Matching articles for "antidepressants"
Drugs for Bipolar Disorder
The Medical Letter on Drugs and Therapeutics • April 1, 2024; (Issue 1699)
Bipolar disorder is characterized by episodes of
mania, hypomania, and depression. Recurrences of
manic or (more frequently) depressive symptoms
are common. About 15-20% of patients with bipolar
disorder...
Bipolar disorder is characterized by episodes of
mania, hypomania, and depression. Recurrences of
manic or (more frequently) depressive symptoms
are common. About 15-20% of patients with bipolar
disorder die by suicide.
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • March 4, 2024; (Issue 1697)
The primary symptoms of menopause are genitourinary
and vasomotor. The genitourinary syndrome
of menopause (GSM) includes symptoms such as
burning, irritation, dryness, dyspareunia, dysuria,
and recurrent...
The primary symptoms of menopause are genitourinary
and vasomotor. The genitourinary syndrome
of menopause (GSM) includes symptoms such as
burning, irritation, dryness, dyspareunia, dysuria,
and recurrent urinary tract infection. Vasomotor
symptoms (VMS; hot flashes, night sweats) often
disrupt sleep.
Brexpiprazole (Rexulti) for Agitation in Alzheimer's Dementia
The Medical Letter on Drugs and Therapeutics • June 26, 2023; (Issue 1679)
The FDA has approved the oral second-generation
antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated
with dementia due to Alzheimer's disease...
The FDA has approved the oral second-generation
antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated
with dementia due to Alzheimer's disease (AD).
Brexpiprazole is the first drug to be approved in the US
for this indication. It is also approved for treatment of
schizophrenia and as an adjunct to antidepressants for
treatment of major depressive disorder.
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.
Cariprazine (Vraylar) for Adjunctive Treatment of Depression
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
The FDA has approved the second-generation
antipsychotic drug cariprazine (Vraylar — Abbvie) for
adjunctive treatment of major depressive disorder
(MDD) in adults. Cariprazine was previously approved
for...
The FDA has approved the second-generation
antipsychotic drug cariprazine (Vraylar — Abbvie) for
adjunctive treatment of major depressive disorder
(MDD) in adults. Cariprazine was previously approved
for treatment of schizophrenia and bipolar depression,
and for acute treatment of manic or mixed episodes
associated with bipolar I disorder.
In Brief: Off-Label Amitriptyline for Insomnia
The Medical Letter on Drugs and Therapeutics • March 20, 2023; (Issue 1672)
In our article on Drugs for Chronic Insomnia, we said
there is little evidence that antidepressants such as
trazodone, mirtazapine, or amitriptyline are effective
in treating insomnia not associated with...
In our article on Drugs for Chronic Insomnia, we said
there is little evidence that antidepressants such as
trazodone, mirtazapine, or amitriptyline are effective
in treating insomnia not associated with depression.
We received a comment from a reader who has
prescribed the tricyclic antidepressant amitriptyline
for insomnia, particularly for patients with headache
disorders, and finds that most patients are satisfied
with the treatment.
Dupilumab (Dupixent) for Eosinophilic Esophagitis and Prurigo Nodularis
The Medical Letter on Drugs and Therapeutics • February 6, 2023; (Issue 1669)
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12...
The FDA has approved the subcutaneously
injected interleukin (IL)-4 receptor alpha antagonist
dupilumab (Dupixent – Sanofi/Regeneron)
for treatment of eosinophilic esophagitis (EoE)
in patients ≥12 years old who weigh ≥40 kg and
treatment of prurigo nodularis in adults. Dupilumab
is the first drug to be approved in the US for each
of these indications. It is also FDA-approved for
treatment of atopic dermatitis, asthma, and chronic
rhinosinusitis with nasal polyposis.
Drugs for Chronic Insomnia
The Medical Letter on Drugs and Therapeutics • January 9, 2023; (Issue 1667)
Cognitive behavioral therapy for insomnia (CBT-I) is
recommended for initial treatment of chronic insomnia.
CBT-I includes stimulus control, sleep education
and hygiene, sleep restriction, relaxation...
Cognitive behavioral therapy for insomnia (CBT-I) is
recommended for initial treatment of chronic insomnia.
CBT-I includes stimulus control, sleep education
and hygiene, sleep restriction, relaxation training, and
cognitive therapy. When CBT-I alone is not effective,
pharmacologic treatment should be added.
Dextromethorphan/Bupropion (Auvelity) for Depression
The Medical Letter on Drugs and Therapeutics • December 26, 2022; (Issue 1666)
The FDA has approved an extended-release fixed-dose
combination of dextromethorphan and
bupropion (Auvelity – Axsome) for treatment of major
depressive disorder (MDD) in...
The FDA has approved an extended-release fixed-dose
combination of dextromethorphan and
bupropion (Auvelity – Axsome) for treatment of major
depressive disorder (MDD) in adults.
Drugs for Cognitive Loss and Dementia
The Medical Letter on Drugs and Therapeutics • August 22, 2022; (Issue 1657)
Alzheimer's disease (AD) is the most common
cause of dementia, but cognitive decline 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 decline is also
associated with other neurological conditions such
as Parkinson's disease, dementia with Lewy bodies,
vascular dementia, and frontotemporal dementia.
Lumateperone (Caplyta) for Bipolar Depression
The Medical Letter on Drugs and Therapeutics • August 8, 2022; (Issue 1656)
The oral second-generation antipsychotic drug
lumateperone (Caplyta – Intra-Cellular Therapies),
which was approved by the FDA in 2020 for treatment
of schizophrenia, is now approved for use...
The oral second-generation antipsychotic drug
lumateperone (Caplyta – Intra-Cellular Therapies),
which was approved by the FDA in 2020 for treatment
of schizophrenia, is now approved for use as
monotherapy or as an adjunct to lithium or valproate
for treatment of depressive episodes associated with
bipolar I or II disorder in adults.
