Minimising inappropriate prescribing in older people and other stories . . .

Before starting an elderly person on a new drug, think what you can stop. This principle is implied in the name of the STOPP/START criteria, the second version of which has just appeared in Age and Ageing (2014, doi:10.1093/ageing/afu145). The 114 criteria were agreed on by 19 experts from 13 European countries, with a view to minimising inappropriate prescribing in older people. Over the water, however, the American Geriatrics Society promotes its own system, known as Beers criteria (Journal of the American Geriatric Society 2012;60:616-31, doi:10.1111/j.1532-5415.2012.03923.x). Whatever they are called, criteria like these need to be used where most needed—general practices, community pharmacies, and nursing homes.

People with bipolar disorder have a three times higher risk of type 2 diabetes than the general population, and a new Canadian study finds that insulin resistance is linked with resistance to lithium treatment (British Journal of Psychiatry 2014, doi:10.1192/bjp.bp.114.152850). Fasting glucose and insulin levels were measured in …