Tag Archives: Elavil

Treatment of Insomnia

Several classes of medications are used in the treatment of insomnia. They include the benzodiazepines, non-benzodiazepine hypnotics, antidepressants, and over-the-counter medications. There are six benzodiazepines that are specifically marketed as hypnotics in the United States or in Canada: flurazepam, temazepam, triazolam, estazolam, quazepam, and (in Canada only) nitrazepam. Several other benzodiazepines (e.g., lorazepam, clonazepam, oxazepam),… Read More »

Current Therapies for Insomnia

Most individuals who suffer from insomnia either self-treat with nonprescription sleep aids (e.g., antihistamines, herbal remedies), use alcohol as a sedative, or take no drug therapy at all. For those who do seek professional help (approximately one-third of insomniacs), the majority receive physician-prescribed benzodiazepine or non-benzodiazepine sedative hypnotics to treat their insomnia. Such hypnotic agents… Read More »

Information about Alzheimer’s Disease for Patients and Families

Alzheimer’s disease is the most common and well-known form of degenerative dementia. By definition, dementia is a syndrome, a cluster of symptoms, of impaired memory and cognition. Dementia is a cognitive disorder that impairs an individual’s memory and ability for reasoning, awareness, and judgment. Cognitive impairment in Alzheimer’s disease may involve disturbance of language (aphasia),… Read More »

Minor Depression: Tricyclic Antidepressant

Tricyclic antidepressants entered the market in the 1960s after the Monoamine Oxidase Inhibitors but quickly lost their popularity when the selective serotonin reuptake inhibitors entered the market. Although tricyclic antidepressants are as effective as the selective serotonin reuptake inhibitors and serotonin/norepinephrine reuptake inhibitors in treating most forms of depression, they have the potential for cardiotoxicity… Read More »

Minor Depression: Escitalopram, Paroxetine, Sertraline, and Fluoxetine

Selective Serotonin Reuptake Inhibitors The seven available agents in the selective serotonin reuptake inhibitor class are citalopram (Lund-beck’s Cipramil, Forest Laboratories’ Celexa, generics) and its single enan-tiomer, escitalopram (Lundbeck’s Cipralex, Forest’s Lexapro); paroxetine (GSK’s Paxil/Seroxat, Novartis’s Frosinor, generics); the controlled-release version of paroxetine (GSK’s Paxil CR); sertraline (Pfizer’s Zoloft); fluoxetine (Eli Lilly’s Prozac, generics); and… Read More »

Bipolar Disorder – Chronic Illness

Etiology and Pathophysiology Bipolar disorder is a chronic illness characterized by recurrent episodes of aberrant mood. Episodes may manifest with symptoms of mania, hypomania (a less severe form of mania), depression, or a mixture of both depression and mania. Mania is characterized by persistently elevated, expansive, or highly irritable mood that typically lasts for at… Read More »

TTHs occurring about once to twice a week…

At a new-patient appointment, a 29-year-old woman reported TTHs occurring about once to twice a week. She had multiple repetitive questions about her headaches and, despite normal brain imaging in the past year, was difficult to reassure that her headaches were not due to a dread disease. At your suggestion, she considered a preventative medication;… Read More »

Which of the drugs appears to be the most effective preventative drug for children and adolescents with headaches?

Which of the following appears to be the most effective preventative medication for children and adolescents with migraine headaches? A. Propranolol (Inderal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Levetiracetam (Keppra) E. Zonisamide (Zonegran) The answer is C. Data on preventative medication for children and adolescents with migraine headaches is sparse, as noted by the… Read More »

What is therapeutic gain?

What is therapeutic gain? A. The improvement in quality of living gained by headache relief. B. The percentage response for active treatment minus the percentage response for placebo. C. The minimum response that can be reliably expected from treatment. D. The percentage response with active treatment. E. The consistent improvement seen each time treatment is… Read More »

Which of the antidepressants is most efficacious in the prevention of migraine?

Which of the following antidepressant medications is most efficacious in the prevention of migraine headache? A. Venlafaxine (Effexor) B. Fluoxetine (Prozac) C. Paroxetine (Paxil) D. Citalopram (Celexa) E. Sertraline (Zoloft) The answer is A. The SSRIs have not been shown to be effective in the prevention of migraine headaches. However venlafaxine (Effexor), a combined norepinephrine… Read More »