Daridorexant (Quviviq) for Insomnia
The Medical Letter on Drugs and Therapeutics • July 11, 2022; (Issue 1654)
The FDA has approved daridorexant (Quviviq –
Idorsia), an orexin receptor antagonist, for treatment
of sleep-onset and/or sleep-maintenance insomnia
in adults. Daridorexant is the third orexin...
The FDA has approved daridorexant (Quviviq –
Idorsia), an orexin receptor antagonist, for treatment
of sleep-onset and/or sleep-maintenance insomnia
in adults. Daridorexant is the third orexin receptor
antagonist to be approved for this indication;
suvorexant (Belsomra) and lemborexant (Dayvigo)
were approved earlier.
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.
A New Indication for Esketamine Nasal Spray (Spravato)
The Medical Letter on Drugs and Therapeutics • September 21, 2020; (Issue 1607)
Esketamine (Spravato – Janssen), an intranasal
N-methyl-D-aspartate (NMDA) receptor antagonist
that was previously approved by the FDA for treatmentresistant
depression,1 has now been approved...
Esketamine (Spravato – Janssen), an intranasal
N-methyl-D-aspartate (NMDA) receptor antagonist
that was previously approved by the FDA for treatmentresistant
depression,1 has now been approved for
treatment of depressive symptoms in adults with
major depressive disorder (MDD) and acute suicidal
ideation or behavior. Esketamine is the S-enantiomer
of the anesthetic ketamine (Ketalar, and generics).
It is the first drug to be approved for this indication.
Most clinical trials of antidepressants have excluded
patients with acute suicidal ideation.
Drugs for Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • August 10, 2020; (Issue 1604)
The primary symptoms of menopause are genitourinary
(genitourinary syndrome of menopause; GSM) and
vasomotor (VMS). Vulvovaginal atrophy can cause
vaginal burning, irritation and dryness, dyspareunia,...
The primary symptoms of menopause are genitourinary
(genitourinary syndrome of menopause; GSM) and
vasomotor (VMS). Vulvovaginal atrophy can cause
vaginal burning, irritation and dryness, dyspareunia, and
dysuria, and increase the risk of urinary tract infections.
Vasomotor symptoms ("hot flashes") cause daytime
discomfort and night sweats that may disrupt sleep.
Hormone therapy is the most effective treatment for both
genitourinary and vasomotor symptoms.
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.
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.
Esketamine Nasal Spray (Spravato) for Treatment-Resistant Depression
The Medical Letter on Drugs and Therapeutics • April 8, 2019; (Issue 1569)
The FDA has approved esketamine (Spravato –
Janssen), an N-methyl-D-aspartate (NMDA) receptor
antagonist, for intranasal treatment (in conjunction
with an oral antidepressant) of adults with...
The FDA has approved esketamine (Spravato –
Janssen), an N-methyl-D-aspartate (NMDA) receptor
antagonist, for intranasal treatment (in conjunction
with an oral antidepressant) of adults with treatment-resistant
depression (TRD). This is the first FDA
approval for esketamine, which is the S-enantiomer
of the intravenous anesthetic ketamine (Ketalar,
and generics). In recent years, IV ketamine has been
increasingly used (off-label) for treatment of TRD.
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.
Opioids for Pain
The Medical Letter on Drugs and Therapeutics • April 9, 2018; (Issue 1544)
Use of nonopioid drugs for pain was reviewed in a
previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations...
Use of nonopioid drugs for pain was reviewed in a
previous issue. For many types of moderate to severe acute pain, acetaminophen and/or an NSAID may be as effective as an opioid. Immediate-release formulations of full opioid agonists should generally be used for acute pain that is severe enough to require treatment with an opioid. Use of extended-release or long-acting opioid formulations initially and treatment durations >1 week have been associated with an increased risk of unintended long-term use.
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 Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • November 20, 2017; (Issue 1534)
The motor symptoms of Parkinson's disease (PD) are
caused primarily by degeneration of dopaminergic
neurons in the substantia nigra. The nonmotor
symptoms of the disease are thought to be caused...
The motor symptoms of Parkinson's disease (PD) are
caused primarily by degeneration of dopaminergic
neurons in the substantia nigra. The nonmotor
symptoms of the disease are thought to be caused by
degeneration of other neurotransmitter systems.
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 Bipolar Disorder
The Medical Letter on Drugs and Therapeutics • August 15, 2016; (Issue 1501)
Bipolar disorder is characterized by intermittent
episodes of mania and/or depression. Even with
maintenance treatment, recurrences of manic or (more
frequently) depressive episodes are common. Some of
the...
Bipolar disorder is characterized by intermittent
episodes of mania and/or depression. Even with
maintenance treatment, recurrences of manic or (more
frequently) depressive episodes are common. Some of
the drugs and dosages recommended here have not
been approved by the FDA for use in bipolar disorder.
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.
Brexpiprazole (Rexulti) for Schizophrenia and Depression
The Medical Letter on Drugs and Therapeutics • August 17, 2015; (Issue 1475)
The FDA has approved the oral, once-daily, second-generation
antipsychotic brexpiprazole (Rexulti –
Otsuka/Lundbeck) for treatment of schizophrenia
and as an adjunct to antidepressants for treatment
of...
The FDA has approved the oral, once-daily, second-generation
antipsychotic brexpiprazole (Rexulti –
Otsuka/Lundbeck) for treatment of schizophrenia
and as an adjunct to antidepressants for treatment
of major depressive disorder (MDD). Aripiprazole
(Abilify), a structurally similar second-generation
antipsychotic also comarketed by Otsuka (with BMS),
recently became available generically.
