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CNS Drugs

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https://www.readbyqxmd.com/read/28337727/newer-antiepileptic-drugs-in-status-epilepticus-prescription-trends-and-outcomes-in-comparison-with-traditional-agents
#1
Isabelle Beuchat, Jan Novy, Andrea O Rossetti
INTRODUCTION: Newer antiepileptic drugs (AEDs) are increasingly prescribed; however, relatively limited data are available regarding their use in status epilepticus (SE) and the impact on outcome. OBJECTIVES: The aim of this study was to explore the evolution in prescription patterns of newer and traditional AEDs in this clinical setting, and their association with prognosis. METHODS: We analyzed our prospective adult SE registry over a 10-year period (2007-2016) and assessed the yearly use of newer and traditional AEDs and their association with mortality, return to baseline conditions at discharge, and SE refractoriness, defined as treatment resistance to two AEDs, including benzodiazepines...
March 24, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28303466/do-statins-have-antidepressant-effects
#2
Ole Köhler-Forsberg, Christiane Gasse, Michael Berk, Søren Dinesen Østergaard
Statins are used widely in primary and secondary prevention of cardiovascular disease; a treatment effect that has long been thought to be due to their cholesterol-lowering properties. However, statins also have a wide range of anti-inflammatory effects independent of their lipid-lowering mechanisms. In depression, low-grade inflammation is a replicated finding, and several studies have shown antidepressant properties of diverse anti-inflammatory drugs. Large observational studies have suggested reduced risks of depression amongst those taking statins, an effect that is thought to be explained by the anti-inflammatory properties of this class of drugs...
March 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28303465/pharmacotherapy-in-generalized-anxiety-disorder-novel-experimental-medicine-models-and-emerging-drug-targets
#3
REVIEW
David S Baldwin, Ruihua Hou, Robert Gordon, Nathan T M Huneke, Matthew Garner
Many pharmacological and psychological approaches have been found efficacious in patients with generalized anxiety disorder (GAD), but many treatment-seeking patients will not respond and others will relapse despite continuing with interventions that initially had beneficial effects. Other patients will respond but then stop treatment early because of untoward effects such as sexual dysfunction, drowsiness, and weight gain. There is much scope for the development of novel approaches that could have greater overall effectiveness or acceptability than currently available interventions or that have particular effectiveness in specific clinical subgroups...
March 16, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28290082/statin-adherence-and-the-risk-of-stroke-a-dose-response-meta-analysis
#4
REVIEW
Tao Xu, Xinyuan Yu, Shu Ou, Xi Liu, Jinxian Yuan, Yangmei Chen
BACKGROUND: Statins are one of the most common medications for stroke prevention. Increasing evidence indicates that the effect of statins against stroke may depend on the optimal adherence of the patients to the long-term therapies. However, the magnitude of the association between statin adherence and the risk of stroke has not been determined. OBJECTIVE: We conducted a dose-response meta-analysis to investigate the association between statin adherence and the risk of stroke...
March 13, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28290081/potential-use-of-microrna-for-monitoring-therapeutic-response-to-antidepressants
#5
Raoul Belzeaux, Rixing Lin, Gustavo Turecki
Major depressive disorder (MDD) is a serious and common psychiatric disorder that affects millions of people worldwide. The most common treatment methods for MDD are antidepressant drugs, many of which act by regulating monoamines by inhibiting pre-synaptic reuptake and/or by modulating monoamine receptors. Despite advances in antidepressants and other treatment options, therapy is often based on subjective decisions made by the physician. Moreover, it requires time to determine treatment outcome and to define whether the prescribed treatment is effective...
March 13, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28290080/a-retrospective-cohort-study-of-acute-kidney-injury-risk-associated-with-antipsychotics
#6
Yawen Jiang, Jeffrey S McCombs, Susie H Park
BACKGROUND: A recent large database analysis raised concerns of potential acute kidney injury (AKI) risk associated with antipsychotics. However, whether individual atypical and typical antipsychotics are associated with differential AKI risks has not been investigated. OBJECTIVE: The current study compared the risks of AKI and known causes of AKI associated with a broad range of atypical and typical antipsychotics. METHOD: This retrospective cohort analysis used January 2007-June 2013 US nationwide Humana claims data to define episodes of antipsychotic drug therapy for patients with schizophrenia and bipolar disorder...
March 13, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28285378/monoclonal-antibodies-for-relapsing-multiple-sclerosis-a-review-of-recently-marketed-and-late-stage-agents
#7
REVIEW
Morten Blinkenberg, Per Soelberg Sørensen
Treatment of multiple sclerosis (MS) has improved considerably over the last decade because of new insights into MS pathology and biotechnological advances. This has led to the development of new potent pharmaceutical compounds targeting different processes in the complex autoimmune pathology leading to chronic central nervous system (CNS) demyelination, neural loss, and, finally, neurological disability. Although a number of disease-modifying treatments are available for the treatment of the inflammatory phase of MS, there is still a need for highly efficacious therapies with an acceptable safety profile in order to gain therapeutic control early in the disease course...
