Matching articles for "tricyclic antidepressants"
Zuranolone (Zurzuvae) – An Oral Drug for Postpartum Depression
The Medical Letter on Drugs and Therapeutics • December 25, 2023; (Issue 1692)
The FDA has approved the oral GABAA receptor
modulator zuranolone (Zurzuvae – Sage Therapeutics/Biogen) for treatment of postpartum depression
(PPD). Zuranolone is the second drug to be approved
for this...
The FDA has approved the oral GABAA receptor
modulator zuranolone (Zurzuvae – Sage Therapeutics/Biogen) for treatment of postpartum depression
(PPD). Zuranolone is the second drug to be approved
for this indication; brexanolone (Zulresso), another
GABAA receptor modulator, was approved for IV
treatment of PPD in 2019.
Drugs for Depression
The Medical Letter on Drugs and Therapeutics • December 11, 2023; (Issue 1691)
A selective serotonin reuptake inhibitor (SSRI) is
generally used for initial treatment of major depressive
disorder (MDD). A serotonin-norepinephrine reuptake
inhibitor (SNRI), bupropion (Wellbutrin SR,...
A selective serotonin reuptake inhibitor (SSRI) is
generally used for initial treatment of major depressive
disorder (MDD). A serotonin-norepinephrine reuptake
inhibitor (SNRI), bupropion (Wellbutrin SR, and
others), and mirtazapine (Remeron, and others) are
reasonable alternatives. Improvement in symptoms
can occur within the first two weeks of treatment
with these drugs, but a substantial benefit may not be
achieved for 4-8 weeks.
Drugs for Anxiety Disorders
The Medical Letter on Drugs and Therapeutics • August 7, 2023; (Issue 1682)
Anxiety disorders (generalized anxiety disorder,
panic disorder, social anxiety disorder, and various
phobias) are the most common form of psychiatric
illness. They can be treated effectively with...
Anxiety disorders (generalized anxiety disorder,
panic disorder, social anxiety disorder, and various
phobias) are the most common form of psychiatric
illness. They can be treated effectively with cognitive
behavioral therapy (CBT) and/or pharmacotherapy.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • June 12, 2023; (Issue 1678)
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for
acute treatment of mild to moderate migraine pain
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine in most patients without vascular disease.
Treatment of pain when it is still mild to moderate in
intensity improves headache response and reduces
the risk of recurrence.
Nonopioid Drugs for Pain
The Medical Letter on Drugs and Therapeutics • March 7, 2022; (Issue 1645)
Nonopioid drugs can be used in the treatment of
many nociceptive and neuropathic pain conditions.
For severe pain, especially severe chronic cancer
pain, use of opioids may be necessary....
Nonopioid drugs can be used in the treatment of
many nociceptive and neuropathic pain conditions.
For severe pain, especially severe chronic cancer
pain, use of opioids may be necessary. Noninvasive
nonpharmacologic treatments, including physical
and psychological therapies, have been shown to
improve pain and function in patients with some
common chronic pain conditions and are unlikely
to cause serious harms. A multimodal approach to
analgesic therapy can increase pain control while
reducing opioid use and adverse effects.
Pitolisant (Wakix) for Narcolepsy
The Medical Letter on Drugs and Therapeutics • February 8, 2021; (Issue 1617)
The FDA has approved pitolisant (Wakix – Harmony), a histamine-3 (H3)-receptor antagonist/inverse agonist, for treatment of excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy. It is the...
The FDA has approved pitolisant (Wakix – Harmony), a histamine-3 (H3)-receptor antagonist/inverse agonist, for treatment of excessive daytime sleepiness (EDS) or cataplexy in adults with narcolepsy. It is the first H3-receptor antagonist/inverse agonist to become available in the US and the first non-controlled substance to receive FDA approval for these indications. Pitolisant has been available in Europe since 2016.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • October 5, 2020; (Issue 1608)
An oral nonopioid analgesic is often sufficient for acute
treatment of mild to moderate migraine headache
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to...