Drugs for Insomnia
The Medical Letter on Drugs and Therapeutics • July 6, 2015; (Issue 1472)
Pharmacological treatment of insomnia includes
prescription drugs, non-prescription medications, and
"natural" remedies. Behavioral approaches such as
cognitive behavioral therapy, which are not...
Pharmacological treatment of insomnia includes
prescription drugs, non-prescription medications, and
"natural" remedies. Behavioral approaches such as
cognitive behavioral therapy, which are not discussed
here, are also used. Pharmacologic treatment and
behavioral therapy are often combined.
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.
Diet, Drugs, and Surgery for Weight Loss
The Medical Letter on Drugs and Therapeutics • February 16, 2015; (Issue 1462)
Adults with a body mass index (BMI) between
25 and 29.9 kg/m2 are considered overweight. Those
with a BMI ≥30 are considered obese. Losing even
a small amount of weight and increasing physical
activity...
Adults with a body mass index (BMI) between
25 and 29.9 kg/m2 are considered overweight. Those
with a BMI ≥30 are considered obese. Losing even
a small amount of weight and increasing physical
activity can prevent some of the complications
of obesity, particularly type 2 diabetes. Diet and
exercise are the preferred methods for losing weight,
but long-term failure rates are high. Several drugs
have been approved by the FDA for weight reduction,
but adherence is poor, adverse effects are common,
and patients usually regain the lost weight when
the drug is stopped. Bariatric surgery can produce
substantial weight loss and significantly reduce
obesity-related comorbidities; long-term data on its
safety are encouraging, but still limited. Guidelines
for the management of overweight or obese adults
have recently been published.
In Brief: Khedezla - A New Brand of Desvenlafaxine
The Medical Letter on Drugs and Therapeutics • January 6, 2014; (Issue 1433)
The FDA has approved the marketing of another extended-release brand-name formulation of the serotonin and norepinephrine reuptake inhibitor (SNRI) desvenlafaxine (Khedezla – Par/Osmotica) for treatment of...
The FDA has approved the marketing of another extended-release brand-name formulation of the serotonin and norepinephrine reuptake inhibitor (SNRI) desvenlafaxine (Khedezla – Par/Osmotica) for treatment of depression. It is the third extended-release formulation of desvenlafaxine to become available in the US. Khedezla was approved using a 505(b)(2) application, a new drug application (NDA) that relies upon the FDA's findings of safety and/or effectiveness for a previously approved drug.
Khedezla does not appear to offer any advantage over the other extended-release formulations of desvenlafaxine. There is no evidence that any formulation of desvenlafaxine is more effective for treatment of depression than other SNRIs or any SSRI, which are available in less expensive generic formulations.1
1. Drugs for psychiatric disorders. Treat Guidel Med Lett 2013; 11:53.
Download complete U.S. English article
Khedezla does not appear to offer any advantage over the other extended-release formulations of desvenlafaxine. There is no evidence that any formulation of desvenlafaxine is more effective for treatment of depression than other SNRIs or any SSRI, which are available in less expensive generic formulations.1
1. Drugs for psychiatric disorders. Treat Guidel Med Lett 2013; 11:53.
Download complete U.S. English article
Drugs for Migraine
The Medical Letter on Drugs and Therapeutics • December 1, 2013; (Issue 136)
Treatment of migraine in the emergency department,
which may involve use of intravenous drugs, is not
discussed...
Treatment of migraine in the emergency department,
which may involve use of intravenous drugs, is not
discussed here.
Vortioxetine (Trintellix) for Depression
The Medical Letter on Drugs and Therapeutics • November 25, 2013; (Issue 1430)
The FDA has approved vortioxetine (vor" tye ox' e teen;
Trintellix – Takeda/Lundbeck), a new serotonergic drug,
for treatment of major depressive disorder. Like vilazodone
(Viibryd), another serotonergic...
The FDA has approved vortioxetine (vor" tye ox' e teen;
Trintellix – Takeda/Lundbeck), a new serotonergic drug,
for treatment of major depressive disorder. Like vilazodone
(Viibryd), another serotonergic antidepressant,
it has been claimed to have a low incidence of sexual
side effects and no significant effect on weight.
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.
Paroxetine (Brisdelle) for Hot Flashes
The Medical Letter on Drugs and Therapeutics • October 28, 2013; (Issue 1428)
The FDA has approved a low-dose formulation of the
selective serotonin reuptake inhibitor (SSRI) paroxetine
mesylate (Brisdelle – Noven Therapeutics) for treatment
of moderate-to-severe vasomotor symptoms...
The FDA has approved a low-dose formulation of the
selective serotonin reuptake inhibitor (SSRI) paroxetine
mesylate (Brisdelle – Noven Therapeutics) for treatment
of moderate-to-severe vasomotor symptoms associated
with menopause. It is the first non-hormonal therapy to
be approved for this indication. Paroxetine mesylate
(Pexeva) and paroxetine hydrochloride (Paxil, and
generics) are marketed in higher doses for treatment of
depression and other psychiatric disorders.
Citalopram, Escitalopram and the QT Interval
The Medical Letter on Drugs and Therapeutics • July 22, 2013; (Issue 1421)
In 2011, the FDA asked the manufacturers of the selective
serotonin reuptake inhibitor (SSRI) citalopram
(Celexa, and generics) to lower the maximum daily
dosage of the drug because of a dose-related...
In 2011, the FDA asked the manufacturers of the selective
serotonin reuptake inhibitor (SSRI) citalopram
(Celexa, and generics) to lower the maximum daily
dosage of the drug because of a dose-related increase
in the QT interval. Since then, some of our readers
have asked whether escitalopram (Lexapro, and generics),
the active enantiomer of citalopram, could have the
same effect.
