Benzodiazepines: it's time to return to the evidence.

SUMMARY: We propose that discussions of benzodiazepines in the current psychiatric literature have become negatively biased and have strayed from the scientific evidence base. We advocate returning to the evidence in discussing benzodiazepines and adhering to clear definitions and conceptual rigour in commentary about them.

Exploring the co-occurrence of depression, anxiety and insomnia symptoms, diagnoses and treatments in primary care: observational study using UK primary care data.

BACKGROUND: Depression, anxiety and insomnia often co-occur. However, there is a lack of research regarding how they cluster and how this is related to medication used to treat them. AIMS: To describe the frequencies and associations between depression, anxiety and insomnia, and treatment for these conditions in primary care. METHOD: A retrospective cohort study using UK electronic primary care records. We included individuals aged between 18 and 99 years old with one or more records suggesting they had a diagnosis, symptom or drug treatment for anxiety, depression or insomnia between 2015 and 2017. We report the conditional probabilities of having different combinations of diagnoses, symptoms and treatments recorded. RESULTS: There were 1 325 960 records indicative of depression, anxiety or insomnia, for 739 834 individuals. Depression was the most common condition (n = 106 117 records), and SSRIs were the most commonly prescribed medication (n = 347 751 records). Overall, individuals with a record of anxiety were most likely to have co-occurring symptoms and diagnoses of other mental health conditions. For example, of the individuals with a record of generalised anxiety disorder (GAD), 24% also had a diagnosis of depression. In contrast, only 0.6% of those who had a diagnosis of depression had a diagnosis or symptom of GAD. Prescribing of more than one psychotropic medication within the same year was common. For example, of those who were prescribed an SNRI (serotonin-norepinephrine reuptake inhibitor), 40% were also prescribed an SSRI (selective serotonin reuptake inhibitor). CONCLUSIONS: The conditional probabilities of co-occurring anxiety, depression and insomnia symptoms, diagnoses and treatments are high.

Association between psychotropic drug prescription and suicide rates in Scotland: population study.

AIMS AND METHOD: Rates of prescriptions of antidepressants and suicide are inversely correlated at an epidemiological level. Less attention has been paid to relationships between other drugs used in mental health and suicide rates. Here we tested relationships between prescriptions of anxiolytics and antipsychotics and suicide rates in Scotland. RESULTS: Suicide rates were inversely correlated with prescriptions of antidepressants and antipsychotics over 14 years (2004-2018), and positively with prescriptions of anxiolytics. CLINICAL IMPLICATIONS: This illustrates the role of medications used in mental health in suicide prevention, and highlights the importance of identifying causal mechanisms that link anxiolytics with suicide.

Clinical study of Chaihu-Longgu-Muli decotion combined with western medicine in the treatment of somatic anxiety disorder / 国际中医中药杂志

Objective@#To evaluate the therapeutic effect of Chaihu-Longgu-Muli decotion combined with western medicine in the treatment of somatic anxiety disorder.@*Methods@#A total of 93 patients with somatic anxiety were divided into control group (46 cases) and study group (47 cases) according to random number table method. The control group was treated with conventional western medicine. The study group was treated with Chaihu-Longgu-Muli decotion on the basis of the control group. The two groups were treated for 4 weeks. Before and after treatment, TCM syndrome scores were conducted. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The Self-rating Anxiety Scale (SAS) was used to evaluate anxiety. The adverse reaction was recorded and clinical efficacy was evaluated.@*Results@#The total effective rate of the study group was 93.62% (44/47), 67.39% (31/46) of the control group, and the difference was statistically significant between the two groups (χ2=10.244, P=0.001). After treatment, insomnia, limb chills, palpitation, limb burnout, limb pain scores in the study group were significantly lower than those of the control group (t values were 4.190, 4.707, 4.714, 3.686, 7.070, respectively, all Ps<0.01). After treatment, the scores of PSQI (9.4 ± 3.2 vs. 13.8 ± 3.8, t=6.045) and SAS (48.7 ± 13.7 vs. 58.1 ± 12.9, t=3.405) in the study group were significantly lower than those in the control group (P<0.01). During the treatment, the incidence of adverse reactions was 19.6% (9/46) in the control group and 4.3% (2/47) in the study group. The difference between the two groups was statistically significant (χ2=5.225, P=0.022).@*Conclusions@#The Chaihu-Longgu-Muli decotion combined with western medicine can improve the symptoms of traditional Chinese medicine, sleep quality and anxiety of patients with somatic anxiety, reduce adverse reactions and improve the clinical efficacy.