An oral nonopioid analgesic is often sufficient for acute
treatment of mild to moderate migraine headache
without severe nausea or vomiting. A triptan is the
drug of choice for treatment of moderate to severe
migraine headache pain in most patients without
vascular disease. Early treatment of pain when it is
still mild to moderate in intensity improves headache
response and reduces the risk of recurrence.
Lemborexant (Dayvigo) for Insomnia
The Medical Letter on Drugs and Therapeutics • June 29, 2020; (Issue 1601)
The FDA has approved lemborexant (Dayvigo – Eisai),
an orexin receptor antagonist, for treatment of sleep-onset
and/or sleep-maintenance insomnia in adults. It
is the second orexin receptor antagonist to...
The FDA has approved lemborexant (Dayvigo – Eisai),
an orexin receptor antagonist, for treatment of sleep-onset
and/or sleep-maintenance insomnia in adults. It
is the second orexin receptor antagonist to be approved
for this indication; suvorexant (Belsomra) was the first.
Eptinezumab (Vyepti) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • June 1, 2020; (Issue 1599)
The FDA has approved eptinezumab-jjmr (Vyepti –
Lundbeck), a calcitonin gene-related peptide (CGRP)
antagonist administered IV once every 3 months, for
migraine prevention in adults. It is the fourth...
The FDA has approved eptinezumab-jjmr (Vyepti –
Lundbeck), a calcitonin gene-related peptide (CGRP)
antagonist administered IV once every 3 months, for
migraine prevention in adults. It is the fourth monoclonal
antibody to be approved for this indication; erenumab
(Aimovig), fremanezumab (Ajovy), and galcanezumab
(Emgality), which are all given subcutaneously once
monthly (fremanezumab can also be given once every 3
months), were approved earlier.
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • March 23, 2020; (Issue 1594)
Irritable bowel syndrome (IBS) is a common disorder
characterized by recurrent abdominal pain and altered
bowel habits, often accompanied by bloating.IBS
is classified according to the predominant...
Irritable bowel syndrome (IBS) is a common disorder
characterized by recurrent abdominal pain and altered
bowel habits, often accompanied by bloating.IBS
is classified according to the predominant bowel
symptom as IBS with constipation (IBS-C), IBS with
diarrhea (IBS-D), mixed type (IBS-M), or unclassified
(IBS-U). Alterations in the microbiome, stress
responses, sensory and motor function of the gut,
and host genetic factors may be contributing factors.
Since the exact cause of IBS is unknown, the goal of
treatment is symptom control.
Table: Safety of Drugs for IBS in Pregnancy and Lactation (online only)
The Medical Letter on Drugs and Therapeutics • March 23, 2020; (Issue 1594)
...
View the Table: Safety of Drugs for IBS in Pregnancy and Lactation
Drugs for Depression
The Medical Letter on Drugs and Therapeutics • February 24, 2020; (Issue 1592)
Complete remission of symptoms is the goal of
treatment for major depressive disorder; a partial
response is associated with an increased risk of
relapse. Improvement in symptoms can occur within
the first...
Complete remission of symptoms is the goal of
treatment for major depressive disorder; a partial
response is associated with an increased risk of
relapse. Improvement in symptoms can occur within
the first two weeks of treatment with an antidepressant,
but it may take 4-8 weeks to achieve a substantial
benefit. Following successful treatment of a first major
depressive episode, antidepressant treatment should
be continued at the same dose for at least 4-9 months
to consolidate recovery. In patients with recurrent
depressive episodes, long-term maintenance treatment
can reduce the risk of relapse.
Drugs for Anxiety Disorders
The Medical Letter on Drugs and Therapeutics • August 12, 2019; (Issue 1578)
Anxiety disorders (generalized anxiety disorder, panic
disorder, social anxiety disorder, and various phobias)
are the most common form of psychiatric illness. They
can be treated effectively with cognitive...
