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Mental health

Managing delirium and psychological symptoms in the last days of life

When delirium occurs in the last days of life it is usually irreversible. Pharmacological treatment is only required for patients... View Article

September 2023

Recognising and managing OCD in primary care

Obsessive compulsive disorder (OCD) affects approximately 2% of the population and can have a significant impact on quality of... View Article

July 2022

The role of medicines in the management of depression in primary care

A selective serotonin reuptake inhibitor (SSRI) is usually the first-line pharmacological treatment for patients with moderate... View Article

May 2021

Benzodiazepines and zopiclone: is overuse still an issue?

Despite being recommended for short-term use only, and usually second-line to non-pharmacological management strategies, benzodiazepines... View Article

February 2021

Withdrawing patients from long-term use of benzodiazepines or zopiclone

Stopping benzodiazepine or zopiclone treatment in people who have been taking these medicines long-term can be challenging. Strategies... View Article

February 2021

Case study: ten men addicted to Ayurvedic medicines (Kamini and Barshasha) presenting for opioid substitution treatment

We present a special edition “Case of the week” submitted by Dr Jo Lane and Dr Susan Lane, Waitematā DHB. If you would like to... View Article

September 2020

National report: The use of antipsychotic medicines in older people

The purpose of this report is to provoke thought and discussion about how and why antipsychotic medicines are prescribed to older... View Article

May 2020

Understanding the role of palliative care for people with advanced dementia

Advanced dementia is a terminal condition for which palliative care is appropriate, however, knowing when to initiate this process... View Article

April 2020

Symptom management in palliative dementia care

Physical symptoms commonly experienced by people with advanced dementia include pain, difficulties with hydration and nutrition,... View Article

April 2020

Managing the behavioural and psychological symptoms of dementia

Most people with dementia develop behavioural and psychological symptoms (BPSD) at some point during their journey, which can... View Article

April 2020

Recognising and managing early dementia

Dementia (mate wareware - see below) is a growing healthcare challenge. There are an estimated 70,000 people with dementia in... View Article

February 2020

Age-related cognitive decline: prevention and future planning

Declining cognitive function can be a difficult topic to raise with patients and their families. It is important to reassure older... View Article

February 2020

Diagnosing and managing perinatal depression in primary care

The consequences of perinatal depression* can be severe. Suicide is the leading cause of maternal mortality† in New Zealand and... View Article

November 2019

Somatisation: demystifying the “ghost in the machine”

Somatisation is a maladaptive functioning of an organ system, without underlying tissue or organ damage, or where the symptoms... View Article

October 2019

Depression or distress? Examining SSRI prescribing in primary care

Differentiating short-term psychological distress from depression can be difficult, particularly at the first consultation. Diagnostic... View Article

October 2019

Motivational interviewing in primary care

Motivational Interviewing is a way of building and strengthening people’s drive to change longstanding behaviours that pose a... View Article

September 2019

The funded brand of lamotrigine is changing

Changes in funded brands of antiepileptic medicines can lead to concern from patients or caregivers that the medicine they are... View Article

August 2019

Aripiprazole prescribing changes: Special Authority approval no longer required, new sole-subsidised brand

From 1 June, 2018, aripiprazole can be prescribed without Special Authority approval, making access easier for patients who require... View Article

June 2018

Suicide prevention: what can primary care do to make a difference?

"The most critical elements in helping those with suicidal ideation are achieving some engagement with the suicidal person and... View Article

November 2017

The role of medicines in the management of depression in primary care

A selective serotonin reuptake inhibitor (SSRI) is usually the first-line pharmacological treatment for patients with moderate... View Article

October 2017

I dream of sleep: managing insomnia in adults - Part 1

bpacnz recognises that the assessment and management of insomnia in general practice can be difficult, especially in relation... View Article

October 2017

I dream of sleep: managing insomnia in adults - Part 2

bpacnz recognises that the assessment and management of insomnia in general practice can be difficult, especially in relation... View Article

October 2017

Clozapine: safe prescribing

In 2014, bpacnz published an article on the safer prescribing of clozapine. Since this time, a number of fatalities, along with... View Article

