Aleksi Hamina
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aleksihamina.bsky.social
Aleksi Hamina
@aleksihamina.bsky.social
43 followers 80 following 31 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.
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aleksihamina.bsky.social
New publication in World Psychiatry! We applied standard RCT excludion criteria to adults with MDD on maintenance antidepressants in Finland (n=73,720) and Sweden (n=135,092). >33% were RCT‑ineligible and had ≈2.5× higher risk of main outcome. #medsky 🧪🧠🩺

Open access! www.doi.org/10.1002/wps.70013
Graphical abstract of the study. Same information in the written abstract: We determined the proportion of individuals with major depressive disorder (MDD) receiving maintenance antidepressant treatment in routine care who would be ineligible for RCTs, and compared their outcomes with those who were eligible. Utilizing specialized health care registers in Finland (2004-2018) and Sweden (2006-2021), we identified adults diagnosed with non-psychotic MDD (ICD-10: F32, F33) who were stabilized on maintenance antidepressant monotherapy. Through multidisciplinary expert consensus on latest meta-analytic evidence, we derived a standardized list of RCT inclusion and exclusion criteria. These criteria were systematically applied to classify individuals as RCT-eligible or RCT-ineligible. We then used Cox proportional models to derive hazard ratios (HRs) of a composite primary outcome of hospitalization due to any psychiatric reason or suicide attempt, and all-cause mortality, during a 6-month follow-up. Secondary outcomes were treatment changes (i.e., discontinuation, switch or augmentation) and psychiatric sick leave ≥2 weeks. A total of 73,720 individuals in Finland and 135,092 in Sweden were included. More than one third of patients with MDD (33.5% in Finland and 35.3% in Sweden) were found to be ineligible for RCTs. The most common reasons for ineligibility were comorbidities (serious somatic disease, other psychiatric disorders, or substance use disorder). RCT-ineligible individuals had more than twice the risk of the composite primary outcome compared to eligible individuals (HR=2.44, 95% CI: 2.15-2.76 in Finland; HR=2.61, 95% CI: 2.37-2.87 in Sweden)
January 15, 2026 at 1:18 PM
Reposted by Aleksi Hamina
altmetric.com
Since Jan 1 2025, which feels like four trillion years ago, research has been shared on here 5 million whole-ass times. Bluesky recently passed 2 billion posts IN TOTAL.

So 0.25% of the entire site's traffic was citations to research.

That is actually massively high. Is it? Yes. Here's why.
Altmetric Explorer screenshot: Showing 5,011,088 mentions (from 4,918,333 individual posts) of research outputs from the results of your search query.
January 8, 2026 at 1:08 PM
Reposted by Aleksi Hamina
walaszek.medsky.social
Weight gain, increased blood sugar & elevated blood sugar can be major problems in people with #schizophrenia taking antipsychotics.

This small RCT found that weekly semaglutide injections improved hemoglobin A1c in people taking olanzapine or clozapine.

#medsky

jamanetwork.com/journals/jam...
Semaglutide in Schizophrenia Spectrum Disorders
This randomized clinical trial investigates the effects of semaglutide on glycemic control and weight outcomes in individuals with early-stage prediabetes or diabetes and schizophrenia spectrum disord...
jamanetwork.com
December 5, 2025 at 1:21 AM
Reposted by Aleksi Hamina
thelancetpsych.bsky.social
"clozapine is more effective than other oral antipsychotics in reducing psychiatric hospitalisations and several secondary outcomes in schizophrenia-spectrum disorders, bipolar disorder, inpatient-treated major depressive disorder, & psychotic depression"

Article:
www.thelancet.com/journals/lan...
Transdiagnostic effectiveness and safety of clozapine in individuals with psychotic, affective, and personality disorders: nationwide and meta-analytic comparisons with other antipsychotics
These findings support the transdiagnostic effectiveness and safety of clozapine, particularly in schizophrenia-spectrum disorders, bipolar disorder, and severe depression. Given the overall consisten...
www.thelancet.com
November 3, 2025 at 8:42 AM
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
Reposted by Aleksi Hamina
thementalelf.bsky.social
🧪 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
October 22, 2025 at 6:41 AM
Reposted by Aleksi Hamina
thementalelf.bsky.social
🧠 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
October 6, 2025 at 6:41 AM
Reposted by Aleksi Hamina
tapiomaatta.bsky.social
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
October 2, 2025 at 11:00 AM
Reposted by Aleksi Hamina
chrisaikenmd.bsky.social
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
September 19, 2025 at 12:03 PM
Reposted by Aleksi Hamina
chrisaikenmd.bsky.social
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...
September 5, 2025 at 12:01 PM
Reposted by Aleksi Hamina
walaszek.medsky.social
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
July 12, 2025 at 3:28 PM
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
Reposted by Aleksi Hamina
chrisaikenmd.bsky.social
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...
July 4, 2025 at 12:09 PM
Reposted by Aleksi Hamina
olufemiotaiwo.bsky.social
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?
June 30, 2025 at 2:15 PM
Reposted by Aleksi Hamina
chrisaikenmd.bsky.social
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
June 12, 2025 at 2:03 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
Reposted by Aleksi Hamina
jama.com
Varenicline, combined with behavioral counseling, increased vaping abstinence in youth who vape nicotine and do not regularly smoke tobacco.

https://ja.ma/4jvML5W
Visual Abstract
June 4, 2025 at 10:00 AM
Reposted by Aleksi Hamina
walaszek.medsky.social
1- New international guidelines for algorithmic treatment (INTEGRATE) of #schizophrenia were just published:

#medsky

www.thelancet.com/journals/lan... (paywall, unfortunately)
May 23, 2025 at 5:39 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
Reposted by Aleksi Hamina
walaszek.medsky.social
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
May 5, 2025 at 1:08 PM
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