Tag Archives: Nortriptyline

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 »

Nonstimulant medications in the treatment of adults with ADHD

Here are some important points regarding nonstimulants in the treatment of adults with ADHD. Tricyclic antidepressants and bupropion are second-line therapies. Antidepressant dosing of the agents appears necessary for attention deficit hyperactivity disorder efficacy. Serotonergic medications do not appear effective in the treatment of core attention deficit hyperactivity disorder symptoms but may be useful for… Read More »

Information about ADHD for Patients and Families

Attention-deficit/hyperactivity disorder (ADHD) is a common psychiatric disorder in young and school-aged children. However, it is not merely a childhood disorder. In recent years, an increasing number of adults have been diagnosed with ADHD, raising some concern that it may be overdiagnosed. Estimates of the prevalence (i.e., percentage of the population affected) of attention-deficit/hyperactivity disorder… Read More »

Pharmacological Treatment of Pain

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 »

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 »

Preventive Treatment for Migraine

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 »

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 »

Specific Migraine-Preventive Agents: Antidepressants

Antidepressants consist of a number of different classes of drugs with different mechanisms of action. Only tricyclic antidepressants (TCAs) have proven efncacy in migraine; we cover the newer components for completeness and reader interest. Mechanism of Action TCAs, selective serotonin-reuptake inhibitors (SSRIs), and serotonin NE-reuptake inhibitors increase synaptic NE or serotonin (5-HT) by inhibiting high-affinity… Read More »

Treatment of late-onset mental disorder with antidepressants and neuroleptics

Drug treatment of late-life depression or schizophrenia is of great importance, as the functional psychoses are among the most common psychiatric diseases in the elderly. It therefore seems astonishing that there are great deficits in the drug research that has been done with this age group. There are almost no studies specifically on the treatment… Read More »