Highlights of this issue

Antipsychotic drugs and elderly patients

Do all antipsychotic drugs pose an increased risk of death among elderly people? Schneeweiss and coauthors assessed the short-term mortality among elderly patients who began taking conventional and atypical antipsychotic drugs. Health Canada has already warned that the atypical formulations increase the risk of death. The authors's findings suggest that the conventional ones be added to the warning.

See page 627

Sex differences in the use of antidepressants and consumption of alcohol

Differences are found between men and women in this study by Graham and Massak, who examined the relation between the use of antidepressants and the level of alcohol consumption. They surveyed 14 063 Canadians on alcohol use, signs of depression and use of antidepressants.

See page 633

Digoxin — used for centuries; still debated!

The Digitalis Investigation Group trials in 1991–1993 assessed how digoxin affected the survival of thousands of patients with heart failure. Since then, the results of multiple post hoc analyses of the trials' findings have continued to fuel debate on the role of digoxin in the management of heart failure. In these linked commentaries, Ahmed and colleagues and Heckman and McKelvie relate their views on the current status of digoxin.

See pages 641 and 644

Does pravastatin pose a cancer risk?

In a meta-analysis, Bonovas and Sitaras show a possible association between pravastatin therapy and an increased risk of cancer among elderly people. In a related commentary, Brophy discusses the clinical implications of this finding.

See pages 646 and 649

Practice

Mirror movements: Lim and Seet describe an uncommon case of a man whose one hand mirrors the actions of the other (page 619).

What's your call? Three diagnostic challenges await in this issue's Clinical Vistas Briefs: first, head CT scans that give clues in a case of attempted suicide; second, bilateral breast tenderness and enlargement in an elderly man with congestive heart failure; and third, a soft-tissue radiograph of the neck of a man who presented after 3 days of fever, sore throat, odynophagia and a muffled voice (page 620).

Problem drinking: This issue's Public Health column addresses alcohol use disorders and how general practitioners can identify and offer help to problem drinkers (page 621).