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topiramate diabetic

Bruno Halpern, Marcio C Mancini
Few studies on combination therapies for the treatment of obesity had been conducted until recently, when two fixed-dose combinations, bupropion-naltrexone ER fixed-dose combination and phentermine-topiramate ER titrated-dose combinations were evaluated in clinical studies that ultimately led to FDA approval. Areas covered: In this review, we discuss safety concerns about both combinations, the rationale and history of combination therapies for obesity (including phentermine plus fenfluramine), and possible future new combinations...
October 12, 2016: Expert Opinion on Drug Safety
Therese S Salameh, Gul N Shah, Tulin O Price, Melvin R Hayden, William A Banks
All forms of diabetes mellitus are characterized by chronic hyperglycemia resulting in the development of a number of microvascular and macrovascular pathologies. Diabetes is also associated with changes in brain microvasculature, leading to dysfunctions and ultimately disruption of the blood-brain barrier (BBB). These changes are correlated with a decline in cognitive function. In diabetes, BBB damage is associated with increased oxidative stress and reactive oxygen species (ROS). This occurs because of the increased oxidative metabolism of glucose caused by hyperglycemia...
October 11, 2016: Journal of Pharmacology and Experimental Therapeutics
Michael Erlandson, Laurie C Ivey, Katie Seikel
Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall health. Dietary strategies emphasizing reduced caloric intake, regardless of the nutrient composition, are important for weight loss. Behavioral interventions such as motivational interviewing and encouraging physical activity lead to additional weight loss when combined with dietary changes...
September 1, 2016: American Family Physician
Nele Plock, Leon Bax, Douglas Lee, Deborah DeManno, Gezim Lahu, Marc Pfister
The presented analysis was performed to characterize the relationship between treatment-related early (week 4) and longer-term (3-6 months) weight loss to understand the potential utility of 4-week proof-of-mechanism studies in the early decision-making process during clinical development of new anti-obesity compounds. A regression-based meta-analysis was performed leveraging publically available clinical outcomes data to (i) characterize the within-trial relationship between treatment-related early and longer-term body weight loss, (ii) identify and quantify key covariate effects on this relationship...
June 9, 2016: Journal of Clinical Pharmacology
Juan A Guisado-Macías, Fabiola Méndez-Sánchez, Itziar Baltasar-Tello, Francisco J Zamora-Rodríguez, Ana B Escudero-Sánchez, Francisco J Vaz-Leal
INTRODUCTION: Pharmacotherapy for the management of obesity is primarily aimed at weight loss, weight loss maintenance and risk reduction (reduction in body fat, risk factors for cardiovascular disease and the incidence of diabetes mellitus). Among drugs that have been evaluated for weight loss include antidepressants (fluoxetine) and antiepileptic (topiramate). MATERIAL AND METHODS: We analyzed eating behavior and weight loss in a sample of morbid obesity patients before bariatric surgery...
May 2016: Actas Españolas de Psiquiatría
Katherine H Saunders, Rekha B Kumar, Leon I Igel, Louis J Aronne
Obesity is a growing epidemic in the USA with over one third of adults presently classified as obese. Obesity-related comorbidities include many leading causes of preventable death such as heart disease, stroke, type 2 diabetes, and certain types of cancer. Modest weight loss of 5-10 % of body weight is sufficient to produce clinically relevant improvements in cardiovascular disease risk factors among patients with overweight and obesity. Until recently, there were limited pharmacologic options approved by the Food and Drug Administration to treat obesity...
July 2016: Current Atherosclerosis Reports
Bridget Paravattil, Kyle J Wilby, Ricky Turgeon
AIMS: To conduct a systematic review with meta-analysis to determine the efficacy and safety of topiramate as monotherapy for weight reduction in patients with type 2 diabetes mellitus. METHODS: We searched MEDLINE, Embase, and International Pharmaceutical Abstracts from inception to June 2015. We included randomized controlled trials that evaluated topiramate monotherapy versus control agents or placebo for weight loss in obese type 2 diabetes patients. RESULTS: Of the 284 studies identified, 5 studies fulfilled the inclusion criteria...
April 2016: Diabetes Research and Clinical Practice
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No abstract text is available yet for this article.
May 5, 2016: New England Journal of Medicine
Burak Yulug, Lütfü Hanoglu, Ahmet Mithat Tavlı, Tansel Cakir, Oktay Olmuscelik, Burak Pakoz, Gülşen Ünlü
BACKGROUND: There is still limited knowledge regarding the role of impaired brain glucose metabolism in the generation of aggression during diabetes. Additionally, there are rapidly replicating piece of evidence suggesting that topiramate may exert significant mood stabilizing effect. In this respect, we aimed to evaluate the neurometabolic correlates of the therapeutic effect of topiramate in a patient with diabetes and Intermittent explosive disorder (IED). METHODS: We measured regional cerebral glucose metabolism using 2-[18F]-fluoro-2-deoxy-D-glucose and positron emission tomography (FDG-PET) in a diabetic patient with aggressive outbursts before and after treatment with topiramate...
February 29, 2016: Central Nervous System Agents in Medicinal Chemistry
Antonio Alcántara-Montero, Clara I Sánchez-Carnerero
INTRODUCTION: Most of the clinical practice guidelines consulted agree that tricyclics, dual (venlafaxine/duloxetine) antidepressants, gabapentin/pregabalin antiepileptic drugs, lidocaine 5% patches and capsaicin 8% patches are the first-line drugs in the treatment of peripheral neuropathic pain, being tramadol and some strong opioids (morphine, oxycodone and tapentadol) second-line drugs treatment. Moreover, the prevalence of neuropathic pain refractory to treatment is about 1.5% of the population, so that an estimated 50% of patients not responding to prescribed treatment...