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 Pain
The Medical Letter on Drugs and Therapeutics • April 1, 2013; (Issue 128)
Pain can be acute or chronic. The two major types of
chronic pain are nociceptive pain and neuropathic
pain. Nociceptive pain can be treated with nonopioid
analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. The two major types of
chronic pain are nociceptive pain and neuropathic
pain. Nociceptive pain can be treated with nonopioid
analgesics or opioids. Neuropathic pain is less responsive
to opioids and is often treated with adjuvant drugs
such as antidepressants and antiepileptics. Combining
different types of analgesics may provide an additive
analgesic effect without increasing adverse effects.
In Brief: Budeprion XL 300 Has Been Withdrawn
The Medical Letter on Drugs and Therapeutics • October 29, 2012; (Issue 1402)
The FDA has asked Impax Laboratories/Teva Pharmaceuticals to stop production and distribution of Budeprion XL 300 mg, a generic extended-release formulation of the antidepressant bupropion (Wellbutrin XL),...
The FDA has asked Impax Laboratories/Teva Pharmaceuticals to stop production and distribution of Budeprion XL 300 mg, a generic extended-release formulation of the antidepressant bupropion (Wellbutrin XL), because it has found that Budeprion XL 300 mg releases bupropion more rapidly than Wellbutrin XL 300 mg, the original brand name product. Patients switched from the brand name to the generic formulation have complained for years that the generic was less effective and caused more side effects than the original formulation. In 2007, ConsumerLab.com, an independent laboratory, conducted dissolution testing of Budeprion XL, which uses a matrix for slow release, and Wellbutrin XL, which uses a membrane. According to the test results, the Budeprion XL matrix released more bupropion in the first 4 hours than the Wellbutrin XL membrane did.1 The FDA decided to conduct its own studies of Budeprion XL 300 mg and arrived at a similar conclusion. The original approval of the generic formulation was based on pharmacokinetic tests conducted on 150-mg tablets of the Impax/Teva formulation, with results extrapolated to the 300-mg tablet.
Bupropion is often used as an alternative to a selective serotonin reuptake inhibitor (SSRI) or another antidepressant because it does not cause sexual dysfunction, sedation, or weight gain.2 It is also used as an aid in smoking cessation.3 It is contraindicated in patients at increased risk of seizures (including patients with a history of an eating disorder). Other 300-mg formulations of generic extended-release bupropion have not been associated with post-marketing complaints and continue to be available.
1. Wellbutrin versus generic bupropion. Med Lett Drugs Ther 2008; 50:54.
2. Drugs for depression and bipolar disorder. Treat Guidel Med Lett 2010; 8:35.
3. Drugs for tobacco dependence. Treat Guidel Med Lett 2008; 6:61.
Download complete U.S. English article
Bupropion is often used as an alternative to a selective serotonin reuptake inhibitor (SSRI) or another antidepressant because it does not cause sexual dysfunction, sedation, or weight gain.2 It is also used as an aid in smoking cessation.3 It is contraindicated in patients at increased risk of seizures (including patients with a history of an eating disorder). Other 300-mg formulations of generic extended-release bupropion have not been associated with post-marketing complaints and continue to be available.
1. Wellbutrin versus generic bupropion. Med Lett Drugs Ther 2008; 50:54.
2. Drugs for depression and bipolar disorder. Treat Guidel Med Lett 2010; 8:35.
3. Drugs for tobacco dependence. Treat Guidel Med Lett 2008; 6:61.
Download complete U.S. English article
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 Menopausal Symptoms
The Medical Letter on Drugs and Therapeutics • May 28, 2012; (Issue 1391)
The primary symptoms of menopause are vasomotor
and genitourinary. Vasomotor symptoms ("hot flashes")
cause daytime discomfort and chronic insomnia. A thin,
dry vaginal lining and thin urethral mucosa can...
The primary symptoms of menopause are vasomotor
and genitourinary. Vasomotor symptoms ("hot flashes")
cause daytime discomfort and chronic insomnia. A thin,
dry vaginal lining and thin urethral mucosa can cause
vaginal and vulvar irritation, pain during intercourse, and
an increased risk for urinary tract infection.
Vilazodone (Viibryd) - A New Antidepressant
The Medical Letter on Drugs and Therapeutics • July 11, 2011; (Issue 1368)
Vilazodone (Viibryd – Forest), a selective serotonin
reuptake inhibitor (SSRI) and partial 5-HT1A receptor
agonist, has been approved by the FDA for treatment
of depression. It has been claimed to have no...
Vilazodone (Viibryd – Forest), a selective serotonin
reuptake inhibitor (SSRI) and partial 5-HT1A receptor
agonist, has been approved by the FDA for treatment
of depression. It has been claimed to have no sexual
side effects and not to cause weight gain.
Capsaicin Patch (Qutenza) for Postherpetic Neuralgia
The Medical Letter on Drugs and Therapeutics • May 30, 2011; (Issue 1365)
The FDA has approved a topical 8% patch formulation
of capsaicin (Qutenza – NeurogesX), available only by
prescription, for local treatment of postherpetic neuralgia.
Postherpetic neuralgia occurs after...
The FDA has approved a topical 8% patch formulation
of capsaicin (Qutenza – NeurogesX), available only by
prescription, for local treatment of postherpetic neuralgia.
Postherpetic neuralgia occurs after herpes zoster
in about one third of patients ≥60 years old and can
persist for months or even years.
Diet, Drugs and Surgery for Weight Loss
The Medical Letter on Drugs and Therapeutics • April 1, 2011; (Issue 104)
...
Adults with a body mass index (BMI=kg/m2) of 25-<30 are considered overweight; those with a BMI of ≥30 are considered obese.
