General guidelines for psychotropic medication use in frail elderly patients are applicable. Systematic evidence to support the effectiveness of particular psychotropic drugs in dementia patients is limited. Therefore, choice of drug class may be based on clinical evidence, and choice of agent is often based on the side-effect profile and on the characteristics of a… Read More »
Overview. A consequence of Alzheimer’s disease is neuronal loss, the result of a cascade of complex intracellular events. Excitotoxic reactions due to excessive glutamate release are thought to contribute to this neuronal cell death. Blocking glutamate receptors (NMDA receptors) is one approach to reducing cell death. In the past, however, drugs targeting NMDA receptors have… Read More »
Many medical problems have been reported to cause anxiety, but their significance is in some cases uncertain due to reporting bias and lack of controlled studies. Nonetheless, it is important for the psychosomatic medicine physician to consider medical causes of anxiety when evaluating an anxious patient. It is particularly important to evaluate medical causes when… Read More »
Question. I’m a medical student who is trying to find out exactly what the term “psychotropic drugs” includes. Does it cover marijuana and other street drugs, or is it only for mood-altering drugs (developed by pharmaceutical companies) without euphoric effects? What is the true definition? Answer. Good question, but a bit like trying to nail… Read More »
While medications are often prescribed for all types of chronic pain, research has consistently shown that several classes have proven efficacy for the treatment of neuropathic pain. Ideally, pharmacotherapy of pain would be specifically selected on the basis of considerations of etiology (e.g., ischemic, neuropathic), pathophysiology (e.g., demyelination, central pain), and anatomy (e.g., C fibers,… Read More »
Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »
Monotherapy for bipolar disorder is well established as both acute and prophylactic treatment, the most familiar drugs used in these roles being lithium, sodium valproate, and carbamazepine. The choice of agent can be guided at least in part by the subtype of bipolar disorder, for instance, valproate possibly being more efficacious in rapid cycling illness… Read More »
The main goal of bipolar disorder drug treatment is to establish euthymia (stable mood with a persistent sense of well-being) without inducing mania or rapid cycling (i.e., four or more mood episodes in a 12-month period). For this reason, drug treatment usually consists of an agent or, more frequently, combinations of agents that exert both… Read More »
Few new drugs are in clinical development for the treatment of Bipolar disorder. Most agents in clinical trials for this disorder (e.g., Bristol-Myers Squibb’s aripiprazole, Novartis’s oxcarbazepine, AstraZeneca’s quetiapine, Janssen’s risperidone, Ortho-McNeil’s topiramate, Pfizer’s ziprasidone) are already available in the major markets (United States, France, Germany, Italy, Spain, United Kingdom, and Japan) for the treatment… Read More »
Migraine is a common episodic headache disorder characterized by attacks that consist of various combinations of headache and neurologie, gastrointestinal, and autonomie symptoms. It has a one-year prevalence of approximately 18% in women, 6% in men, and 4% in children. The second edition of the International Classification of Headache Disorders (ICHD-2) subclassifies migraine into migraine… Read More »