Anxiety disorders (generalized anxiety disorder, panic
disorder, social anxiety disorder, and various phobias)
are the most common form of psychiatric illness. They
can be treated effectively with cognitive behavioral
therapy (CBT) and/or pharmacotherapy. Obsessive-compulsive
disorder and posttraumatic stress
disorder are now considered separate entities in the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-5); they can also be treated with CBT and many
of the same drugs.
Drugs for Chronic Insomnia
The Medical Letter on Drugs and Therapeutics • December 17, 2018; (Issue 1562)
Cognitive behavioral therapy for insomnia (CBT-I)
is recommended for initial treatment of chronic
insomnia. Pharmacologic treatment should be used in
addition to CBT-I when CBT-I alone is not...
Cognitive behavioral therapy for insomnia (CBT-I)
is recommended for initial treatment of chronic
insomnia. Pharmacologic treatment should be used in
addition to CBT-I when CBT-I alone is not effective.
Fremanezumab (Ajovy) and Galcanezumab (Emgality) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • November 5, 2018; (Issue 1559)
The FDA has approved two subcutaneously
injected calcitonin gene-related peptide (CGRP)
antagonists, fremanezumab-vfrm (Ajovy – Teva) and
galcanezumab-gnlm (Emgality – Lilly), for migraine
prevention in...
The FDA has approved two subcutaneously
injected calcitonin gene-related peptide (CGRP)
antagonists, fremanezumab-vfrm (Ajovy – Teva) and
galcanezumab-gnlm (Emgality – Lilly), for migraine
prevention in adults. Fremanezumab and galcanezumab
are the second and third subcutaneously
injected monoclonal antibodies that target the CGRP
pathway to be approved by the FDA for this indication;
erenumab-aooe (Aimovig), which targets the CGRP
receptor, was the first.
Erenumab (Aimovig) for Migraine Prevention
The Medical Letter on Drugs and Therapeutics • June 18, 2018; (Issue 1549)
The FDA has approved erenumab-aooe (Aimovig –
Amgen/Novartis), a once-monthly, subcutaneously-injected,
monoclonal antibody against the calcitonin
gene-related peptide receptor, for preventive...
The FDA has approved erenumab-aooe (Aimovig –
Amgen/Novartis), a once-monthly, subcutaneously-injected,
monoclonal antibody against the calcitonin
gene-related peptide receptor, for preventive treatment
of migraine in adults. It is the first drug in its class to
be approved by the FDA.
Nonopioid Drugs for Pain
The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)
Nonopioid drugs can be used in the treatment of many
nociceptive and neuropathic pain conditions. Use of
opioids for pain will be reviewed in a future...
Nonopioid drugs can be used in the treatment of many
nociceptive and neuropathic pain conditions. Use of
opioids for pain will be reviewed in a future issue.
Drugs for Cognitive Loss and Dementia
The Medical Letter on Drugs and Therapeutics • September 25, 2017; (Issue 1530)
Alzheimer's disease (AD) is the most common cause
of dementia, but cognitive loss is also associated with
other neurological conditions such as Parkinson's
disease, dementia with Lewy bodies, vascular...
Alzheimer's disease (AD) is the most common cause
of dementia, but cognitive loss is also associated with
other neurological conditions such as Parkinson's
disease, dementia with Lewy bodies, vascular dementia,
and frontotemporal dementia.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • February 13, 2017; (Issue 1514)
An oral nonopioid analgesic may be sufficient for
treatment of mild to moderate migraine without severe
nausea or vomiting. A triptan is the drug of choice for
treatment of moderate to severe migraine. Use...
An oral nonopioid analgesic may be sufficient for
treatment of mild to moderate migraine without severe
nausea or vomiting. A triptan is the drug of choice for
treatment of moderate to severe migraine. Use of
a triptan early in an attack when pain is still mild to
moderate in intensity improves headache response
and reduces recurrence rates.
