‘Valdo Calocane's family weren’t told he had schizophrenia’ Majorie Wallace, Chief Executive of the mental health charity SANE, says that when families are not given enough information about a relative’s mental health condition, it becomes much harder for them to deal with such a ‘serious problem’.

You missed the drug treatment part.

Psychiatry cant be ignored - here’s why 👉Many medications that make a meaningful difference in ME/CFS, POTS and Long Covid are often classified as “psychiatric medications”. 🚨 The clinical question is not whether a medication is psychiatric, neurological, immunological or cardiovascular. The question is whether it targets a relevant biological process. Psychopharmacology provides a major framework for targeting several domains seen in ME/CFS, POTS and Long Covid: autonomic instability, hyperarousal, sleep disruption, pain amplification, cognitive dysfunction, sensory sensitivity, fatigue, threat circuitry, inflammatory signalling and mast-cell-related pathways. But psychiatry is portrayed as the emery. Most patients are seen by psychiatry late in the picture and it’s often when physicians have tried everything and now they refer to psychiatry . So the irony is psychiatry is really a refuge for the physician’s hopelessness here . So the list - not exhaustive, but includes 1. Naltrexone / low-dose naltrexone 2. Aripiprazole / low-dose aripiprazole 3. Memantine 4. Prazosin and clonidine 5.Guanfacine 6. Vortioxetine 7. Psychostimulants - methylphenidate, dexamphetamine, lisdexamfetamine 8. Modafinil and armodafinil 9. SNRIs :duloxetine, venlafaxine, desvenlafaxine, milnacipran 11. TCAs : amitriptyline, nortriptyline, doxepin 12. Mirtazapine, Trazodone 13. Gabapentinoids : pregabalin, gabapentin 14.Beta-blockers : propranolol 15.’Benzodiazepines 16.Melatonin 17.Low-dose antipsychotics with antihistaminergic properties where hyperarousal, sensory amplification or agitation are dominant 18. Mood stabilisers / anti-kindling agents -e.g lamotrigine in highly selected neuropsychiatric phenotypes Many of these medications are called psychiatric because psychiatrists are often the clinicians most familiar with their mechanisms, dosing, adverse effects, interactions and clinical sequencing. Most physician’s struggle to use these appropriately because this is psychopharmacology. That does not mean they are only treating depression or anxiety. And if the construct infront of them is anxiety or ADHD or agitated depression then the medications re used in a very specific way that makes a difference Several agents used in psychopharmacology have effects on inflammatory signalling, autonomic tone, sleep architecture, pain processing, cognition, arousal, mast-cell-related symptoms, or central threat prediction. This is where the mind–body split becomes clinically unhelpful. A patient may decline an “antidepressant” because they do not have depression. 
A clinician may avoid a medication because it is seen as psychiatric. 
A biological target may then be missed because the medication carries the wrong label. In practice, when brain–body integration is understood, the framing changes. These medications are biological tools. And in complex conditions such as ME/CFS, POTS and Long Covid, dismissing them because of category stigma can limit treatment options and reinforce the very split that prevents more integrated care.

As a neurologist, it is now patently clear to me that the vast majority of people on the planet are suffering from neuroinflammation or brain damage (likely both) The way people speak & behave has changed. Markedly so. Whether irl, or via messaging/social media. It’s noticeable

A recent review proposes integrating POTS, ME/CFS, and Long COVID into the neuroimmunology subspecialty. Here is their compelling case. \ Overlapping Drivers of Disease: The authors outline several major overlapping pathophysiological mechanisms shared by POTS, ME/CFS, and Long COVID. This includes: 1. Autonomic Dysfunction (Dysautonomia) 2. Mitochondrial Dysfunction 3. Cerebral Hypoperfusion 4. Immune Dysregulation 5. Neuroinflammation 6. Autoimmunity \ The Harm of Psychiatric Misdiagnoses: For decades, patients have been wrongly labeled with "functional neurological disorder," anxiety, or somatization because routine tests often look normal. \ A Call for Better Diagnostics: Researchers and clinicians urgently need advanced tools such as: - 7T MRIs - Targeted PET scans - Autoantibody and cytokine panels - Comprehensive autonomic function testing Routine tests are simply not enough. \ The Authors’ Core Proposal: Classify and treat POTS, ME/CFS, and Long COVID as neuroimmune disorders under the subspecialty of neuroimmunology. This shift would: • Improve clinical care • Accelerate research • Enable effective neurotherapeutics (including repurposed immunomodulatory and anti-inflammatory treatments) Thanks, Dysautonomia Clinic, for the awesome paper! #MECFS #POTS #LONGCOVID #PASC Read more here: buff.ly/HqR7NKH

Led by @Chapman_GE our new paper on the fixed nature of delusions is out today in Nature Mental Health.

Yes, I had a very severe reaction to my second Moderna shot. But part of being a responsible scientist with a large platform is not extrapolating my personal experience to the entire population. I also have a rare autoimmune condition called Parsonage-Turner syndrome (diagnosed in 2013), so I may have been particularly vulnerable to side effects. Given my bad experience with the first mRNA vaccine I've ever taken, I have made the personal decision to avoid them in the future. However, it would have been incredibly unscientific and highly irresponsible of me to take this personal experience of mine and start telling millions of people online to not get vaccinated for COVID. There's a reason quack alternative medicine practitioners plaster personal testimonies all over their websites. They sound convincing to a lot of people. But it's purely manipulation. Personal testimony, even a large collection of them, isn't a substitute for real, population-level data. I am not an expert on vaccines, the COVID vaccine, or epidemiology in general. So when I experience a serious side effect taking something with a non-zero rate of serious side effects, I understand that my personal experience likely isn't an indication that we're all being lied to about safety. You should understand that as well. The impulse to extrapolate a very negative personal experience to the entire population is very strong. But responsible scientists, and especially those with large public platforms, should resist that impulse.

The Alzheimer’s Biomarker Studies Are Getting Out of Hand: Confessions of an Alzheimer’s researcher #AndrewBubak . we’ve gotten brilliant at diagnosing a disease we still can’t treat and most of us know it. profbubak.substack.com/p/the… @ProfRobHoward

What Lapland can teach @NHSEngland about treating psychosis: The Nottingham killings inquiry has highlighted major flaws in mental health provision. Is a system pioneered in Finland the way forward? thetimes.com/article/6d722d6… via @RoisinKKelly_ @nuwandiss