September 2017

Alcohol misuse: how to help patients in primary care

This article has been superseded by: Assessment and management of alcohol misuse by primary care bpacNZ, November 2018 If... View Article

May 2016

Medicine use in youth mental health

This report provides an overview of dispensings of medicines indicated for the treatment of depression and anxiety in patients... View Article

April 2016

The role of medicines for the treatment of depression and anxiety in patients aged under 18 years

Psychological and behavioural approaches are the cornerstone of treatment for young people with depression or anxiety. When pharmacological... View Article

March 2016

Managing frequently encountered mental health problems in young people: non-pharmacological strategies

Young people experience a variety of mental health conditions. For patients with mild to moderate depression and anxiety, a stepped... View Article

December 2015

Addressing mental health and wellbeing in young people

This is the first of a series of articles which will examine the diverse theme of mental health in young people. Adolescence is... View Article

October 2015

Overuse of benzodiazepines: still an issue?

Benzodiazepines may be considered as a short-term treatment for insomnia and anxiety; zopiclone, a benzodiazepine-like medicine,... View Article

March 2015

Medicine updates

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

December 2014

Identifying and managing addiction to opioids

The increased use of opioid analgesics in recent years, particularly oxycodone, has resulted in misuse and addiction issues associated... View Article

October 2014

Helping patients cope with chronic non-malignant pain: it’s not about opioids

The role of opioids in the management of chronic non-malignant pain is a controversial subject due to concerns over the long-term... View Article

September 2014

Atypical antipsychotics: one fully subsidised brand for quetiapine, risperidone and olanzapine

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

July 2014

Bipolar disorder: Identifying and supporting patients in primary care

Bipolar disorder can be challenging to diagnose and manage. It is often assumed to be recurrent major depression, until an episode... View Article

July 2014

Fluoxetine brand change: Arrow-Fluoxetine sole subsidised brand from 1 July

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

June 2014

Managing patients with dementia: What is the role of antipsychotics?

Concerns have been raised, both in New Zealand and internationally, about the increasing off-label use of antipsychotics, and... View Article

December 2013

Beating the blues

“Beating the Blues” is a web-based cognitive behavioural programme for people with symptoms of mild or mild-moderate depression,... View Article

November 2013

News updates

Comparing results between different blood glucose meters | Beating the Blues: online cognitive behavioural therapy for mild to... View Article

June 2013

Sleep disturbances: managing parasomnias in general practice

The term "parasomnia" describes a group of sleep disorders associated with unnatural movements, behaviours, emotions, perceptions... View Article

November 2012

Looking back, looking forward: key messages 2005 – 2011

This report highlights four key prescribing and laboratory testing recommendations covered over the past five years. Over this... View Article

March 2012

Prescribing citalopram safely: an update

Evidence of adverse cardiac effects associated with citalopram has prompted a reduction in the recommended maximum daily dose... View Article

February 2012

Upfront: Vulnerable children and young people in New Zealand

In this conclusion to the series on abused and neglected children we revisit key messages and highlight actions that can be taken... View Article

December 2011

Upfront: Mental health issues in adolescents who have experienced abuse and neglect

In the fourth article in our series on vulnerable children and young people in New Zealand, we discuss the complex mental health... View Article

November 2011

Prescribing atypical antipsychotics in general practice

The use of atypical antipsychotics such as quetiapine and olanzapine is increasing. In many cases, these medicines are used for... View Article

November 2011

Upfront: Infant mental health and child protection

The third article in our series on vulnerable children and young people in New Zealand. This article aims to provide primary care... View Article

October 2011

Upfront: Detecting child abuse in general practice

This second article in our series on children and young people in New Zealand who have been abused or neglected, aims to provide... View Article

September 2011

Upfront: Meeting the needs of children and young people in New Zealand who have been abused and neglected

Nearly one quarter of New Zealand children and young people come to the attention of Child, Youth and Family before they reach... View Article

August 2011


Assessment and management of Depression in Older Adults References and Resources View Article