Comparison Table: Some Drugs for Migraine Prevention in Adults (online only)
The Medical Letter on Drugs and Therapeutics • February 13, 2017; (Issue 1514)
...
View the Comparison Table: Some Drugs for Migraine Prevention in Adults
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • September 26, 2016; (Issue 1504)
Irritable bowel syndrome (IBS) is a common disorder
characterized by chronic, intermittent abdominal pain
or discomfort and altered bowel habits. It is subtyped
according to the predominant bowel symptom as...
Irritable bowel syndrome (IBS) is a common disorder
characterized by chronic, intermittent abdominal pain
or discomfort and altered bowel habits. It is subtyped
according to the predominant bowel symptom as IBS
with constipation (IBS-C), IBS with diarrhea (IBS-D),
mixed type (IBS-M), or unclassified (IBS-U). Since the
exact cause of IBS is unknown, the goal of treatment
is symptom control.
Drugs for Depression
The Medical Letter on Drugs and Therapeutics • July 4, 2016; (Issue 1498)
Complete remission of symptoms is the goal of
antidepressant therapy; partial response is associated
with an increased risk of relapse. Improvement can
occur within the first two weeks of drug therapy,
but...
Complete remission of symptoms is the goal of
antidepressant therapy; partial response is associated
with an increased risk of relapse. Improvement can
occur within the first two weeks of drug therapy,
but it may take 4-8 weeks to achieve a substantial
benefit. Fewer than 50% of patients with depression
respond to first-line pharmacotherapy, and the rate of
response decreases with each subsequent drug trial.
Following remission after a first episode of depression,
many experts recommend continuing antidepressant
treatment at the same dose for at least 6-12 months
to consolidate recovery. For patients with recurrent
depressive episodes, long-term maintenance therapy
can reduce the risk of recurrence.
Suvorexant (Belsomra) for Insomnia
The Medical Letter on Drugs and Therapeutics • March 2, 2015; (Issue 1463)
The FDA has approved suvorexant (Belsomra –
Merck), the first orexin receptor antagonist to become
available in the US, for treatment of sleep-onset and/or
sleep-maintenance...
The FDA has approved suvorexant (Belsomra –
Merck), the first orexin receptor antagonist to become
available in the US, for treatment of sleep-onset and/or
sleep-maintenance insomnia.
Drugs for Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • November 1, 2013; (Issue 135)
The motor symptoms of Parkinson's disease (PD) are
caused primarily by progressive degeneration of
dopaminergic neurons in the substantia nigra. The non-motor
symptoms of the disease are thought to be...
The motor symptoms of Parkinson's disease (PD) are
caused primarily by progressive degeneration of
dopaminergic neurons in the substantia nigra. The non-motor
symptoms of the disease are thought to be caused
by degeneration of other neurotransmitter systems.
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • June 1, 2013; (Issue 130)
Drugs are not the only treatment for psychiatric illness.
Psychotherapy remains an important component
in the management of these disorders, and cognitive
behavioral therapy (CBT) can be used for many...
Drugs are not the only treatment for psychiatric illness.
Psychotherapy remains an important component
in the management of these disorders, and cognitive
behavioral therapy (CBT) can be used for many of
them as well. Electroconvulsive therapy (ECT) has a
long history of efficacy and safety when drugs are
ineffective or cannot be used.
Drugs for Insomnia
The Medical Letter on Drugs and Therapeutics • July 1, 2012; (Issue 119)
Pharmacological treatment of insomnia includes prescription
drugs, non-prescription medications and
"natural" remedies. Behavioral changes are often
needed as...
Pharmacological treatment of insomnia includes prescription
drugs, non-prescription medications and
"natural" remedies. Behavioral changes are often
needed as well.
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • July 1, 2011; (Issue 107)
Irritable bowel syndrome (IBS) is a common disorder,
occurring in up to 15% of the US population; it is 2-2.5 times more frequent in women than in men. IBS
is characterized by chronic, intermittent...
