Alan Carson

@DGlaucomflecken Not on the algorithm - metaphorically somewhere beliw cannabis for glaucoma

Question for psychiatrists. Where in the depression treatment algorithm would you place psychedelics? Is this kind of like cannabis being roughly the 86th best treatment for glaucoma? It has a very mild effect but you would never actually prescribe it because there are so many better options. This is an honest question.

@drkeithsiau For those interested in learning more about these complex neuropsychiatric presentations that commonly present on acute medical takes look up fndsociety.org

A 24 year old shares her video to raise awareness of FND - functional neurological disorder.

@ebtapper It s not quite zero yield - 1 subdural in 41 scans. Might be difficult to defend missing

A patient with cirrhosis and altered mental status does not need a head CT New study: high CT utilization, zero yield

@RealAdamHunt Maybe if you trained in psychiatry…

What motivates me in regards to Evolutionary Psychiatry is a certain disappointment with current Psychiatry. Psychiatry is the only medical specialty where the diagnostic manual has no clear validated biomarkers, the treatments are uncertain and with effect sizes that would embarrass any other field, and the response to this is to make the manual bigger. Evolutionary thinking can refocus the field on Mechanism rather than Description.

@DrSteveTaylor Whilst i personally think triage of gp referrals is s senior consultant role, the contact points should at the very least document the responsible individual and their grade and not an anonymous ‘the team’

GP referrals will now be ‘assessed’ by a ‘Consultant led’ Single point of access 1 in 4 is the target to reject GPs & patients must insist on Jess’s Rule in referrals Any rejected referral must have a Consultant name & GMC number This is the only way to ensure patient choice

Oh yes

@DrEvgenyLegedin I m somewhat sceptical of people who have never actually had to do emergency assessments teaching about them

Rosemary McCabe’s talk “Epistemic injustice in emergency psychiatric care and how to overcome it” at the Critical Psychiatry Network Symposium at UCL, 17 April, 2026

@DrJoFranklin @wesstreeting @SKinnock I doubt it will reduce W/L more likely the opposite - less experienced clinicians refer on more and investigate more.

@wesstreeting @SKinnock your plan for A&G, SPOA & MDT non-Drs rejecting referrals is pretty much universally condemned by Drs as unworkable & unsafe. Morbidity, mortality & litigation will rocket. won't paint your few tens of thousands reduced from W/L in light you intend at all.

This is a core issue and a very important - our neurology dept reviews and sometimes redirects referrals but it is done by the two most experienced consultants - that way everyone feels confident. The eye doesn’t see what the mind doesn’t know

@wendyburn Good to see what is obvious confirmed - bed pressures lead directly to poorer care

This is interesting. In Sweden increased inpatient beds correlated with decreased rates of suicide.

@BarbaraRich_law @OnChairs She is a comedian, particularly stand up, so I suspect has a ‘voice’ to suit her act. My daughter went to see her and said very funny and good fun

@OnChairs Her father is or was an influential man in politics and public life, and she must have grown up around others that he knows, and yet her diction and speech delivery are so slovenly and childish. An affectation to appeal to her audience, or her genuine style of expression?

Chip off the old block

Our paper is out: By analysing health records from millions of real-world patients from the literature, we can now finally answer the questions about the long-term outcomes of ECT. What we found, consistently, across well-designed studies from the UK, Canada, US, Sweden, Denmark, and Taiwan, is that ECT does not increase the risk for dementia, heart attacks or stroke, and is associated with a significant reduction in overall mortality. cambridge.org/core/journals/…

@mecfsskeptic I m not sure- medics are entitled to document their collective experience with assessing and treating a condition. To date the only treatments that have stood up to testing are rehabilitative ( inc CBT) but there is an organised campaign to prevent bigger and better studies

@AlanCarson15 Yes but the same can be made for all other theories, including those on microclots, viral persistence, antibodies, etc. Suspect it's best not to speculate too much about aetiology and treatment and simply admit our current lack of knowledge.