March 11, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28258365/dosing-and-switching-strategies-for-paliperidone-palmitate-3-month-formulation-in-patients-with-schizophrenia-based-on-population-pharmacokinetic-modeling-and-simulation-and-clinical-trial-data
#8
REVIEW
Mats O Magnusson, Mahesh N Samtani, Elodie L Plan, E Niclas Jonsson, Stefaan Rossenu, An Vermeulen, Alberto Russu
Paliperidone palmitate 3-month formulation (PP3M), a long-acting injectable atypical antipsychotic, was recently approved in the US and Europe for the treatment of schizophrenia in adult patients who have already been treated with paliperidone palmitate 1-month formulation (PP1M) for ≥4 months. This article reviews the pharmacokinetic rationale for the approved dosing regimens for PP3M, dosing windows, management of missed doses and treatment discontinuation, switching to other formulations, and dosing in special populations...
March 4, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28247239/effect-of-fingolimod-on-brain-volume-loss-in-patients-with-multiple-sclerosis
#9
REVIEW
Nicola De Stefano, Diego G Silva, Michael H Barnett
Brain atrophy occurs at a faster rate in patients with multiple sclerosis (MS) than in healthy individuals. In three randomized, controlled, phase III trials, fingolimod reduced the annual rate of brain volume loss (BVL) in patients with relapsing MS (RMS) by approximately one-third relative to that in individuals receiving placebo or intramuscular interferon beta-1a. Analysis of brain volume changes during study extensions has shown that this reduced rate of BVL is sustained in patients with RMS receiving fingolimod continuously...
February 28, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28205146/binge-drinking-current-diagnostic-and-therapeutic-issues
#10
Benjamin Rolland, Mickaël Naassila
The concept of binge drinking (BD) refers to patterns of heavy episodic alcohol consumption, with BD primarily occurring among adolescents and young adults. Several official definitions of BD have been proposed, in particular by the World Health Organization, the National Institute on Alcoholism and Alcohol Abuse, and the Substance Abuse and Mental Health Services Administration. Nevertheless, none of these definitions address the psychosocial and medical consequences of the type of alcohol use seen in BD. In practice, BD can thus correspond to either hazardous or harmful use of alcohol (HUA), while the episodic nature of heavy drinking in BD means that it does not meet the criteria for 'alcohol dependence'...
February 15, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28110399/safinamide-a-review-in-parkinson-s-disease
#11
Hannah A Blair, Sohita Dhillon
Safinamide (Xadago(®)) is an orally active, selective, reversible monoamine oxidase-B inhibitor with both dopaminergic and non-dopaminergic (glutamatergic) properties. In the EU, safinamide is approved for the treatment of mid- to late-stage fluctuating Parkinson's disease (PD) as add-on therapy to a stable dose of levodopa alone or in combination with other PD medications. Safinamide 50-100 mg/day administered as a fixed or flexible dose significantly increased daily 'on' time without dyskinesia (primary endpoint) in patients with mid- to late-stage PD with motor fluctuations in 24-week, placebo-controlled clinical trials...
January 21, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28105588/nogo-a-antibodies-for-progressive-multiple-sclerosis
#12
Benjamin V Ineichen, Patricia S Plattner, Nicolas Good, Roland Martin, Michael Linnebank, Martin E Schwab
Most of the current therapies, as well as many of the clinical trials, for multiple sclerosis (MS) target the inflammatory autoimmune processes, but less than 20% of all clinical trials investigate potential therapies for the chronic progressive disease stage of MS. The latter is responsible for the steadily increasing disability in many patients, and there is an urgent need for novel therapies that protect nervous system tissue and enhance axonal growth and/or remyelination. As outlined in this review, solid pre-clinical data suggest neutralization of the neurite outgrowth inhibitor Nogo-A as a potential new way to achieve both axonal and myelin repair...
January 19, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28101765/tolerability-and-safety-of-commonly-used-antiepileptic-drugs-in-adolescents-and-adults-a-clinician-s-overview
#13
REVIEW
Martin J Brodie
This paper discusses the issues surrounding the tolerability and safety of the commonly used antiepileptic drugs (AEDs) in adolescents and adults. The content includes dose-related adverse effects, idiosyncratic reactions, behavioural and psychiatric comorbidities, chronic problems, enzyme induction and teratogenesis. Twenty-one AEDs are discussed in chronological order of their introduction into the UK, starting with phenobarbital and ending with brivaracetam. Wherever possible, advice is given on anticipating, recognising and managing these issues and thereby improving the lives of people with epilepsy, most of whom will need to take one or more of these agents for life...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28101764/diazepam-in-the-treatment-of-moderate-to-severe-alcohol-withdrawal
#14
Steven J Weintraub
Benzodiazepines ameliorate or prevent the symptoms and complications of moderate to severe alcohol withdrawal, which can include autonomic hyperactivity, agitation, combativeness, hallucinations, seizures, delirium, and death. The benzodiazepines most commonly used for this purpose are lorazepam, chlordiazepoxide, oxazepam, and diazepam. It is widely asserted that no member of this group is superior to the others for treatment of alcohol withdrawal. However, of these, diazepam has the shortest time to peak effect, which facilitates both rapid control of symptoms and accurate titration to avoid over-sedation...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28078633/benzodiazepine-use-and-risk-of-developing-alzheimer-s-disease-a-case-control-study-based-on-swiss-claims-data
#15
Fabienne A Biétry, Alena M Pfeil, Oliver Reich, Matthias Schwenkglenks, Christoph R Meier
BACKGROUND: A possible association between benzodiazepine use and Alzheimer's disease (AD) has been hypothesized in previous studies. OBJECTIVES: Using claims data from the Helsana Group, a large Swiss health insurance provider, we examined the association between previous benzodiazepine use and the risk of AD. METHODS: We conducted a matched case-control study and identified 1438 incident AD cases between 2013 and 2014 based on recorded first-time use of drugs used to treat AD [i...