Irritable bowel syndrome (IBS) is a common disorder,
occurring in up to 15% of the US population; it is 2-2.5 times more frequent in women than in men. IBS
is characterized by chronic, intermittent abdominal
pain or discomfort accompanied by altered bowel
habits. Since the underlying mechanisms of disease
remain unclear, management of IBS focuses on symptom
control.
Drugs for Treatment of ADHD
The Medical Letter on Drugs and Therapeutics • May 1, 2011; (Issue 105)
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder that occurs in about 5%
of school-age children, most often in boys, and frequently persists into young...
Attention-deficit/hyperactivity disorder (ADHD) is a disruptive behavior disorder that occurs in about 5%
of school-age children, most often in boys, and frequently persists into young adulthood.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • February 1, 2011; (Issue 102)
Drugs for treatment of migraine are listed in Table 2
on page 9. Drugs for prevention of migraine are listed
in Table 3 on page 10. Treatment of migraine in the
emergency room, which may involve use of...
Drugs for treatment of migraine are listed in Table 2
on page 9. Drugs for prevention of migraine are listed
in Table 3 on page 10. Treatment of migraine in the
emergency room, which may involve use of intravenous
drugs, is not included here.
Low-Dose Doxepin (Silenor) for Insomnia
The Medical Letter on Drugs and Therapeutics • October 4, 2010; (Issue 1348)
The FDA has approved a new low-dose formulation of
the tricyclic antidepressant doxepin (Silenor –
Somaxon) for treatment of insomnia associated with
sleep maintenance. The manufacturer claims that...
The FDA has approved a new low-dose formulation of
the tricyclic antidepressant doxepin (Silenor –
Somaxon) for treatment of insomnia associated with
sleep maintenance. The manufacturer claims that this
dose retains the hypnotic effect of doxepin, without
typical tricyclic adverse effects. Doxepin is available
generically in higher-strength capsules and in a liquid
formulation.
Drugs for Depression and Bipolar Disorder
The Medical Letter on Drugs and Therapeutics • May 1, 2010; (Issue 93)
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and...
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety
when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • December 15, 2008; (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
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Drugs for Tobacco Dependence
The Medical Letter on Drugs and Therapeutics • September 1, 2008; (Issue 73)
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking...
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking cessation rates have been.
Duloxetine (Cymbalta) for Fibromyalgia
The Medical Letter on Drugs and Therapeutics • July 28, 2008; (Issue 1291)
Duloxetine (Cymbalta - Lilly) is the second drug to be approved by the FDA for treatment of fibromyalgia. Pregabalin (Lyrica), which is also approved for treatment of neuropathic pain and epilepsy, was the...
Duloxetine (Cymbalta - Lilly) is the second drug to be approved by the FDA for treatment of fibromyalgia. Pregabalin (Lyrica), which is also approved for treatment of neuropathic pain and epilepsy, was the first. Duloxetine is a selective serotonin and norepinephrine reuptake inhibitor (SNRI) that is already marketed for treatment of depression and diabetic neuropathy.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • March 1, 2008; (Issue 67)
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Budesonide/Formoterol (Symbicort) for Asthma
The Medical Letter on Drugs and Therapeutics • February 11, 2008; (Issue 1279)
A combination of the corticosteroid budesonide and the long-acting beta2-agonist formoterol (Symbicort - AstraZeneca) has become available in a metered dose inhaler for long-term maintenance treatment of asthma...
A combination of the corticosteroid budesonide and the long-acting beta2-agonist formoterol (Symbicort - AstraZeneca) has become available in a metered dose inhaler for long-term maintenance treatment of asthma in patients ≥ 12 years old. A combination product that contains fluticasone propionate and salmeterol (Advair) is already available for this indication in the US. Neither one of these combinations is approved for acute treatment of asthma symptoms. A dry powder inhaler formulation of Symbicort has been available in Europe and Canada for several years.
