SUMMARYAfter an ischaemic stroke or transient ischaemic attack, patients have a high risk of having another stroke. Secondary stroke prevention includes antiplatelet therapy, statins and antihypertensivesAspirin, clopidogrel, or a combination of aspirin with dipyridamole are first-line options for secondary stroke prevention in the absence of atrial fibrillationDual antiplatelet therapy has a benefit in the first three weeks after stroke, but patients should change to a single antiplatelet drug after this timeAnticoagulants are indicated if the patient has atrial fibrillation. Avoid combinations of anticoagulants and antiplatelet drugsPatients should be started on statins after an ischaemic stroke. High doses are recommended even if cholesterol concentrations are normalAntihypertensive drugs are recommended for all patients with systolic blood pressures greater than 140/90 mmHg. ACE inhibitors, calcium channel blockers and diuretics are first-line options

SUMMARYPatients with epilepsy who have been free of seizures for at least two years may be able to stop their antiepileptic drugs. Discontinuation may be considered after an individualised harm–benefit assessment and consultation with a neurologist is recommended.It is paramount to discuss with patients whether the risk of seizure recurrence is worth the benefit of stopping the antiepileptic drug.The risk of seizure recurrence after antiepileptic drugs are discontinued depends on the epilepsy syndrome and a number of other risk factors. Approximately 30–50% of patients will relapse.If seizures recur, the majority of patients regain seizure control when treatment is resumed. However up to 20% do not achieve immediate remission.

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SUMMARYMost patients with dementia have behavioural and psychological symptoms. The first-line treatments for these symptoms are not drugs, but behavioural and psychological interventionsAntipsychotic drugs are widely prescribed for people living with dementia. This is despite a high adverse effect burden and limited evidence of efficacyMost behavioural and psychological symptoms will subside spontaneously within six months. Trials of deprescribing are therefore recommendedBehaviours should be seen as symptoms that have an underlying cause. Treatment should target these causes, rather than the resultant behaviours

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Approved indication: non-small cell lung cancer Lorviqua (Pfizer) 25 mg and 100 mg tablets

SUMMARYMigraine causes significant lost time from everyday activities. Addressing lifestyle triggers and comorbidities in patients with migraine is the first step of managementAcute migraine treatments primarily manage the headache component and should be started as early as possible in the migraine attackProphylaxis may be recommended if a patient is having three or more migraines a month or if their migraines are difficult to manageThe choice of prophylactic drugs should be tailored to the individual’s potential for adverse effects, interactions and comorbidities