Extended-Release Trazodone (Oleptro) for Depression
The Medical Letter on Drugs and Therapeutics • November 15, 2010; (Issue 1351)
The FDA has approved the marketing of an
extended-release formulation of trazodone (Oleptro –
Angelini Labopharm) for treatment of major depressive
disorder in adults. Immediate-release trazodone
has been...
The FDA has approved the marketing of an
extended-release formulation of trazodone (Oleptro –
Angelini Labopharm) for treatment of major depressive
disorder in adults. Immediate-release trazodone
has been available for treatment of depression for
many years, but is used mostly in low doses for its
sedating effects.
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.
L-Methylfolate (Deplin) for Depression and Schizophrenia
The Medical Letter on Drugs and Therapeutics • April 19, 2010; (Issue 1336)
L-methylfolate (Deplin — Pamlab) is a “medical food” marketed for adjunctive use in depression or schizophrenia in patients with suboptimal folate levels. It is available only by...
L-methylfolate (Deplin — Pamlab) is a “medical food” marketed for adjunctive use in depression or schizophrenia in patients with suboptimal folate levels. It is available only by prescription.
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • April 1, 2010; (Issue 92)
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids; adjuvant medicines such as antidepressants and anticonvulsants are often used to treat neuropathic pain. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.
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.
Wellbutrin Versus Generic Bupropion
The Medical Letter on Drugs and Therapeutics • July 14, 2008; (Issue 1290)
Bupropion (Wellbutrin - GlaxoSmithKline, and others) is a norepinephrine and dopamine reuptake inhibitor that has been a useful antidepressant because, unlike some other antidepressants, it does not cause...
Bupropion (Wellbutrin - GlaxoSmithKline, and others) is a norepinephrine and dopamine reuptake inhibitor that has been a useful antidepressant because, unlike some other antidepressants, it does not cause sexual dysfunction, weight gain or sedation. Some patients who were switched from Wellbutrin to a generic alternative have reported worsening side effects and relapse of previously controlled depressive symptoms.1 Most of the complaints have come from patients switched from Wellbutrin XL 300 mg to the generic 300-mg formulation of extended-release bupropion marketed by Teva (Budeprion XL).2 In 2007, about 1 million prescriptions per month were dispensed for extended-release formulations of bupropion; about 40% of these were written for Budeprion XL 300 mg.
Diet, Drugs and Surgery for Weight Loss
The Medical Letter on Drugs and Therapeutics • April 1, 2008; (Issue 68)
Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing...
Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing weight but are associated with high long-term failure rates. Drugs may help some patients, but all currently available drugs for weight reduction have drawbacks. Gastric surgery can produce marked weight loss in the severely obese, but long-term data on safety are limited.
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.
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • April 1, 2007; (Issue 56)
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants...
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants and anticonvulsants have been used to treat neuropathic pain. Combining two different types of analgesics may nprovide an additive analgesic effect without increasing adverse effects.
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.
Duloxetine (Cymbalta): A New SNRI for Depression
The Medical Letter on Drugs and Therapeutics • October 11, 2004; (Issue 1193)
Duloxetine hydrochloride (Cymbalta - Lilly), a selective serotonin and norepinephrine reuptake inhibitor (SNRI), has been approved by the FDA for treatment of major depressive disorder in adults, and more...
Duloxetine hydrochloride (Cymbalta - Lilly), a selective serotonin and norepinephrine reuptake inhibitor (SNRI), has been approved by the FDA for treatment of major depressive disorder in adults, and more recently for diabetic peripheral neuropathy as well. The Medical Letter will review its role in diabetic neuropathy in a future issue.
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.
Olanzapine/Fluoxetine (Symbyax) for Bipolar Depression
The Medical Letter on Drugs and Therapeutics • March 15, 2004; (Issue 1178)
The fixed-dose combination of olanzapine and fluoxetine (Symbyax - Lilly) has been approved by the FDA for treatment of depressive episodes associated with bipolar disorder. Olanzapine alone (Zyprexa), which is...
The fixed-dose combination of olanzapine and fluoxetine (Symbyax - Lilly) has been approved by the FDA for treatment of depressive episodes associated with bipolar disorder. Olanzapine alone (Zyprexa), which is mainly used as an antipsychotic (Medical Letter 2003; 45:102), is FDA-approved for treatment of acute manic episodes and for maintenance treatment of bipolar disorder. Fluoxetine alone (Prozac, and others), which is mainly used as an antidepressant (Medical Letter 2003; 45:93), has no specific approval for use in bipolar disorder.
Is Effexor More Effective than an SSRI?
The Medical Letter on Drugs and Therapeutics • February 16, 2004; (Issue 1176)
Venlafaxine (Effexor, Effexor XR - Wyeth), an antidepressant that inhibits both norepinephrine and serotonin reuptake, was first approved by the FDA in 1993. It has been used mainly as a second-line agent for...
Venlafaxine (Effexor, Effexor XR - Wyeth), an antidepressant that inhibits both norepinephrine and serotonin reuptake, was first approved by the FDA in 1993. It has been used mainly as a second-line agent for patients who have not responded to a selective serotonin reuptake inhibitor (SSRI). Some Medical Letter consultants have had the clinical impression that venlafaxine is more effective than an SSRI, particularly for patients with severe, classic depression (melancholia), and believe it should be considered a first-line drug (Treatment Guidelines from the Medical Letter 2003, 1:69). Is venlafaxine more effective than an SSRI for treatment of depression?
Which SSRI?
The Medical Letter on Drugs and Therapeutics • November 24, 2003; (Issue 1170)
Five different selective serotonin reuptake inhibitors (SSRIs) are promoted for treatment of depression and a sixth (fluvoxamine) for use in obsessive compulsive disorder. Which one should we prescribe for our...