July 2011

Management of depression in older people

Older people respond well to treatments for depression. The management of depression in older people essentially follows the same... View Article

July 2011

Causes and Diagnosis of Depression in Elderly People

Depression is common in older adults, although not as prevalent as in younger adults. This may be partly due to under-recognition... View Article

July 2011


Appendices for Assessment and management of Depression in Older Adults View Article

July 2011

News in brief

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

February 2011

Antenatal depression

Unrecognised or untreated depression during pregnancy poses considerable risk to both the mother and the developing foetus. View Article

November 2010


Appendices for Depression in the antenatal and postnatal periods View Article

November 2010

Purpose and introduction

The purpose of this journal is to examine the assessment and management of depression in women during the antenatal and postnatal... View Article

November 2010


References for Depression in the antenatal and postnatal periods View Article

November 2010

Postnatal depression

Depressive symptoms in the postnatal period represent a range of clinical conditions of varying severity from simple “baby blues”... View Article

November 2010

The pharmacological management of Alzheimer’s disease: The place of donepezil

From November 1, 2010 donepezil will be funded without Special Authority, on the Pharmaceutical Schedule. Donepezil and other... View Article

August 2010

Suicide prevention in Māori youth

The rate of suicide in young Māori males is higher than in any other population group in New Zealand. Mental health disorder... View Article

June 2010

Recognising and managing mental health problems in Māori

Mental health problems are common in Māori, yet there is an unmet need for receiving treatment. Identifying mental health... View Article

June 2010

Substance misuse and addiction in Māori

It is estimated that substance misuse and other addictions are experienced by over one quarter of Māori in their lifetime.... View Article

June 2010

Antipsychotics in people with dementia: an update

The Antipsychotics in Dementia (A4D) programme was launched in October 2008. Since then, the use of antipsychotics in older people... View Article

March 2010


Appendices for Depression in Young People View Article

January 2010

Management of depression in young people in primary care

A stepped care approach is used with the intensity of treatment adjusted according to the response to treatment. A combination... View Article

January 2010

Key Messages & Introduction

Evidence indicates that early interventions in a number of mental health conditions for children and young people can result in... View Article

January 2010

Recognition and Assessment of Common Mental Disorders in Young People

In this section the clinical features of the common mental disorders are outlined along with a discussion of suicidal behaviours.... View Article

January 2010


References for Depression in Young People BPJ special edition View Article

January 2010

Generalised anxiety disorder in adults

Anxiety disorders are the most frequently seen mental disorder in general practice and generalised anxiety disorder (GAD) is one... View Article

December 2009

Management of Depression in Primary care

Most adults with depression present with mild depression and can be treated in primary care. The goal of treatment is to achieve... View Article

July 2009

Introduction to adult depression

Mental disorders are extremely common with over one third of adults who attend primary care likely to have met the criteria for... View Article

July 2009

Pharmacological Management of Depression in Adults

All antidepressant drugs are approximately equal in effectiveness, although individual patient response may vary markedly.10 View Article

July 2009

Appendices for BPJ-SE Adult Depression

Adult depression: Apendices View Article

July 2009

Adult depression: References

Adult depression: References View Article

July 2009

Assessment of Depression in Adults in Primary Care

Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group... View Article

July 2009

Prescription drug misuse: how to identify and manage drug seekers

Although an increasing problem in general practice, identifying drug seekers is not always simple. GPs should routinely screen... View Article

September 2008

Upfront: The nature of our nurture

How genes and the environment work together to predict disease or behavioural outcomes. View Article

September 2008

Antipsychotics for dementia

Notification and details of an educational programme on the use of antipsychotics for symptoms associated with dementia View Article

August 2008

Clozapine: A reminder about safe and effective use

Although clozapine is a specialist prescribed drug, GPs still need to be aware of potential problems associated with its use.... View Article

June 2008

Managing insomnia

There is a more recent article on managing insomnia. See: I dream of sleep: managing insomnia” https://bpac.org.nz/2017/insomnia-1.aspx Insomnia... View Article

June 2008

Māori mental health

Improving Māori mental health is a government health priority. This commitment can be achieved through tangible and culturally... View Article

