Fast track appraisal (FTA) was adopted by NICE in 2017. This faster and more simplified process is mainly used for novel pharmaceutical agents that are considered bioequivalent to an already recommended drug with added advantages or reduced costs. In June 2022 NICE used FTA to recommend diroximel fumarate (Vumerity) for the management of relapsing remitting multiple sclerosis (RRMS). This short article explores the potential role the drug may play within the pantheon of disease modifying treatment for RRMS.
{"title":"Diroximel fumarate – a new twist for MS agent best seller","authors":"T. Gaber","doi":"10.1002/pnp.752","DOIUrl":"https://doi.org/10.1002/pnp.752","url":null,"abstract":"Fast track appraisal (FTA) was adopted by NICE in 2017. This faster and more simplified process is mainly used for novel pharmaceutical agents that are considered bioequivalent to an already recommended drug with added advantages or reduced costs. In June 2022 NICE used FTA to recommend diroximel fumarate (Vumerity) for the management of relapsing remitting multiple sclerosis (RRMS). This short article explores the potential role the drug may play within the pantheon of disease modifying treatment for RRMS.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45024940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr Foster and colleagues report a pat ient in whom depress ion caused ‘diagnostic overshadowing’ of sporadic Creutzfeldt-Jakob disease (SCJD).1 Reporting a similar case some years ago,2 my colleagues and I pointed out the inadequacy of the then existing (2009) diagnostic criteria for sCJD, which eschewed any mention of psychiatric symptoms despite an evidence base that described them as being not infrequently present. The sCJD criteria have subsequently (2017) undergone revision,3 but as before the focus is on rapid cognitive decline and certain neurological signs as well as EEG, MRI, and CSF findings, with no mention of psychiatric features. In contrast, variant CJD is acknowledged as a ‘neuropsychiatric disorder’, and even some genetic forms (ie with a pathogenic mutation in the PRNP gene) are noted to be associated with neuropsychiatric disorder.3 Although the revised criteria appear to work relatively well for sCJD, particularly increasing sensitivity versus the prior criteria,4 the absence of any mention of psychiatric features suggests that cases such as that reported by Foster et al. will continue to occur.
{"title":"Diagnostic criteria for sporadic Creutzfeldt‐Jakob disease still missing psychiatric features","authors":"A. Larner","doi":"10.1002/pnp.761","DOIUrl":"https://doi.org/10.1002/pnp.761","url":null,"abstract":"Dr Foster and colleagues report a pat ient in whom depress ion caused ‘diagnostic overshadowing’ of sporadic Creutzfeldt-Jakob disease (SCJD).1 Reporting a similar case some years ago,2 my colleagues and I pointed out the inadequacy of the then existing (2009) diagnostic criteria for sCJD, which eschewed any mention of psychiatric symptoms despite an evidence base that described them as being not infrequently present. The sCJD criteria have subsequently (2017) undergone revision,3 but as before the focus is on rapid cognitive decline and certain neurological signs as well as EEG, MRI, and CSF findings, with no mention of psychiatric features. In contrast, variant CJD is acknowledged as a ‘neuropsychiatric disorder’, and even some genetic forms (ie with a pathogenic mutation in the PRNP gene) are noted to be associated with neuropsychiatric disorder.3 Although the revised criteria appear to work relatively well for sCJD, particularly increasing sensitivity versus the prior criteria,4 the absence of any mention of psychiatric features suggests that cases such as that reported by Foster et al. will continue to occur.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43752197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"COVID‐19 and CPN attendance on ward rounds","authors":"","doi":"10.1002/pnp.762","DOIUrl":"https://doi.org/10.1002/pnp.762","url":null,"abstract":"","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44493502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Specialist mental health pharmacist roles are recognised in providing medicines optimisation for people with mental health disorders. Here, the authors describe an initiative that examined whether a pharmacist could fulfil the role of an ‘extended role practitioner’ on an acute psychiatric ward, so releasing consultant psychiatrist clinical time. The study considers how extended roles such as advanced clinical practitioner can be utilised and service provision redesigned around new patient‐facing roles.
{"title":"Impact of a pharmacist in extended role on an acute mental health ward","authors":"Neil Shepherd, Ed Beveridge, C. Parker","doi":"10.1002/pnp.758","DOIUrl":"https://doi.org/10.1002/pnp.758","url":null,"abstract":"Specialist mental health pharmacist roles are recognised in providing medicines optimisation for people with mental health disorders. Here, the authors describe an initiative that examined whether a pharmacist could fulfil the role of an ‘extended role practitioner’ on an acute psychiatric ward, so releasing consultant psychiatrist clinical time. The study considers how extended roles such as advanced clinical practitioner can be utilised and service provision redesigned around new patient‐facing roles.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47675377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schizophrenia can be a severe and debilitating mental disorder with a complex and multifactorial pathophysiology. The neurobiological mechanisms that underpin this illness, alongside other mental disorders, remain elusive. It is recognised that many patients with schizophrenia suffer with disturbed sleep. Here we discuss the role of the physiologically occurring neurohormone, melatonin, in the treatment of sleep disturbances and other symptoms in schizophrenia.