Five different selective serotonin reuptake inhibitors (SSRIs) are promoted for treatment of depression and a sixth (fluvoxamine) for use in obsessive compulsive disorder. Which one should we prescribe for our patients?
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.
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).
Escitalopram (Lexapro) for Depression
The Medical Letter on Drugs and Therapeutics • September 30, 2002; (Issue 1140)
Escitalopram (Lexapro - Forest), the active S-enantiomer of racemic citalopram (Celexa - Forest), a selective serotonin reuptake inhibitor (SSRI), was recently approved by the FDA for treatment of depression....
Escitalopram (Lexapro - Forest), the active S-enantiomer of racemic citalopram (Celexa - Forest), a selective serotonin reuptake inhibitor (SSRI), was recently approved by the FDA for treatment of depression. The manufacturer plans to stop promoting Celexa in favor of Lexapro; Celexa will continue to be available for patients already taking it.
Prozac Weekly
The Medical Letter on Drugs and Therapeutics • April 2, 2001; (Issue 1101)
The FDA has approved a new formulation of fluoxetine for once-weekly maintenance treatment of depression in patients who have responded to daily fluoxetine...
The FDA has approved a new formulation of fluoxetine for once-weekly maintenance treatment of depression in patients who have responded to daily fluoxetine (Prozac).
Hypnotic Drugs
The Medical Letter on Drugs and Therapeutics • August 7, 2000; (Issue 1084)
Superseded by Drugs of Choice HandbookMany drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be...
Superseded by Drugs of Choice Handbook
Many drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be more effective than drugs.
Many drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be more effective than drugs.
Alosetron (Lotronex) For Treatment of Irritable Bowel Syndrome
The Medical Letter on Drugs and Therapeutics • June 26, 2000; (Issue 1081)
Alosetron hydrochloride (Lotronex - Glaxo Welcome), a selective serotonin receptor antagonist, has received FDA approval for treatment of irritable bowel syndrome (IBS) in women whose primary bowel symptom is...
Alosetron hydrochloride (Lotronex - Glaxo Welcome), a selective serotonin receptor antagonist, has received FDA approval for treatment of irritable bowel syndrome (IBS) in women whose primary bowel symptom is diarrhea.
Amprenavir: A New HIV Protease Inhibitor
The Medical Letter on Drugs and Therapeutics • July 16, 1999; (Issue 1057)
Amprenavir is the fifth protease inhibitor to become available for treatment of HIV infection. It was approved by the FDA for use with other drugs in the treatment of HIV-infected adults and children at least...
Amprenavir is the fifth protease inhibitor to become available for treatment of HIV infection. It was approved by the FDA for use with other drugs in the treatment of HIV-infected adults and children at least four years old.
Drugs for Depression and Anxiety
The Medical Letter on Drugs and Therapeutics • April 9, 1999; (Issue 1050)
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of...
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of anxiety.
Drugs for Psychiatric Disorders
The Medical Letter on Drugs and Therapeutics • April 11, 1997; (Issue 998)
The number of new 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 new 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, 1997.
Mirtazapine - A New Antidepressant
The Medical Letter on Drugs and Therapeutics • December 20, 1996; (Issue 990)
Mirtazapine (mir taz a peen; Remeron - Organon) has been approved by the US Food and Drug Administration for treatment of depression. A tetracyclic piperazinoazepine, it is an analog of mianserin, an...
Mirtazapine (mir taz a peen; Remeron - Organon) has been approved by the US Food and Drug Administration for treatment of depression. A tetracyclic piperazinoazepine, it is an analog of mianserin, an antidepressant available in Europe, but is structurally unrelated to antidepressants previously available in the USA.
Clonidine for Treatment of Attention-Deficit/Hyperactivity Disorder
The Medical Letter on Drugs and Therapeutics • December 6, 1996; (Issue 989)
Clonidine, an Alpha2-selective adrenergic agonist marketed in the USA only for treatment of hypertension, has also been used in recent years to treat children with attention-deficit/hyperactivity disorder...
Clonidine, an Alpha2-selective adrenergic agonist marketed in the USA only for treatment of hypertension, has also been used in recent years to treat children with attention-deficit/hyperactivity disorder (ADHD).
Hypnotic Drugs
The Medical Letter on Drugs and Therapeutics • July 5, 1996; (Issue 978)
Superseded by Drugs of Choice HandbookInsomnia is a commom complaint, particularly among the elderly. Many drugs are approved by the US Food and Drug Administration (FDA) for treatment of insomnia, including...
Superseded by Drugs of Choice Handbook
Insomnia is a commom complaint, particularly among the elderly. Many drugs are approved by the US Food and Drug Administration (FDA) for treatment of insomnia, including five benzodiazepines and zolpidem (Ambien), a non-benzodiazepine that binds to benzodiazepine receptors in the brain. Some drugs marketed for other indications, such as antihistamines, antidepressants and antipsychotics, are also used as hypnotics. For many patients, nonpharmacological treatment of insomnia may be more effective than drugs, especially in the long term (CM Morin et al, Am J Psychiatry, 151:1172, 1994).
Insomnia is a commom complaint, particularly among the elderly. Many drugs are approved by the US Food and Drug Administration (FDA) for treatment of insomnia, including five benzodiazepines and zolpidem (Ambien), a non-benzodiazepine that binds to benzodiazepine receptors in the brain. Some drugs marketed for other indications, such as antihistamines, antidepressants and antipsychotics, are also used as hypnotics. For many patients, nonpharmacological treatment of insomnia may be more effective than drugs, especially in the long term (CM Morin et al, Am J Psychiatry, 151:1172, 1994).
Nefazodone for Depression
The Medical Letter on Drugs and Therapeutics • April 14, 1995; (Issue 946)
Nefazodone (Serzone - Bristol-Myers Squibb) was recently approved by the US Food and Drug Administration for treatment of depression. A phenylpiperazine, nefazodone is chemically related to trazodone...