January 11, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28258419/clozapine-for-treatment-resistant-schizophrenia-still-the-gold-standard
#16
EDITORIAL
David M Taylor
No abstract text is available yet for this article.
March 2017: CNS Drugs
https://www.readbyqxmd.com/read/28236285/cardiovascular-effects-of-stimulant-and-non-stimulant-medication-for-children-and-adolescents-with-adhd-a-systematic-review-and-meta-analysis-of-trials-of-methylphenidate-amphetamines-and-atomoxetine
#17
REVIEW
Leonie Hennissen, Mireille J Bakker, Tobias Banaschewski, Sara Carucci, David Coghill, Marina Danckaerts, Ralf W Dittmann, Chris Hollis, Hanna Kovshoff, Suzanne McCarthy, Peter Nagy, Edmund Sonuga-Barke, Ian C K Wong, Alessandro Zuddas, Eric Rosenthal, Jan K Buitelaar
BACKGROUND: Many children and adolescents with attention deficit/hyperactivity disorder (ADHD) are treated with stimulant and non-stimulant medication. ADHD medication may be associated with cardiovascular effects. It is important to identify whether mean group effects translate into clinically relevant increases for some individual patients, and/or increase the risk for serious cardiovascular adverse events such as stroke or sudden death. OBJECTIVES: To evaluate potential cardiovascular effects of these treatments, we conducted a systematic review and meta-analysis of the effects of methylphenidate (MPH), amphetamines (AMP), and atomoxetine (ATX) on diastolic and systolic blood pressure (DBP, SBP) and heart rate (HR) in children and adolescents with ADHD...
March 2017: CNS Drugs
https://www.readbyqxmd.com/read/28185158/outcome-measures-in-clinical-trials-for-multiple-sclerosis
#18
REVIEW
Caspar E P van Munster, Bernard M J Uitdehaag
Due to the heterogeneous nature of the disease, it is a challenge to capture disease activity of multiple sclerosis (MS) in a reliable and valid way. Therefore, it can be difficult to assess the true efficacy of interventions in clinical trials. In phase III trials in MS, the traditionally used primary clinical outcome measures are the Expanded Disability Status Scale and the relapse rate. Secondary outcome measures in these trials are the number or volume of T2 hyperintense lesions and gadolinium-enhancing T1 lesions on magnetic resonance imaging (MRI) of the brain...
March 2017: CNS Drugs
https://www.readbyqxmd.com/read/28130762/new-formulations-of-methylphenidate-for-the-treatment-of-attention-deficit-hyperactivity-disorder-pharmacokinetics-efficacy-and-tolerability
#19
REVIEW
Samuele Cortese, Giulia D'Acunto, Eric Konofal, Gabriele Masi, Benedetto Vitiello
Psychostimulants are the recommended first-line pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD). Methylphenidate is one of the most commonly used psychostimulants worldwide. Given that immediate-release and/or tablet/capsule formulations may decrease adherence to methylphenidate treatment, several drug companies have been developing novel long-acting and/or liquid/chewable formulations that may improve adherence as well as (for long-acting formulations) reduce abuse potential, decrease stigma associated with multiple administrations per day, and decrease the potential for adverse effects related to dosage peak...
February 2017: CNS Drugs
https://www.readbyqxmd.com/read/28101766/crossing-the-blood-brain-barrier-recent-advances-in-drug-delivery-to-the-brain
#20
Mayur M Patel, Bhoomika M Patel
CNS disorders are on the rise despite advancements in our understanding of their pathophysiological mechanisms. A major hurdle to the treatment of these disorders is the blood-brain barrier (BBB), which serves as an arduous janitor to protect the brain. Many drugs are being discovered for CNS disorders, which, however fail to enter the market because of their inability to cross the BBB. This is a pronounced challenge for the pharmaceutical fraternity. Hence, in addition to the discovery of novel entities and drug candidates, scientists are also developing new formulations of existing drugs for brain targeting...
February 2017: CNS Drugs
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