Tag Archives: Topiramate

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 »

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 »

Selected Chronic Pain Conditions

Postherpetic Neuralgia Postherpetic neuralgia is defined as pain persisting or recurring at the site of shingles at least 3 months after the onset of the acute varicella zoster viral rash. Postherpetic neuralgia occurs in about 10% of patients with acute herpes zoster. More than half of patients over 65 years of age with shingles develop… Read More »

Schizophrenia: AMPA Receptor Modulators

Glutamate modulators for the treatment of schizophrenia have generated some interest because several lines of evidence support the idea that a weakened glutamatergic tone in the brains of schizophrenics upsets a balance between glutamatergic and dopaminergic transmission. This imbalance may then predispose schizophrenics to a risk of sensory overload and exaggerated responsiveness of the monoaminergic… Read More »

Bipolar Disorder – Chronic Illness

Etiology and Pathophysiology Bipolar disorder is a chronic illness characterized by recurrent episodes of aberrant mood. Episodes may manifest with symptoms of mania, hypomania (a less severe form of mania), depression, or a mixture of both depression and mania. Mania is characterized by persistently elevated, expansive, or highly irritable mood that typically lasts for at… 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 »

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: 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 »

Treatment Of Childhood Absence Epilepsy

Childhood absence epilepsy (CAE) typically requires treatment because the seizures are frequent and interfere with normal cognitive functioning. International League Against Epilepsy Guidelines (Newly Diagnosed Epilepsy) According to the ILAE guidelines, the absence of class I and class II randomized controlled trials (RCTs) for children with absence seizures implies a marked deficiency in adequately powered,… Read More »