Nefazodone (Serzone - Bristol-Myers Squibb) was recently approved by the US Food and Drug Administration for treatment of depression. A phenylpiperazine, nefazodone is chemically related to trazodone (Desyrel, and others).
Fluvoxamine for Obsessive-Compulsive Disorder
The Medical Letter on Drugs and Therapeutics • February 17, 1995; (Issue 942)
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine...
Fluvoxamine (Luvox - Solvay), a selective serotonin reuptake inhibitor (SSRI), has been approved for treatment of obsessive-compulsive disorder (OCD) by the US Food and Drug Administration. Fluoxetine (Prozac), another SSRI antidepressant, and clomipramine (Anafranil), a tricyclic antidepressant that also inhibits serotonin reuptake, are the only other drugs available for this indication in the USA. Antidepressants that do not inhibit serotonin reuptake have not been effective for treatment of this condition.
Use of Nicotine to Stop Smoking
The Medical Letter on Drugs and Therapeutics • January 20, 1995; (Issue 940)
Many patients ask physicians to help them stop smoking. Since nicotine gum and patches were first marketed (Medical Letter, 26:47, 1984; 34:37, 1992), more data have become available on their effective use,...
Many patients ask physicians to help them stop smoking. Since nicotine gum and patches were first marketed (Medical Letter, 26:47, 1984; 34:37, 1992), more data have become available on their effective use, and new formulations of the drug have been developed. Because of its slower rate of absorption, nicotine from gum or patches does not produce the pleasure some people associate with cigarette smoking, but it can relieve the irritability, difficulty in concentrating and other symptoms that occur after withdrawal from smoking.
Venlafaxine - A New Antidepressant
The Medical Letter on Drugs and Therapeutics • June 10, 1994; (Issue 924)
Venlafaxine hydrochloride (Effexor - Wyeth-Ayerst) was recently approved by the US Food and Drug Administration for treatment of depression. An aminomethyl-benzyl- cyclohexanol, it is chemically related to...
Venlafaxine hydrochloride (Effexor - Wyeth-Ayerst) was recently approved by the US Food and Drug Administration for treatment of depression. An aminomethyl-benzyl- cyclohexanol, it is chemically related to bupropion (Wellbutrin).
Drugs for Parkinson's Disease
The Medical Letter on Drugs and Therapeutics • April 16, 1993; (Issue 894)
Approaches to treatment of Parkinson's disease have changed in recent years. Previously, the only goal was to treat symptoms with levodopa or other drugs. A new approach is to try to slow progression of the...
Approaches to treatment of Parkinson's disease have changed in recent years. Previously, the only goal was to treat symptoms with levodopa or other drugs. A new approach is to try to slow progression of the disease. (This issue is superseded by 1999 Drugs of Choice.)
Sotalol for Cardiac Arrhythmias
The Medical Letter on Drugs and Therapeutics • April 2, 1993; (Issue 893)
Sotalol (hydrochloride (Betapace -Berlex; Sotacor -Bristol Laboratories of Canada), an antiarrhythmic drug that prolongs repolarization (Class III) and also has beta-adrenergic-blocking activity (Class II),...
Sotalol (hydrochloride (Betapace -Berlex; Sotacor -Bristol Laboratories of Canada), an antiarrhythmic drug that prolongs repolarization (Class III) and also has beta-adrenergic-blocking activity (Class II), was recently approved by the US Food and Drug Administration (FDA) for oral treatment of life-threatening ventricular arrhythmias.
Atovaquone for Pneumocystis Carinii Pneumonia
The Medical Letter on Drugs and Therapeutics • April 2, 1993; (Issue 893)
Atovaquone (Mepron - Burroughs Wellcome), a hydroxynaphthoquinone, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of mild to moderate Pneumocystis carinii pneumonia (PCP)...
Atovaquone (Mepron - Burroughs Wellcome), a hydroxynaphthoquinone, was recently approved by the US Food and Drug Administration (FDA) for oral treatment of mild to moderate Pneumocystis carinii pneumonia (PCP) in patients who cannot tolerate trimethoprim-sulfamethoxazole (Septra, Bactrim, and others). PCP is a common opportunistic infection and frequent cause of death in patients with AIDS.
Paroxetine for Treatment of Depression
The Medical Letter on Drugs and Therapeutics • March 19, 1993; (Issue 892)
Paroxetine (Paxil - SmithKline Beecham), a new selective serotonin reuptake inhibitor (SSRI), is now available in the USA. Two other SSRIs, fluoxetine (Prozac - Medical Letter, 30:45, 1988; 32:83, 1990) and...
Paroxetine (Paxil - SmithKline Beecham), a new selective serotonin reuptake inhibitor (SSRI), is now available in the USA. Two other SSRIs, fluoxetine (Prozac - Medical Letter, 30:45, 1988; 32:83, 1990) and sertraline (Zoloft - Medical Letter, 34:47, 1992), were approved previously.
Choice of an Antidepressant
The Medical Letter on Drugs and Therapeutics • March 19, 1993; (Issue 892)
Since the introduction of fluoxetine (Prozac - Medical Letter, 30:45, 1988), bupropion (Wellbutrin - Medical Letter, 31:97, 1989), sertraline (Zoloft - Medical Letter, 34:47, 1992) and paroxetine (Paxil -...
Since the introduction of fluoxetine (Prozac - Medical Letter, 30:45, 1988), bupropion (Wellbutrin - Medical Letter, 31:97, 1989), sertraline (Zoloft - Medical Letter, 34:47, 1992) and paroxetine (Paxil - this issue), the choice of an antidepressant has become more difficult. Should these widely prescribed new drugs replace tricyclic antidepressants such as amitriptyline (Elavil, and others), imipramine (Tofranil, and others), or nortriptyline (Aventyl, and others) for treatment of most patients with depression?