1) 🇧🇪🇫🇷 A group of patient representatives, physicians and researchers from (mainly) Belgium and France have published a statement on how psychologizing Long COVID can cause harm.

There is more robust data on placebo/nocebo responses than anything in the history medicine...yet somehow, we are barely taught about it🧐 Very grateful to lead this new two-part Lancet Psychiatry Collection "Reconceptualizing Placebo and Nocebo Effects"🧵thelancet.com/journals/lanps…

expert reaction to Cochrane review of anti-amyloid monoclonal antibodies for Alzheimer’s Disease | Science Media Centre Informative commentary on what is a contentious issue. The divides as to how to view the evidence base are clear. sciencemediacentre.org/expert-reactio…

@mecfsskeptic It only has potential to cause harm if they’re wrong. If on the other hand they’re correct, the systematic denial of the possibility will cause harm

2) This is a critique of an earlier paper by Brigitte Ranque and Elie Cogan who proposed to treat Long Covid as a functional somatic disorder (FSD). They did a survey which supposedly shows that most internists in France agree with them.

Best communicator on the left anywhere in the world right now. And it’s just how he’s saying it- he actually has something to say.

@BNPA @UCLBrainScience @UCLPsychiatry @global_gng @rcpsychNeuro

@danielgoyal @premnsikka @22_Gilly The most surprising thing is the apparent lack of understanding if who the work force is- it is the same pool of clinicians just being paid more

@premnsikka @22_Gilly Thank you! It’s not complicated.

Private firms got £12bn NHS contracts. Private equity, offshore tax haven firms big winners. £1.6bn profit in 2 yrs. Enough to pay for 9,178 doctors or 19,428 nurses Health service “taken for a ride”. Say NO to privatisation. Must expand NHS capacity. theguardian.com/society/2026/a…

@ArturNadol7566 @dr_benoy_n_shah Until there are criminal consequences for such managers nothing will change- that it is an endemic problem is beyond doubt- too many people have died

NHS DESTROYED A DOCTOR FOR TRYING TO SAVE LIVES Dr Raj Mattu was a cardiologist at Walsgrave Hospital in Coventry. In 2001 he noticed something that should have been blindingly obvious to management: cramming five patients into a cardiac ward designed for four was killing people, because essential services like oxygen were being cut off. He went to the @BBC. He named the problem. He tried to save lives. Management's response was to suspend him in 2002 and then bury him under a deluge of around 200 complaints to the General Medical Council. Not one. Not ten. Two hundred. Every single one was rejected. A tribunal later found that a senior manager had openly said: "Don't worry, as far as Raj is concerned, we are not worried about a parking ticket, we want to get him off the road completely." The suspension arrived within weeks. @sharmilaxx Dr Mattu suffered detriments on more than 25 separate occasions. NHS even hired private investigators to try to discredit him. A 2005 inquiry chaired by Andrew Stafford QC recommended he be reinstated. Management ignored it. He was finally dismissed in 2010. The tribunal process ran for six months and produced a 400-page judgment. The total legal cost to the @NHS is estimated at over £11 million in taxpayers' money. Coventry Live All to silence one doctor who told the truth. He was eventually awarded £1.22 million in compensation. The managers who orchestrated the campaign mostly remained in post. David Loughton, the CEO who oversaw the whole thing, is now a CBE. I know a fraction of what Dr Mattu went through. In 2024 I was the target of 3 fabricated complaints. Three. And even that was enough to make me understand exactly how this weapon works. You do not need evidence. You just need volume, institutional backing, and the willingness to grind someone down for as long as it takes. Dr Mattu said it best himself: the people who lost out most were the patients. For 13 years the trust prevented him from looking after them. And by doing so, they sent a message to every other NHS whistleblower: this is what happens if you speak up. Nothing has changed. Source: @guardian / @BBC / @lexology / @sharmilaxx