Clinical study of Chaihu-Longgu-Muli decotion combined with western medicine in the treatment of somatic anxiety disorder / 国际中医中药杂志

Objective To evaluate the therapeutic effect of Chaihu-Longgu-Muli decotion combined with western medicine in the treatment of somatic anxiety disorder. Methods A total of 93 patients with somatic anxiety were divided into control group (46 cases) and study group (47 cases) according to random number table method. The control group was treated with conventional western medicine. The study group was treated with Chaihu-Longgu-Muli decotion on the basis of the control group. The two groups were treated for 4 weeks. Before and after treatment, TCM syndrome scores were conducted. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality. The Self-rating Anxiety Scale (SAS) was used to evaluate anxiety. The adverse reaction was recorded and clinical efficacy was evaluated. Results The total effective rate of the study group was 93.62% (44/47), 67.39% (31/46) of the control group, and the difference was statistically significant between the two groups (χ2=10.244, P=0.001). After treatment, insomnia, limb chills, palpitation, limb burnout, limb pain scores in the study group were significantly lower than those of the control group (t values were 4.190, 4.707, 4.714, 3.686, 7.070, respectively, all Ps<0.01). After treatment, the scores of PSQI (9.4 ± 3.2 vs. 13.8 ± 3.8, t=6.045) and SAS (48.7 ± 13.7 vs. 58.1 ± 12.9, t=3.405) in the study group were significantly lower than those in the control group (P<0.01). During the treatment, the incidence of adverse reactions was 19.6% (9/46) in the control group and 4.3% (2/47) in the study group. The difference between the two groups was statistically significant ( χ 2=5.225, P=0.022). Conclusions The Chaihu-Longgu-Muli decotion combined with western medicine can improve the symptoms of traditional Chinese medicine, sleep quality and anxiety of patients with somatic anxiety, reduce adverse reactions and improve the clinical efficacy.

Analysis of Deanxit-combined Treatment of Functional Dyspepsia / 昆明医科大学学报

Objective To investigate the improvement and safety of the conventional treatment combined with Deanxit in the treatment of digestive adverse (FD) of gastrointestinal symptoms and sleep efficacy.Methods Ninety cases of patients with FD were randomly divided into the control group (pantoprazole capsule and Mosapride will + Capsule associated with sleep disorders with estazolam tablets) and observation group (pantoprazole capsule and Mosapride will + capsule with sleep disorders and estazolam tablets plus Deanxit).Both groups were treated for 4 weeks.After the course of treatment,the improvement degree and adverse reaction of digestive tract symptoms and sleep were compared between the two groups.Results After 4 weeks of treatment in the observation group with gastrointestinal symptoms were improved and the total effective rate was 86.7％,higher than that of the control group (66.7％).The difference was statistically gigmificart (P ＜ 0.05).The total effective rate of was sleep disorders improvement 83.3％,higher than that of control group (61.9％),but the difference was not statistically significant (P ＞ 0.05).Adverse reaction rates were not significantly different between the two groups.Conclusion On the basis of conventional therapy,treatment of functional dyspepsia (FD) with Deanxit can significantly alleviate gastrointestinal symptoms.Medication after 3-7 days can relieve the symptoms.After 4 weeks,the total efficiency is the highest with fewer adverse reactions.Clinical application is recommended.