For how we live.
The 2024 American Academy of Sleep Medicine guideline strongly backs intravenous iron and gabapentinoids, and now suggests against the dopamine agonists that were first-line for two decades.
A randomised trial and a 21-study meta-analysis found thyroid hormone normalised the blood test but left tiredness and symptom scores unchanged. A guideline now advises against routine treatment.
The 2024 AASM guideline now advises against routinely using the dopamine agonists that were once standard, because over time they often make the condition worse — and puts anticonvulsants and iron first.
A matched cohort of 173,910 people with dementia in England tied the drugs to raised risks of pneumonia, stroke, clots, heart attack, fracture and kidney injury — highest just after starting.
The old antidepressant is prescribed at low doses for insomnia far more than its evidence supports. A Cochrane review found only a modest, low-certainty effect on subjective sleep and none on measured sleep efficiency.
The largest meta-analysis puts the incidence attributable to the drug at about 15% — one in six or seven. Critics who reanalysed part of it put it above 50%. The gap is about what counts as evidence.
Reviewing and stopping unnecessary drugs in older people is safe in trials and reduces inappropriate prescriptions. Whether it makes them live longer or feel better is far less settled than the enthusiasm implies.
ABYSS and SMART-DECISION together cover 6,238 stable patients. Discontinuation cleared both noninferiority margins, though the authors say the primary endpoint's composition limits what it shows.
In a UK trial of 1,956 critically ill adults, neither carbocisteine nor nebulised hypertonic saline shortened time on a ventilator, and each was tied to a specific harm.
An individual-patient meta-analysis of 17,801 patients found a hazard ratio of 0.97 for death, reinfarction or heart failure — a result precise enough to make the question look settled.
The guidance is built on one negative instruction: do not stop abruptly in patients likely to be physically dependent. Hong Kong records show the sharpest prescribing rise in 18-to-25-year-olds.