This means that anyone on 45mg a day or more shouldn’t panic. Talk about this to your doctor next time you meet. You could either reduce the dose, switch medicines (although this effect has been known with other antidepressants too), or carry on, but with an ECG (a test of your heart’s electrical activity).

There is no need to panic. If you are taking up to 40mg a day there is no problem. If you are taking 45mg or more a day you should probably see your doctor about this in the next few weeks. You may get a bit of a blank look because this warning has not been issued in Europe yet, just the USA.

Findings from the studies include:

• two common antidepressants are not clinically effective for treating significant depression in Alzheimer’s
• agitation levels of people with moderate or severe dementia in care homes who were treated with pain medication were reduced by 17 per cent over eight weeks
• the Alzheimer’s drug Ebixa was not beneficial for treating clinically significant agitation in people with later stage Alzheimer’s although there was a potential benefit for aggression and it did improve cognition

Read more about the studies on the Alzheimer’s Society website

The research shows that a huge number of women use antidepressants for long periods without being reviewed or offered any alternatives to drugs.

http://www.platform51.org/resources/Check_and_choices:_women_and_antidepressants

• Download The Right Prescription: a call to action on the use of antipsychotic drugs for people with dementia
• Alzheimer’s Society and the Department of Health (2011) Optimising treatment and care for people with behavioural and psychological symptoms of dementia. London, Alzheimer’s Society.
  The guide provides information, advice and resources for treatment and person-centred care for people with dementia experiencing behavioural and psychological symptoms.

A long-acting depot injection (once-a-month) became available in April 2011 in the UK.

A long-acting injection of paliperidone (which is very similar to risperidone) for psychosis or schizophrenia .

• Good points: Can be given monthly, can be given in the arm or bum, easier to use than risperidone Consta
• Bad points: it’s not risperidone

The dataset answers questions, such as: How many prescription items were dispensed? What was the net ingredient cost of prescriptions? Which NICE appraised drugs are used in hospitals? What is the variation in hospital supplied medicines across strategic health authorities?

• Download the dataset in full
• Access and use a free tool called iView, which will allow you to manipulate and extract data. To use NHS iView you need to register for an NHS IC account.

This was issued on 23rd March 2011 and says that:
The review and re-appraisal of donepezil, galantamine, rivastigmine and memantine for the treatment of Alzheimer’s disease has resulted in a change in the guidance. Specifically:

This is a change because before memantine was not approved, but now it is considered an option. English PCTs and Trusts have to implement the guidelines by the end on June.

• What is Choice and medication?
• The aims of Choice and medication
• The challenges that the industry faces

• Good points: can be given every 2 or 4 weeks, and is a long-acting injection of the well known and effective antipsychotic olanzapine
• Bad points: very rarely, the injection can cause heavy sedation for a few hours after an injection. So the injection has to be given in a health care establishment (e.g. hospital, surgery), and the person looked after for 3 hours afterwards.

Download a PILL (Patient Information Leaflet), a two-page summary about Agomelatine which can be printed.

Agomelatine is a different type of antidepressant.

• Good points: very different way of working, effective, almost no side effects, helps sleep
• Bad points: need a blood test every few weeks for several months, considered to be too expensive by some parts of the NHS (£30 a month for the standard 25mg a day dose)

Quality Accounts are annual reports to the public on the quality of the services which an NHS organisation delivers. By producing a Quality Account, each NHS provider, led by their board, is committing to improve the quality of services it delivers and inviting the public to hold them account.

This consultation sets out the recommendations for the regulations and guidance supporting Quality Accounts in the first year, and is based on findings from a series of engagement, testing and design exercises over the past year.

Responses to this consultation will inform a report setting out the regulations and guidance for NHS organisations to use when producing their first Quality Accounts in 2010.

The consultation will close on 10 December 2009.

Further information:

• letter from Professor Sir Bruce Keogh
• consultation document (PDF, 740KB)
• consultation response form (MS Word, 3191KB)
• Quality Accounts web pages
• Impact assessments for the Health Bill 2009

Please send your completed response form by email to QualityAccounts@dh.gsi.gov.uk or by post to Dr Karen Noakes, NHS Quality Framework Division, Department of Health, Room 552C Skipton House, 80 London Road, London, SE1 6LH.

Antisocial personality disorder is a condition that affects a person’s thoughts, emotions and behaviour in a way that is disruptive to, and may be harmful to, other people. People with ASPD exhibit traits of impulsivity, anger and associated behaviours including irresponsible, recklessness and deceitfulness. They have often grown up in fractured families in which parental conflict is typical and parenting is harsh and inconsistent. Many people with antisocial personality disorder have a criminal conviction and are imprisoned or die prematurely as a result of reckless behaviour.

