.bsky.social · Sep 5

New APA delirium guideline says NO to antipsychotics unless severe danger/distress. They failed in large trials:
www.psychiatry.org/getmedia/51e...

Use non-pharm approaches (and address underlying cause) in all patients, such as table 9:
pmc.ncbi.nlm.nih.gov/articles/PMC...

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Art Walaszek, MD @walaszek.medsky.social · Jul 12

1- Stopping an antidepressant causes, on average one more discontinuation symptom than not stopping it, according to a systematic review and meta-analysis of 50 studies involving 17,282 participants.

#medsky #psychsky

jamanetwork.com/journals/jam...

Table 1. Incidence of Individual Symptoms in the First 2 Weeks Following Discontinuation in Placebo-Controlled Studies

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Aleksi Hamina @aleksihamina.bsky.social · Jul 5

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

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Chris Aiken, MD @chrisaikenmd.bsky.social · Jul 4

Pramipexole lifted treatment-resistant #depression with large effect size (0.87) in 48-wk, placebo-controlled augmentation trial of 150
pubmed.ncbi.nlm.nih.gov/40602411

Used 2.5mg as high dose works better in TRD (vs 1.5mg) but more side effects

How to use:
www.thecarlatreport.com/articles/308...

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Olúfẹ́mi O. Táíwò @olufemiotaiwo.bsky.social · Jun 30

I gotta say I find a lot of AI discourse around higher ed very confusing. "if ChatGPT can write your essays is college even worth it?" did people think math teachers were assigning problem sets because *they* couldn't figure out the answers?

190 1.4K 7.9K

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Chris Aiken, MD @chrisaikenmd.bsky.social · Jun 12

People with #schizophrenia lived longer on #clozapine than other antipsychotics in this 11-year study of 41,695 from Hong Kong, confirming earlier findings:
www.ncbi.nlm.nih.gov/pubmed/40412...

Long-acting injectables (LAIs) also had an edge, particularly paliperidone.

#psychiatry #pmhnp

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Aleksi Hamina @aleksihamina.bsky.social · Jun 12

Yes! This is actually discussed as one mechanism that might contribute to lithium's disease-modifying effects!

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Aleksi Hamina @aleksihamina.bsky.social · Jun 12

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.

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Aleksi Hamina @aleksihamina.bsky.social · Jun 12

doi.org/10.1016/S221...

Redirecting

doi.org

Aleksi Hamina @aleksihamina.bsky.social · Jun 12

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.

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Reposted by Aleksi Hamina

JAMA @jama.com · Jun 4

Varenicline, combined with behavioral counseling, increased vaping abstinence in youth who vape nicotine and do not regularly smoke tobacco.

https://ja.ma/4jvML5W

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Art Walaszek, MD @walaszek.medsky.social · May 23

1- New international guidelines for algorithmic treatment (INTEGRATE) of #schizophrenia were just published:

#medsky

www.thelancet.com/journals/lan... (paywall, unfortunately)

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Aleksi Hamina @aleksihamina.bsky.social · May 16

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.

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Aleksi Hamina @aleksihamina.bsky.social · May 13

Yes! The TIME trial was indeed the first one outside this one Spanish research group to properly study this. Hence the "further" in the original post.

Aleksi Hamina @aleksihamina.bsky.social · May 13

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.

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Aleksi Hamina @aleksihamina.bsky.social · May 7

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).

Reposted by Aleksi Hamina

Art Walaszek, MD @walaszek.medsky.social · May 5

The average longest duration between ANC checks was 88 days, consistent with a 2020 consensus guideline recommending quarterly in patients with continuous clozapine treatment for > 1 year who never had an ANC < 2000/μL.

www.jpn.ca/content/45/3...

Consensus statement on the use of clozapine during the COVID-19 pandemic

With the ongoing coronavirus disease 2019 (COVID-19) pandemic, psychiatrists find themselves in the clinical situation of being asked by patients, family members and patient advocacy societies to help...

www.jpn.ca

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Aleksi Hamina @aleksihamina.bsky.social · Apr 30

@cp-neuron.bsky.social

Aleksi Hamina @aleksihamina.bsky.social · Apr 30

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 🧪

$The results of an open-label pilot study to investigate the effects of fecal microbiota transplantation from healthy female donors on fibromyalgia symptoms in 14 women with severe, refractory fibromyalgia. Figure showing statistically significant (positive) effects on pain intensity, Fibromyalgia Impact Questionnaire results, anxiety, depression, sleep disturance, and physical quality of life.$

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Aleksi Hamina @aleksihamina.bsky.social · Apr 15

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.

Aleksi Hamina @aleksihamina.bsky.social · Apr 9

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".

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