Tag Archives: Pregabalin

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 »

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 »

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 »

Treatment Of The Child Or Adolescent With Newly Diagnosed Epilepsy

Paediatric epilepsy is amazingly diverse. In some children, basic diagnosis, seizure classification and treatment are straightforward. Other patients have difficult-to-diagnose seizures, complicated seizure classification and a variable response to treatment. Some seizures are subclinical, others are barely noticeable, and occasionally they are life threatening. Many children with epilepsy have no associated disabilities, but all children… 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 »

Lithium And Antiepileptic Drugs In Bipolar Depression

Lithium has been the gold standard for the treatment of bipolar illness for over 50 years (). There is more clinical and research experience with this drug than any other used to treat bipolar illness. Its utility in depression has been demonstrated in older studies and is generally underappreciated by the current generation of psychiatrists.… Read More »

Treatment of the epilepsy patient with hepatic disease

The liver is the principal organ of drug metabolism. Some drugs are absorbed from the gut, delivered to the liver and undergo first-pass metabolism prior to reaching the systemic circulation. Metabolism of these drugs is significantly affected by hepatic vascular supply; if hepatic blood flow is reduced, first-pass metabolism is decreased and more drug reaches… Read More »

Treatment of the epilepsy patient with renal disease

Seizures may occur in uraemic encephalopathy, dialysis disequilibrium syndrome and dialysis encephalopathy. In addition, renal insufficiency and dialysis may both have effects on anti-epileptic drug pharmacokinetics. Renal impairment can alter the fraction of anti-epileptic drug absorbed, volume of distribution, protein binding and renal drug clearance. Renal impairment may alter the gastric pH, cause small intestinal… Read More »

Treatment of the elderly with epilepsy

Older adults have increased steadily in number and proportion of the total world population. In the United States, the population aged 65 and older numbered 35 million in 2000 and is expected to more than double by 2050. The older population was 12% of the total population in 2000 and will increase to 20% by… Read More »

Best evidence for choosing anti-epileptic drugs in the older adult

There are few trials to support the choice of one medication for all older patients with epilepsy. However, some comparative head-to-head trials of anti-epileptic drugs in older adults have been conducted. Craig and colleagues compared valproic acid with phenytoin. A total of 166 patients over the age of 65 with adult-onset seizures were randomized to… Read More »