2009/005 New NICE guidelines set to improve treatment and management of people with antisocial personality disorder (52.6 Kb 15 sec @ 28.8Kbps)

Antisocial Personality Disorder – Implementing NICE guidance from Super Mega Action Plus.

Visit http://www.nice.org.uk/CG77 for the guideline, the quick reference guide, costing report and template and audit support.

borderline personality disorder

Borderline personality disorder is a condition that affects a person’s thoughts, emotions and behaviour. Symptoms include having emotions that are up and down, with feelings of emptiness and often anger, difficulty in making and maintaining relationships, having an unstable sense of identity and harming yourself or thinking about harming yourself (for example, cutting yourself or overdosing). People with borderline personality disorder come from many different backgrounds, but most will have suffered some kind of trauma or neglect as children.

2009/004 New NICE guidelines set to improve treatment and management of people with borderline personality disorder (56.65 Kb 16 sec @ 28.8Kbps)

Borderline Personality Disorder – Implementing NICE guidance from Super Mega Action Plus.

Visit http://www.nice.org.uk/CG78 for other guideline formats, costing report and template and audit support.

• Read more about the guidelines
• Depression: Guidelines & Article
• Suicidal thoughts and behaviours: Guidelines & Article
• Psychosis: Guidelines & Article
• Panic attacks: Guidelines       
• Non-suicidal self injury : Guidelines & Article
• Adult trauma: Guidelines
• Child trauma: Guidelines
• Eating disorders: Guidelines
• Problem drinking: Guidelines
• Problem drug use: Guidelines
• Problem cannabis use: Guidelines

The guidelines are designed to help individuals, families and communities who find themselves faced with mental illness and would like to find some reputable information about how they should provide assistance. The guidelines encourage early intervention by suggesting action is taken early in the development of an illness.

Comments should be added to the comments matrix and emailed to Bryony.Stuart@coi.gsi.gov.uk

The deadline for responses is Monday 21 September 2009.

Read more here:

• Consultation on the CQC mental health strategy
• Consultations

The Care Quality Commission is keen to get your views on the following issues:

1. Where does the Care Quality Commission need to focus its efforts in the next three to five years to really make a difference in mental health?

In particular, it would be helpful to have your views on:

• What are the priority areas for improvement in mental health?
• How can CQC best make an impact in relation to these areas?

What should we do?

• When should CQC tackle these issues?
• What would success look like?

2. How should we involve people who use services and their families and carers in developing, implementing and monitoring the strategy?

In particular, it would be helpful to have your views on:

• How should we feature this in the mental health strategy?
• What approaches should we use to make sure involvement is effective throughout this process?

To ensure that we can take account of your views, the deadline for submissions has been extended to: Monday 7th September 2009. You can give us your views by:

• By email: mentalhealthstrategy@cqc.org.uk
• By post (no stamp required) by sending your response to: Nicola Vick, Mental Health Strategy Team, Care Quality Commission, 13th Floor, Finsbury Tower, 103-105 Bunhill Row, LON 15399 FREEPOST, London, EC1B 1QW
• By phone: call Jay Harman, Policy Manager, Care Quality Commission, on 01159 437 104 (an answerphone will be available from 5pm to 9am Monday to Friday and over the weekends).

In addition to further service improvements, New Horizons sets out a dynamic new approach to improving well-being for the whole population, aiming for the first time to create a powerful alliance that can target the root causes of poor mental health.

While New Horizons describes some clear ideas that have emerged during discussions with a wide range of people it is not a final document. There are still important questions to be answered and your response can help influence the final version.

• Download consultation document (PDF, 3659K)
• Download executive summary (PDF, 1397K)
• Download equality impact assessment (PDF, 122K)
• Answers to common questions about New Horizons and the consultation process

Have your say about New Horizons:

• Fill in an on-line response form www.info.doh.gov.uk/questionnaire/newhorizons.nsf
• Respond by post using the response form at the back of the consultation document and sending it to Mental Health Policy Team, Department of Health, Wellington House, 133-155 Waterloo Road, London, SE1 8UG.

A number of key themes are being consulted on:

• prevention and public mental health– recognising the need to prevent as well as treat mental health and promote mental health and well-being
• stigma – strengthening our focus on social inclusion and tackling stigma and discrimination wherever they occur
• early intervention – expanding  the principle of early intervention to improve long term outcomes
• personalised care – ensuring care is based on individuals’ needs and wishes leading to recovery
• multi-agency commissioning/collaboration – working to achieve a joint approach between local authorities, the NHS and others, mirrored by cross government collaboration
• innovation – seeking out new and dynamic ways to achieve our objectives based on research and new technologies
• value for money – delivering cost-effective and innovative services in a period of recession
• strengthening transition – improving the often difficult transition from child and adolescent mental health services to adult services, for those with continuing needs and issues.

