Tag Archives: Estradiol

Specific Migraine-Preventive Agents: Anticonvulsants

Anticonvulsant medication is increasingly recommended for migraine prevention, because it was proved to be effective by placebo-controlled, double-blind trials. With the exceptions of valproic acid, topiramate, and zonisamide, anticonvulsants may interfere substantially with the efficacy of oral contraceptives. Nine controlled trials of five different anticonvulsants were included in the AHCPR Technical Report. Carbamazepine The only… Read More »

Which drug can increase the metabolism and decrease the efficacy of oral contraceptives?

Which medication can increase the metabolism and decrease the efficacy of oral contraceptives? A. Tegretol B. Oxcarbazepine (Trileptal) C. Phenytoin (Dilantin) D. Topiramate (Topamax) E. All of the above The answer is E. Medications with predominantly hepatic metabolism may decrease the efficacy of oral contraceptives, especially when higher-thanusual doses of the medications are combined with… Read More »

Oral contraceptives reduce the level of which drug by up to 50%?

Oral contraceptives reduce the level of which drug by up to 50%? A. Gabapentin (Neurontin) B. Divalproex sodium (Depakote) C. Lamotrigine (Lamictal) D. Zonisamide (Zonegran) E. All of the above The answer is C. Ethinyl estradiol induces the main metabolic enzyme for lamotrigine (Lamictal), and levels may be reduced by up to 50% in women… Read More »

Management of Periodic Limb Movement Disorder

Periodic limb movements in sleep represent a habitual motor accompaniment of restless legs syndrome, found in over 80% of the cases on polysomnography. The recent finding that genes associated with restless legs syndrome are highly associated with periodic limb movements in sleep also indicates the close, but poorly understood relationship between the two. Periodic limb… Read More »

Depression and Menopause

Prevalence Controversy over the existence of ‘involutional melancholia’ has spanned several centuries. More recently, the influence of estrogen on serotonin (5HT) receptors has been a topic of growing interest. There is also evidence that depressive symptoms increase around the perimenopause. Approximately 30% of women in this age group endorse symptoms associated with major depression or… Read More »

Hypersomnia: Pharmacologic Therapy

Narcolepsy: Pharmacologic Therapy Recurrent Hypersomnias The recurrent hypersomnias described in the ICSD-2 are the Kleine-Levin syndrome and menstrual-related hypersomnia. Kleine-Levin Syndrome The Kleine-Levin syndrome was first described by Antimoff in 1898, detailed by Willi Kleine in 1925, clearly summarized by Max Levin in 1929, and formally named the Kleine-Levin syndrome by Critchley and Hoffmann in… Read More »

Postpartum Depression

Shortly after the birth of a child, many women experience a period of dysphoria known as postpartum blues. It has been estimated that up to 80% of postpartum women experience symptoms of negative mood and affect that sharply contrast with expectations of feeling happy and a sense of accomplishment. These feelings usually remit without intervention.… Read More »

Postmenopausal Depression

Menopause is defined as the absence of menses for 12 consecutive months. Early post-menopause is defined as the first 4 years after the menopause. When depression occurs during this time, some have referred to it as postmenopausal depression. Major depressive disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric… Read More »