Tag Archives: Mirtazapine

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 »

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 »

Sedating Antidepressants

Given the high comorbidity of insomnia and depression and / or anxiety, sedating antidepressants have considerable relevance for treating insomnia. (Note: Sedating antidepressants can effectively treat both depressive and anxious symptoms.) The sleep-promoting properties of the sedating antidepressants, as well as their lack of abuse potential or propensity to induce tolerance, make these agents viable… Read More »

Emerging Therapies for Insomnia

Most of the late-stage compounds in clinical development for insomnia are non-benzodiazepine gamma-aminobutyric acid -acting agents. These drugs’ developers are hoping that their new compounds, once approved, will achieve less restrictive labeling from regulatory authorities than the currently marketed benzodiazepine and non-benzodiazepine hypnotics — most of which have short-term prescribing limits and all of which… 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: Duloxetine, Venlafaxine, and Milnacipran

Serotonin-Norepinephrine Reuptake Inhibitors Several antidepressants have dual action at both serotonergic and noradrenergic receptors. The most notable are the serotonin/norepinephrine reuptake inhibitors, particularly extended-release venlafaxine (Wyeth’s Effexor XR) and milnacipran (bioMerieux-Pierre Fabre’s Ixel/Dalcipran, Asahi Kasei/Janssen-Kyowa’s Toledomin; available only in France and Japan). The noradrenergic and specific serotonergic antidepressants (NaSSAs) mirtazapine (Organon’s Remeron/Remergil), nefazodone (Bristol-Myers Squibb’s… 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 »

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 »

Specific Migraine-Preventive Agents

β-Adrenergic Blockers β-blockers, the most widely used class of drugs in prophylactic migraine treatment, are approximately 50% effective in producing a greater than 50% reduction in attack frequency. Rabkin et al. serendipitously discovered propranolol’s effectiveness in headache treatment in patients who were being treated for angina. The Agency for Healthcare Policy and Research (AHCPR) Technical… Read More »