Care Services Minister Phil Hope said:

‘Better mental health and well-being is vital for a healthy society. People with mental health problems are more likely to do other things that damage their health, such as have a poor diet, smoke or take drugs. So promoting good mental health is a key part of tackling many other health inequalities.’

‘Over the last ten years of the national service framework we’ve transformed mental healthcare but now we want to go further. Our aim is to build on recent achievements, whilst simultaneously taking the next logical step – helping to prevent mental health problems from developing in the first place. New Horizons will help us do this.’

‘We want to involve everyone in building mentally healthier communities, which is why it is important  that people up and down the country tell us what they think about the ideas set out in New Horizons.’

Louis Appleby, National Director for Mental Health Services said:

‘Around 50% of lifetime mental illness starts before the age of 14 and continues to have a detrimental affect on people’s lives. Potentially half of these problems are preventable.’

‘The New Horizons vision is about promoting better mental health and well-being. It is also about high quality, responsive services, that intervene early and effectively to lessen the long-term effects of mental ill-health. Services that are focused not only on treatment outcomes, but on wider quality of life issues, strengthened by efforts to promote social inclusion and tackle stigma and discrimination of every kind.’

‘Poor mental health is already believed to cost the economy £77billion a year, with the King’s Fund predicting that the cost in terms of GDP will double to over 10% by 2026. The indirect costs of poor mental health include poor educational attainment, unemployment and increased crime and anti-social behaviour.’

“The Government is already taking action so that we can all make the most of the opportunities that longer lives bring. We have fundamentally reformed our pension system, increasing the state pension age and making sure that much greater numbers of people are saving adequately for their retirement. We are outlawing age discrimination in goods, facilities and services and will shortly publish options for reforming care and support. We are now at a demographic tipping point and today’s strategy will build on foundations to equip the UK to meet the needs and aspirations of the future.”

With pensioners now outnumbering school children, the Government is acting to make sure we are all – as individuals and families, as communities and service providers – prepared for the challenges and opportunities ahead.

The strategy, the latest in the series of announcements to follow the publication of the Government’s plan for ‘Building Britain’s Future’, draws together action to help individuals, families, businesses, public services and communities respond to demographic change. It follows the Government’s major reforms to respond to demographic change including the Turner reforms to the Pension system, the measures to outlaw age discrimination in the new Equality Bill, and the new Care and Support Green Paper to be published this week.

As part of helping the economy respond to an ageing society, a review of the Default Retirement Age (DRA) will be brought forward to take place next year. Currently employers can require all staff to retire at 65 regardless of their circumstances. The majority of people retire before 65, however 1.3m people choose to work beyond state pension age, and many more say they would work past 65 if their employer permitted it. The Government had previously promised to review the DRA in 2011 to see if it was still needed, but Ministers have brought the review forward to respond to changing demographic and economic circumstances.

Speaking about the Default Retirement Age, Angela went on to say;

“It is time to look again at this. Some people prefer to take early retirement, others prefer to keep working. We want to give older people flexible retirement options. The Government is responding to the changed economic landscape. The different circumstances today – for businesses, and for individuals coming up to retirement – suggest that an earlier review is appropriate. As Britain’s demographics change, it is sensible that we have the debate on what works for business and individuals. The retirement laws need to reflect modern social and economic circumstances.”

The Government also believes that more needs to be done to respond to changing families as a result of the ageing society – with grandparents playing a stronger role and more people caring for elderly relatives. Building on the National Insurance measures taken in the budget to help those caring for grandchildren, a summit will take place in the autumn to explore the changing role of grandparents more widely and what more we can do to support them in maintaining strong relationships with their grandchildren after parental separation and divorce.

The Government believes that public services need to make responding to older people part of the mainstream of services and we will also work with local authorities to increase participation in later life by using smartcard technology to provide all-in-one cards giving access to a range of local opportunities. Smart card technology is already used in bus passes; these have the potential to also be used in leisure centres, libraries, sports clubs and other services. We will work with local authorities to test an all in one smart card that provides both central and local government entitlements.

Mid life health checks will be available on the NHS for everyone over 40 to help people prepare for a healthier old age.

The strategy is available at: www.hmg.gov.uk/buildingasocietyforallages

Recent Government policies to prepare for an ageing society include:

• Recognition in the Budget of the contribution made by grandparents to bringing up children by crediting them with contributions towards a state pension;
• The Equality Bill which will outlaw unjustifiable discrimination in the provision of goods and services on the grounds of age. Age discrimination in employment has been unlawful since 2006;
• A wide ranging reform of the pensions which will provide for an affordable and sustainable system for both state and personal pensions.

In 2008 the Government announced that we would be bringing forward a prevention package designed to raise the focus on services that can help people to maintain their health, wellbeing and independence in later life. The Department of Health will publish the details later in the year.