NB Hot Topics Podcast S6 E12: Anti-Ds for Insomnia; SSRIs & Hypotension; Cancer Cures
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Jul 4, 2025 Explore the debate on the efficacy of anti-depressants for insomnia and their potential side effects in older patients, particularly postural hypotension. Learn about recent breakthroughs in cancer treatment focusing on mismatch repair genes, highlighting a promising trial of dostalimab that boasts a remarkable response rate. The podcast also critiques current NHS reforms and discusses the need for innovation in healthcare. Tune in for fascinating insights and developments that could reshape patient care!
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NHS Plan Risks GP Quality
- The NHS ten-year plan largely rebrands existing general practice initiatives.
- It risks hospital-run GP practices, which may worsen GP service quality due to hospitals' operational issues.
Short-term Insomnia Drug Effects
- Metazapine significantly improves insomnia short-term; amitriptyline shows some but non-significant benefit.
- By 12 weeks, placebo effect narrows differences; both drugs lack long-term superiority over placebo.
Monitor Postural Hypotension Early
- All antidepressants increase postural hypotension risk in the first 28 days; SSRIs have the highest risk.
- Monitor older patients carefully after starting antidepressants to manage dizziness and fall risk.