SSRIs and Osteoporosis
The Medical Letter on Drugs and Therapeutics • November 19, 2007; (Issue 1274)
Some recently published studies suggest that taking selective serotonin reuptake inhibitors (SSRIs) may increase the risk of developing osteoporosis. A relationship between SSRIs and osteoporosis is...
Some recently published studies suggest that taking selective serotonin reuptake inhibitors (SSRIs) may increase the risk of developing osteoporosis. A relationship between SSRIs and osteoporosis is biologically plausible because bone has serotonin receptors, and SSRI-treated mice have reduced bone mass.
Drugs for Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • October 1, 2007; (Issue 62)
ParkinsonÆs disease (PD) is caused primarily by progressive degeneration of dopamine-containing neurons in the substantia nigra. Dopamine itself cannot be used to treat PD because it does not cross the...
ParkinsonÆs disease (PD) is caused primarily by progressive degeneration of dopamine-containing neurons in the substantia nigra. Dopamine itself cannot be used to treat PD because it does not cross the bloodbrain barrier.
Pregabalin (Lyrica) for Fibromyalgia
The Medical Letter on Drugs and Therapeutics • September 24, 2007; (Issue 1270)
Pregabalin (Lyrica - Pfizer) is the first drug approved by the FDA for management of fibromyalgia. When it was first marketed, pregabalin, which is structurally similar to gabapentin (Neurontin, and others),...
Pregabalin (Lyrica - Pfizer) is the first drug approved by the FDA for management of fibromyalgia. When it was first marketed, pregabalin, which is structurally similar to gabapentin (Neurontin, and others), was approved for treatment of neuropathic pain associated with postherpetic neuralgia and diabetic peripheral neuropathy and for adjunctive treatment of partial onset seizures in adults with epilepsy. It has also been prescribed off-label for other types of neuropathic pain such as sciatica.
Pharmaceutical Drug Overdose
The Medical Letter on Drugs and Therapeutics • September 1, 2006; (Issue 49)
Every pharmaceutical drug is a dose-dependent poison. This article describes the clinical presentation and treatment of some dangerous overdoses commonly reported in...
Every pharmaceutical drug is a dose-dependent poison. This article describes the clinical presentation and treatment of some dangerous overdoses commonly reported in adults.
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • June 1, 2006; (Issue 46)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Drugs for Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • March 1, 2006; (Issue 43)
Irritable bowel syndrome (IBS) is a common disorder, occuring in about 15% of the US population; it is 2-3 times more frequent in women than in men. IBS is characterized by chronic abdominal pain or discomfort...
Irritable bowel syndrome (IBS) is a common disorder, occuring in about 15% of the US population; it is 2-3 times more frequent in women than in men. IBS is characterized by chronic abdominal pain or discomfort and altered bowel habits.
Drugs in the Elderly
The Medical Letter on Drugs and Therapeutics • January 16, 2006; (Issue 1226)
The physiologic changes that occur with aging can affect the pharmacokinetics and pharmacodynamics of many prescription and over-the-counter drugs, increasing the likelihood of adverse...
The physiologic changes that occur with aging can affect the pharmacokinetics and pharmacodynamics of many prescription and over-the-counter drugs, increasing the likelihood of adverse effects.
Pregabalin (Lyrica) for Neuropathic Pain and Epilepsy
The Medical Letter on Drugs and Therapeutics • September 12, 2005; (Issue 1217)
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the...
Pregabalin (Lyrica - Pfizer), a structural analog of gamma-aminobutyric acid (GABA) similar to gabapentin (Neurontin - Pfizer, and others), which recently became available generically, has been approved by the FDA for treatment of neuropathic pain associated with postherpetic neuralgia (PHN) and diabetic peripheral neuropathy (DPN), and for adjunctive treatment of partial onset seizures in adults with epilepsy.
Topiramate (Topamax) for Prevention of Migraine
The Medical Letter on Drugs and Therapeutics • January 31, 2005; (Issue 1201)
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent...