June 2008

Snippets: Anticonvulsants & Salbutamol

This article has been archived. If you would like access to the original article please contact: editor@bpac.org.nz View Article

June 2008

The investigation and management of nocturnal enuresis

Nocturnal enuresis, or bedwetting, is a common condition which children usually grow out of. Advice to parents on simple behavioural... View Article

June 2008

Ten minute tutorial

Adding a pop-up alert for patients on clozapine. View Article

June 2008

Snippets: Varenicline & Smoking

Varenicline and suicidal behaviour. Wider access to quit cards.The lung age of smokers. View Article

May 2008

Should antidepressants be used to treat depression in children and adolescents?

Depressive disorder is a major health issue for young people, affecting not only function but overall development. Recent debate... View Article

April 2008

Upfront: Evidence based medicine

The dilemma of practicing evidence based medicine when it keeps changing. View Article

April 2008

Dilemmas: Depression in elderly people

Depression in elderly people can be a significant cause of disability and is under-recognised and often complex to treat. A SSRI... View Article

February 2008

Brand change update: Ritalin SR now available by special access

This article has been archived; for a copy of the original, please email editor@bpac.org.nz View Article

December 2007

Dear Dave

Does the "seven day rule" still apply with the concomitant use of combined oral contraceptives and all antibiotics? Serotonin... View Article

September 2007

Dear Dave

Can Sumatriptan be used safely with SSRIs? Can you ever use beta-blockers in someone with a history of Asthma? View Article

August 2007

Clozapine - Safe and Effective Use

Clozapine is the gold-standard treatment for people with schizophrenia who are unresponsive to, or intolerant of, other antipsychotics.... View Article

April 2007

Changing to a Generic Drug

An explanation of the issues around the switching of patients to generic medication including international research in the area. View Article

March 2007

Drug Interactions with Antidepressants

Table of important drug interactions with antidepressant medications. View Article

March 2007

Depression causes presentation and treatment

Review of the causes, symptoms and treatment of depression. View Article

March 2007

Key messages on the use of SSRIs

Key messages on the use of SSRIs. View Article

March 2007

Mental Health Foundation

Mental Health Foundations aims and key services. View Article

March 2007

The CYP450 System

An overview of the CYP450 system with particular reference to the metabolism of antidepressant drugs. View Article

March 2007

ADHD: The Primary Care role

The role of primary care clinicians in improving outcomes for people with ADHD. View Article

February 2007

CARM Reports; Serotonin Syndrome and Neuroleptic Malignant Syndrome

Covers the symptoms and causes of Serotonin Syndrome and Neuroleptic Malignant Syndrome View Article

February 2007

Dear Dave

Can smoking cessation affect the dose of antipsychotics?Do statins cause nightmares?How important is it to give simvastatin at... View Article

February 2007

Lithium in General Practice

In this article we provide an overview and guidance on the management of patients taking lithium. View Article

February 2007

Practice Debate: antipsychotics in the treatment of dementia

This article covers the role and safety concerns of antipsychotics in the treatment of behavioural and psychological symptoms... View Article

February 2007

Ten minute audit

Identifies patients on Lithium using MedTech View Article

February 2007

Dear Dave

SSRIs can increase the risk of bleeding disorders, especially if taken with an NSAID. View Article

December 2006

TCAs are useful for depression and neuropathic pain

Tricyclic antidepressants (TCAs) are an effective alternative to selective serotonin re-uptake inhibitors (SSRIs) in the treatment... View Article

December 2006

Ten minute audit

Identifies people under the age of 18 years on paroxetine to enable checks for suicidal and aggressive behaviour View Article

October 2006

Depression antidepressant update

Venlafaxine: how and when to use | Antidepressants for elderly people | Antidepressants in pregnancy and breastfeeding | Suicide... View Article

October 2006


Pharmacogenetics: relevance in the treatment of depression View Article

October 2006

Substance misuse in adolescents: alcohol, cannabis & other drugs

The risk of injury or death during adolescence is two to three times higher than it is during childhood. The main reason for this... View Article

February 2012