Journal Watch: Complex Polypharmacy and Bipolar Disorder; Prazosin for Military Combat-Related PTSD; Caffeine Intake Steady Among Children, Adolescents

We know you don't have time to read it all.  Here are some of the studies that caught our eye this week.



Complex Polypharmacy and Bipolar Disorder

The treatment and management of bipolar disorder (BD) has trended towards increasing rates of complex polypharmacy (defined as ≥ 4 psychotropic medications), despite a lack of clinical data supporting the efficacy of treatment with >3 drugs. Concerns with complex polypharmacy include the risk of adverse side effects, drug interactions, medication errors, patient non-adherence, and medical comorbidities. A retrospective chart review study of adults presenting for psychiatric hospital admission found that an average of 3.31 psychotropic and 5.94 total medications were noted at intake. Overall, 36% of patients met the criteria for complex polypharmacy and were more likely to be female, depressed, have a history of suicide attempt, and have a comorbid anxiety disorder.

Original source: Psychiatry Research
 

Prazosin for Military Combat-Related PTSD

Trauma-related nightmares are a common symptom of post-traumatic stress disorder (PTSD), with 50–70% of combat veterans with PTSD reporting this occurrence. These nightmares are also one of the most treatment-resistant symptoms of the disorder, as SSRIs have not been shown to be effective for this symptom. Prazosin, an antihypertensive, has been recognized as a potential off-label addendum to traditional antidepressant treatment for the management of combat-related PTSD nightmares. An examination of research into this off-label use found positive evidence for prazosin as an augmentation to other PTSD medications and therapies for combat-related PTSD nightmares.

Original Source: Journal of Neuropsychiatry and Clinical Neurosciences
 

Caffeine Intake Steady Among Children, Adolescents

Excess consumption of caffeine has been shown to have negative effects in adults, but potential adverse effects on children and adolescents have not been studied. This study evaluated reported caffeine consumption in children and adolescents from 1999–2010 and found that mean consumption has remained steady at 73% of those surveyed. While the proportion of caffeine consumed from soda declined in this time, caffeine from coffee and energy drinks increased over the time span. Additional research is needed to evaluate if children and adolescents are substituting coffee or energy drinks for soda due to varying amounts of caffeine in these products.

Original Source: Pediatrics
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