Patients with frequent, severe or disabling migraine headaches may benefit from taking a drug to prevent the attacks. Beta-blockers traditionally have been the prophylactic treatment of choice, but in recent years some antiepileptic drugs such as valproate (Depakote, and others) and topiramate (Topamax) have also been used for this indication. Valproate was approved by the FDA for such use in 1996. Now topiramate has also been approved.
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • September 1, 2004; (Issue 25)
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004;...
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004; 63:520). Drugs for prevention of migraine are listed in the table on page 65. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • July 1, 2004; (Issue 23)
Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of...
Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of as analgesics, such as antidepressants, which can act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Combining two different types of analgesics may provide an additive analgesic effect without necessarily increasing adverse effects.
Drugs for Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • June 1, 2004; (Issue 22)
Parkinson's disease is caused by progressive degeneration of dopamine-containing neurons in the substantia nigra. Dopamine itself cannot be used to treat Parkinson's disease because it does not cross the...
Parkinson's disease is caused by progressive degeneration of dopamine-containing neurons in the substantia nigra. Dopamine itself cannot be used to treat Parkinson's disease because it does not cross the blood-brain barrier.
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • July 1, 2003; (Issue 11)
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Drugs for Tobacco Dependence
The Medical Letter on Drugs and Therapeutics • June 1, 2003; (Issue 10)
Tobacco dependence is a chronic illness that may require pharmacological treatment (MC Fiore et al, JAMA 2000; 283:3244; DPL Sachs in JE Hodgkin et al, eds, Pulmonary Rehabilitation: Guidelines to Success, 3rd...
Tobacco dependence is a chronic illness that may require pharmacological treatment (MC Fiore et al, JAMA 2000; 283:3244; DPL Sachs in JE Hodgkin et al, eds, Pulmonary Rehabilitation: Guidelines to Success, 3rd ed, Philadelphia; Lippincott Williams & Wilkins, 2000, page 261).
Atomoxetine (Strattera) for ADHD
The Medical Letter on Drugs and Therapeutics • February 3, 2003; (Issue 1149)
Atomoxetine (Strattera - Lilly) is the first non-stimulant drug to be approved by the FDA for treatment of attention deficit hyperactivity disorder (ADHD). Unlike other drugs approved for use in ADHD, it is not...
Atomoxetine (Strattera - Lilly) is the first non-stimulant drug to be approved by the FDA for treatment of attention deficit hyperactivity disorder (ADHD). Unlike other drugs approved for use in ADHD, it is not a controlled substance and is approved for use in adults as well as children. Older non-stimulant drugs that have been used to treat ADHD, although not FDA-approved, include the alpha2-agonist clonidine (Catapres, and others) and the tricyclic antidepressant desipramine (Norpramin, and others) (Medical Letter 1996; 38:109).
Drugs That May Cause Psychiatric Symptoms
The Medical Letter on Drugs and Therapeutics • July 8, 2002; (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Drugs that may cause Cognitive Disorders in the Elderly
The Medical Letter on Drugs and Therapeutics • November 27, 2000; (Issue 1093)
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic...
Older patients are especially susceptible to drug-induced cognitive impairment. They are more likely to be taking multiple drugs, to have higher blood levels of those drugs because of renal or hepatic dysfunction, and to have pre-existing cognitive problems that make it difficult to detect the role of drugs causing new symptoms or making old ones worse.
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • August 21, 2000; (Issue 1085)
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought...
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Non-opioids can be given concurrently with opioids for an additive analgesic effect.
Dofetilide for Atrial Fibrillation
The Medical Letter on Drugs and Therapeutics • May 15, 2000; (Issue 1078)
Dofetilide (Tikosyn - Pfizer), a new methanesulfonamide antiarrhythmic drug, has recently been marketed for oral treatment of atrial fibrillation and...
Dofetilide (Tikosyn - Pfizer), a new methanesulfonamide antiarrhythmic drug, has recently been marketed for oral treatment of atrial fibrillation and flutter.