March 1, 2016: Revista de Neurologia
Qingqin S Li, James M Lenhard, Yiping Zhan, Karel Konvicka, Maria C Athanasiou, Richard S Strauss, Stephan Francke
OBJECTIVE: Clinical response to topiramate can vary greatly in obese patients. Identifying genetic variants associated with treatment response could help gain insight into the mechanism of action of topiramate. Little is known about the relationship between genetic variability and topiramate treatment response. We performed a large-scale candidate-gene study to identify genetic risk factors predictive of topiramate-induced weight loss. METHODS: We collected DNA samples from patients who had previously participated in clinical trials to assess the efficacy of topiramate for the treatment of obesity...
February 2016: Pharmacogenetics and Genomics
Wayne Rankin, Gary Wittert
PURPOSE OF REVIEW: The prevalence of obesity across the world continues to climb, bringing with it otherwise preventable obesity-related comorbidities including type 2 diabetes, hypertension and cardiovascular disease. Weight loss is difficult to achieve and maintain through lifestyle interventions alone, leading to intense efforts to develop adjunctive pharmacological approaches. Herein, we examine recent advances in this field and limitations of currently available and emerging agents...
December 2015: Current Opinion in Lipidology
S Naidoo, A M Meyers
This article on drug nephrotoxicity is detailed, as it is important to be fully aware of renal side-effects of drugs with regard to prevention andearly diagnosis in order to manage the condition correctly. Many therapeutic agents are nephrotoxic, particularly when the serum half-life isprolonged and blood levels are raised because of decreased renal excretion. Distal nephrotoxicity is markedly enhanced when the glomerularfiltration rate (GFR) is reduced and is a particular threat in elderly patients with so-called 'normal' creatinine levels...
2015: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
Ping Patrick, Tulin O Price, Ana L Diogo, Nader Sheibani, William A Banks, Gul N Shah
Hyperglycemia in diabetes mellitus causes oxidative stress and pericyte depletion from the microvasculature of the brain thus leading to the Blood-Brain Barrier (BBB) disruption. The compromised BBB exposes the brain to circulating substances, resulting in neurotoxicity and neuronal cell death. The decline in pericyte numbers in diabetic mouse brain and pericyte apoptosis in high glucose cultures are caused by excess superoxide produced during enhanced respiration (mitochondrial oxidative metabolism of glucose)...
2015: Journal of Endocrinology and Diabetes
Kinga Anna Budai, Arash Mirzahosseini, Noszál Béla, Gergő Tóth
Obesity is considered the most concerning and blatantly visible--yet most neglected--public health problem by the WHO. The steadily increasing number of overweight and obese people has reached 2.3 billion and 700 million worldwide, respectively. Obesity is a complex condition, one that presents serious health risks with respect to type 2 diabetes, ischemic heart disease, and hypertension, therefore controlling the global obesity epidemic decreases not only health problems, but also expenditure. The underlying cause of obesity is a metabolic disorder of genetic, central nervous system or endocrine etiology that manifests in increased nutritional intake and/or decreased physical activity ultimately leading to excessive lipogenesis...
2015: Acta Pharmaceutica Hungarica
Tulin O Price, Susan A Farr, Michael L Niehoff, Nuran Ercal, John E Morley, Gul N Shah
Diabetes mellitus-associated damage to the microvasculature of the brain is caused by hyperglycemia-induced oxidative stress, which results in pericyte loss, blood-brain barrier disruption, and impaired cognitive function. Oxidative stress, in diabetes, is caused by reactive oxygen species produced during accelerated respiration (mitochondrial oxidative metabolism of glucose). The rate of respiration is regulated by mitochondrial carbonic anhydrases (CAs). Inhibition of these enzymes protects the brain from diabetic damage...
March 16, 2015: International Library of Diabetes & Metabolism
Jill S Carmody, Nadia N Ahmad, Sriram Machineni, Scott Lajoie, Lee M Kaplan
Roux-en-Y gastric bypass (RYGB) typically leads to substantial, long-term weight loss (WL) and diabetes remission, although there is a wide variation in response to RYGB among individual patients. Defining the pathways through which RYGB works should aid in the development of less invasive anti-obesity treatments, whereas identifying weight-regulatory pathways unengaged by RYGB could facilitate the development of therapies that complement the beneficial effects of surgery. Activation of serotonin 2C receptors (5-HT2CR) by serotonergic drugs causes WL in humans and animal models...
September 2015: Endocrinology
K Fujioka
Recently, the recognition of obesity as a complex disease that requires chronic management has become more widespread. There has also been a movement away from a focus on body mass index alone, and toward the management of obesity-related comorbidities as well as excess weight. This article examines the current and emerging pharmacological options for weight management in people with overweight or obesity who have, or are at a high risk of, weight-related comorbidities. In the USA, the current options for pharmacological weight management are phentermine (indicated for short-term use only), orlistat, combined phentermine/topiramate extended release, lorcaserin, naltrexone/bupropion and liraglutide 3...
November 2015: Diabetes, Obesity & Metabolism
Nasreen Alfaris, Alyssa M Minnick, Christina M Hopkins, Robert I Berkowitz, Thomas A Wadden
INTRODUCTION: Losing ≥ 5% of initial weight improves quality of life and risk factors for cardiovascular disease (CVD) in obese individuals. Lifestyle modification, the cornerstone of weight reduction, may be complemented by pharmacotherapy. In 2012, the FDA approved the combination of phentermine and topiramate extended release (ER) for chronic weight management, as an adjunct to lifestyle modification. AREAS COVERED: This review examines the safety and efficacy of phentermine-topiramate ER, as determined by randomized controlled trials (RCTs)...
June 2015: Expert Opinion on Pharmacotherapy
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