Tag Archives: Escitalopram

Pharmacological Treatment of Dementia

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 »

Alzheimer’s Therapy: Antidepressants

Overview. Major depression affects approximately 15% of Alzheimer’s disease patients. By comparison, 5-12% of the general population aged 15 years or older in the major pharmaceutical markets experience at least one episode of major depression per year. Because depression itself may lead to declines in cognition and function, treatment of depression in Alzheimer’s disease patients… Read More »

Treatment of Social Anxiety Disorder

Current recommended treatment options for social anxiety disorder include pharmacotherapy and cognitive behavioural therapy (CBT). Although several randomised controlled trials (RCTs) have failed to show efficacy for beta-adrenoceptor antagonists in generalised social anxiety disorder (SAD), it has been suggested that these agents may be useful in non-generalised social anxiety disorder (SAD), patients with performance anxiety… Read More »

Treatment of Anxiety in the Medically Ill

Psychotherapy An overemphasis on psychopharmacology in the care of medically ill patients may result in overlooking the value of psychotherapy. The first step in the treatment of anxiety is to spend time listening to and talking with the patient. Just as in psychotherapy with any patient, empathic listening is a powerful tool to relieve distress.… Read More »

Minor Depression

Etiology and Pathophysiology Minor depression is only a proposed diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and there are no International Classification of Diseases codes to categorize it. The proposed diagnostic category for minor depression in Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition describes a depressive disorder that… Read More »

Minor Depression: Bupropion

Dopaminergic/Noradrenergic Agents Bupropion (GSK’s Wellbutrin/Wellbutrin XR) acts on the noradren-ergic and dopaminergic system by inhibiting reuptake of norepinephrine and dopamine. Because bupropion does not affect the serotonergic system, this drug has become a common alternative or adjunct therapy for patients unable to bear the serotonergic side effects associated with serotonin reuptake inhibition (e.g., sedation, weight… 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 »

Minor Depression: Dopaminergic/Noradrenergic Agents

Dual-mechanism dopaminergic/noradrenergic antidepressants are not a popular focus of drug development programs; only a small percentage of drugs in development are based on this mechanism. These compounds offer the promise of freedom from sexual side effects (bupropion [GSK’s Wellbutrin, Wellbutrin XR] is commonly praised for its freedom from sexual side effects), but they have poor… Read More »

Chronic Illness: Current Therapies

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 »

Chronic Illness: Emerging Therapies

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 »