{"title":"Is there a role for melatonin in the treatment of schizophrenia?","authors":"S. Hardman, Elizabeth O'Mahony","doi":"10.1002/pnp.755","DOIUrl":"https://doi.org/10.1002/pnp.755","url":null,"abstract":"Schizophrenia can be a severe and debilitating mental disorder with a complex and multifactorial pathophysiology. The neurobiological mechanisms that underpin this illness, alongside other mental disorders, remain elusive. It is recognised that many patients with schizophrenia suffer with disturbed sleep. Here we discuss the role of the physiologically occurring neurohormone, melatonin, in the treatment of sleep disturbances and other symptoms in schizophrenia.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48370495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qaiser Javed, Sarwat Javed, B. Memon, Oluwakemi Okopi
Emotionally unstable personality disorder (EUPD) has become a public health challenge due to its prevalence, cost to health care services and comorbidities. Prescribers are faced with a clinical conundrum when offering medication to patients with EUPD due to the risk of deliberate overdose. Here, the authors analyse clinicians’ views and experiences pertaining to prescribing medications for EUPD within the context of the NICE guidelines, with resulting messages to enable positive change in future clinical guidelines and policies.
{"title":"Prescribing for emotionally unstable personality disorder: clinicians’ views","authors":"Qaiser Javed, Sarwat Javed, B. Memon, Oluwakemi Okopi","doi":"10.1002/pnp.759","DOIUrl":"https://doi.org/10.1002/pnp.759","url":null,"abstract":"Emotionally unstable personality disorder (EUPD) has become a public health challenge due to its prevalence, cost to health care services and comorbidities. Prescribers are faced with a clinical conundrum when offering medication to patients with EUPD due to the risk of deliberate overdose. Here, the authors analyse clinicians’ views and experiences pertaining to prescribing medications for EUPD within the context of the NICE guidelines, with resulting messages to enable positive change in future clinical guidelines and policies.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51712349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent years have seen the expansion of the concept of bipolar disorder. In particular, two main diagnoses have been defined within DSM V. These are bipolar I (BD I) and bipolar II disorder (BD II). The former manifests with both depressive and manic episodes. The latter is characterised chiefly by depressive phases and at least one hypomanic period. A similar distinction was later made within ICD 11, which expands the description of BD II, briefly mentioned by ICD 10, its predecessor. The argument presented here is that these are really one and the same condition and the distinction between them is largely meaningless.
{"title":"Diagnostic status of bipolar II disorder","authors":"S. Nicholson","doi":"10.1002/pnp.746","DOIUrl":"https://doi.org/10.1002/pnp.746","url":null,"abstract":"Recent years have seen the expansion of the concept of bipolar disorder. In particular, two main diagnoses have been defined within DSM V. These are bipolar I (BD I) and bipolar II disorder (BD II). The former manifests with both depressive and manic episodes. The latter is characterised chiefly by depressive phases and at least one hypomanic period. A similar distinction was later made within ICD 11, which expands the description of BD II, briefly mentioned by ICD 10, its predecessor. The argument presented here is that these are really one and the same condition and the distinction between them is largely meaningless.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49351955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aphasia, an acquired disorder of language function, may sometimes be an early and isolated sign of neurodegenerative disease or may sometimes evolve in the course of an existing neurodegenerative disorder. We present two cases in which aphasia progressively evolved, one in the context of an existing non‐linguistic cognitive disorder, and one in which aphasia was the presenting symptom. Awareness of the trajectory of neurodegenerative disorders is required when assessing patients longitudinally in clinics devoted to the assessment of cognitive disorders.
{"title":"Evolving aphasia: trajectories of neurodegenerative diseases","authors":"R. Heartshorne, A. Larner","doi":"10.1002/pnp.741","DOIUrl":"https://doi.org/10.1002/pnp.741","url":null,"abstract":"Aphasia, an acquired disorder of language function, may sometimes be an early and isolated sign of neurodegenerative disease or may sometimes evolve in the course of an existing neurodegenerative disorder. We present two cases in which aphasia progressively evolved, one in the context of an existing non‐linguistic cognitive disorder, and one in which aphasia was the presenting symptom. Awareness of the trajectory of neurodegenerative disorders is required when assessing patients longitudinally in clinics devoted to the assessment of cognitive disorders.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48184116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Creutzfeldt‐Jakob disease (CJD) is a rare, progressive neurological condition of which the sporadic form is most common. It can present with a wide variety of symptoms that make its recognition difficult. In this case there was a rapid progression of neurological symptoms that presented as catatonia. The presence of a history of depression contributed to diagnostic overshadowing, delaying medical investigation of catatonia. While not included in the Euro CJD or WHO criteria, psychiatric symptoms are common in sporadic CJD and their presence therefore should not preclude thorough medical investigation.
{"title":"Diagnostic overshadowing in sporadic Creutzfeldt‐Jakob disease?","authors":"H. Foster, A. Barker, P. Nirodi, Y. Ahmed","doi":"10.1002/pnp.743","DOIUrl":"https://doi.org/10.1002/pnp.743","url":null,"abstract":"Creutzfeldt‐Jakob disease (CJD) is a rare, progressive neurological condition of which the sporadic form is most common. It can present with a wide variety of symptoms that make its recognition difficult. In this case there was a rapid progression of neurological symptoms that presented as catatonia. The presence of a history of depression contributed to diagnostic overshadowing, delaying medical investigation of catatonia. While not included in the Euro CJD or WHO criteria, psychiatric symptoms are common in sporadic CJD and their presence therefore should not preclude thorough medical investigation.","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42882973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Eating disorders in the pandemic","authors":"J. Ogden","doi":"10.1002/pnp.744","DOIUrl":"https://doi.org/10.1002/pnp.744","url":null,"abstract":"","PeriodicalId":43913,"journal":{"name":"Progress in Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46450651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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