A commonly-used antidepressant doesn’t improve recovery after stroke
The antidepressant fluoxetine works no better than placebo to reduce disability after a stroke, lowering hopes that had been raised by other smaller studies.
After a six month trial including more than 3,000 adult stroke patients recruited at 103 UK hospitals, researchers concluded that fluoxetine should not be used to promote recovery from stroke-related disability, or routinely prescribed to prevent depression after stroke.
Several smaller studies and animal trials had found promising result...
No additional weight-loss reported from a lifestyle programme for people with psychosis
For adults with psychosis, such as schizophrenia, who are taking antipsychotic medication, a carefully designed 12-month group diet and exercise programme did not lead to clinically important weight loss after 12 months. The programme was compared with those receiving usual care including written lifestyle advice. Intervention and usual care groups each lost half a kilo on average, with no measurable changes in diet or physical activity.
People with schizophrenia are twice as likely to be overw...
Treatments for depression may help irritable bowel symptoms
Antidepressants are likely to provide more than a placebo effect for those with symptoms of irritable bowel syndrome. Antidepressants improve symptoms in about 60% of those taking them, but two-thirds of that effect may be due to placebo. Psychological therapies, such as talking therapies also appear effective in about half of those offered them but may be partly due to expectations because it is not possible to provide a placebo control.
Irritable bowel syndrome is a chronic disorder of the gu...
Training for clinical competence and resilience reduced job strain among intensive care nurses in France
A five-day educational course showed potential to reduce work-based stress and burnout among nurses working in intensive care units in France. The study conducted in multiple adult intensive care units aimed to identify the effects of an intensive, continuing medical education program on occupational stress.
The course focussed on nursing theory, role-play and debriefing sessions. Six months after attending the programme, intensive care unit nurses showed reduced levels of job strain compared t...
London 2012 Olympics regeneration had minimal impact on physical and mental health
The London 2012 Olympic and Paralympic Gameshad only small and transient effects on physical activity, mental health and well-being for those living nearby. Although access to sporting facilities and green space improved, local adolescents and their parents did not receive any sustained positive effect on physical activity, mental health or well-being.
This NIHR-funded study assessed the impact of a multicomponent urban regeneration programme linked to the Olympics. It looked at changes in heal...
Aerobic exercise is an effective treatment for depression
A systematic review shows aerobic exercise improves clinically diagnosed major depression compared with antidepressants or treatment as usual. Previous reviews found conflicting evidence of benefit. The new review only included the trials thought to have the most applicable results.
This meant that trials recruiting people who might not have a clinical diagnosis of depression or through media adverts were not considered. Also, studies were only included if they featured aerobic exercise –...
Combining mirtazapine with other antidepressants is not effective for treatment-resistant depression
Adding mirtazapine to first-line antidepressants for adults with treatment-resistant depression does not improve symptoms when compared with placebo (dummy pills). People taking mirtazapine are more likely to experience side effects, and stop taking their treatment.
This NIHR-funded trial took place in 106 general practices in England, recruiting 480 adults with mild to severe depression. All participants had been taking selective serotonin reuptake inhibitor (SSRI) or serotonin-noradrenaline r...
Antidepressants do not help treat depression in people living with dementia
Antidepressants do not reduce symptoms of depression in people with dementia compared with placebo (dummy pills). Measured 6 to 13 weeks after starting the treatment, there is little or no difference in participants’ symptoms, but an increased chance of unwanted side effects. The review did not identify enough data to determine if antidepressants have an effect in the longer-term.
This Cochrane review included randomised controlled trials of any antidepressant drugs compared to placebo. P...
Thyroid hormone treatment does not help adults with mildly abnormal thyroid tests
There appears to be no benefit from treating adults with subclinical hypothyroidism. Treatment has no effect on quality of life or symptoms compared with placebo or no treatment.
Thyroid function tests are commonly performed in general practice for patients who present with a range of symptoms, including fatigue or tiredness. When subclinical hypothyroidism is detected, there is uncertainty whether treatment is worthwhile or how to best monitor success. A recent large study found that hormone l...
Benzodiazepines may increase length of stay and chance of delirium in intensive care
Benzodiazepines given during mechanical ventilation in intensive care could increase the risk of a longer hospital stay and delirium compared to other sedatives.
A range of sedatives are used to reduce psychological distress in critically ill patients, but prior to this study, it was not clear which drugs are most effective. This systematic review looked at all the evidence from randomised controlled trials for the effectiveness of six different types of sedative used in people given mechanical...