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • January 8, 1993; (Issue 887)
Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as...
Three types of analgesic drugs are available in the USA: first, 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. (American Pain Society, Principles of analgesic Use, 3rd ed, Skokie, illinois: American pain society, 1992).
Flumazenil
The Medical Letter on Drugs and Therapeutics • July 10, 1992; (Issue 874)
Flumazenil (Mazicon - Roche), a benzodiazepine receptor antagonist, has been approved by the US Food and Drug Administration to reverse the sedative effects of benzodiazepines after anesthesia, sedation for...
Flumazenil (Mazicon - Roche), a benzodiazepine receptor antagonist, has been approved by the US Food and Drug Administration to reverse the sedative effects of benzodiazepines after anesthesia, sedation for brief surgical or diagnostic procedures, or after benzodiazepine overdosage. The drug does not antagonize opioids, non-benzodiazepine sedatives, or anesthetic drugs.
Sertraline For Treatment Of Depression
The Medical Letter on Drugs and Therapeutics • May 15, 1992; (Issue 870)
Sertraline (Zoloft - Roerig), a serotonin reuptake inhibitor, was recently approved for marketing by the US Food and Drug Administration for treatment of depression. Another serotonin reuptake inhibitor,...
Sertraline (Zoloft - Roerig), a serotonin reuptake inhibitor, was recently approved for marketing by the US Food and Drug Administration for treatment of depression. Another serotonin reuptake inhibitor, fluoxetine (Prozac), is prescribed more frequently in the USA than any other antidepressant (Medical Letter, 32:83, 1990).
Alprazolam For Panic Disorder
The Medical Letter on Drugs and Therapeutics • April 5, 1991; (Issue 841)
Alprazolam (Xanax - Upjohn), a triazolobenzodiazepine previously available in the USA for treatment of anxiety (Medical Letter 24:41, 1982), was recently approved by the US Food and Drug Administration (FDA)...
Alprazolam (Xanax - Upjohn), a triazolobenzodiazepine previously available in the USA for treatment of anxiety (Medical Letter 24:41, 1982), was recently approved by the US Food and Drug Administration (FDA) for treatment of panic disorder, with or without agoraphobia. According to one report, alprazolam was the fifth most widely prescribed drug in the USA last year (American Medical News, March 4, 1991, page 4).
Fluoxetine (Prozac) Revisited
The Medical Letter on Drugs and Therapeutics • September 7, 1990; (Issue 826)
In the short time since fluoxetine (Prozac - Lilly) first became available in the USA (Medical Letter, 30:45, 1988), it has become the most frequently prescribed of all antidepressants. Some recent reports,...
In the short time since fluoxetine (Prozac - Lilly) first became available in the USA (Medical Letter, 30:45, 1988), it has become the most frequently prescribed of all antidepressants. Some recent reports, however, have questioned its safety.
Sudden Death in children A Tricyclic Antidepressant
The Medical Letter on Drugs and Therapeutics • June 1, 1990; (Issue 819)
The 1990 labeling for Norpramin, the Merrell Dow brand of the tricyclic antidepressant desipramine, reports the occurrence of sudden death in an eight-year-old child treated with the drug. Desipramine is also...
The 1990 labeling for Norpramin, the Merrell Dow brand of the tricyclic antidepressant desipramine, reports the occurrence of sudden death in an eight-year-old child treated with the drug. Desipramine is also available as Pertofrane (Rorer) and generically.
Bupropion For Depression
The Medical Letter on Drugs and Therapeutics • November 3, 1989; (Issue 804)
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the...
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the market in early 1986 because of a high incidence of seizures in one study.
Oral Hypnotic Drugs
The Medical Letter on Drugs and Therapeutics • March 10, 1989; (Issue 787)
Three benzodiazepines and 16 other compounds are marketed in the USA for treatment of insomnia. Many authorities believe that insomnia is overdiagnosed and overtreated (MK Erman, ed, Sleep Disorders,...
Three benzodiazepines and 16 other compounds are marketed in the USA for treatment of insomnia. Many authorities believe that insomnia is overdiagnosed and overtreated (MK Erman, ed, Sleep Disorders, Psychiatr Clin North Am, Volume 10, Dec 1987).
Foods Interacting With MAO Inhibitors
The Medical Letter on Drugs and Therapeutics • February 10, 1989; (Issue 785)
Many fermented foods contain tyramine as a byproduct formed by the bacterial breakdown of the amino acid tyrosine; it can also be formed by para-hydroxylation of phenylethylamine or dehydroxylation of DOPA and...
Many fermented foods contain tyramine as a byproduct formed by the bacterial breakdown of the amino acid tyrosine; it can also be formed by para-hydroxylation of phenylethylamine or dehydroxylation of DOPA and dopamine. Tyramine and some other amines found in food can cause hypertensive reactions in patients taking monoamine oxidase (MAO)inhibitors.
Drugs for Parkinsonism
The Medical Letter on Drugs and Therapeutics • December 16, 1988; (Issue 781)
Patients with Parkinson's disease have a deficiency of the neurotransmitter dopamine, a catecholamine. Dpamine itself cannot be used to treat the disease because it does not cross the blood-brain barrier, but...
Patients with Parkinson's disease have a deficiency of the neurotransmitter dopamine, a catecholamine. Dpamine itself cannot be used to treat the disease because it does not cross the blood-brain barrier, but its metabolic precursor, levodopa, does cross into the brain and is converted to dopamine by a decarboxylase present both in the brain and in the intestinal tract (JM Cedarbaum, Clin Pharmacokinet, 13:141, 1987).
Clomipramine for Obsessive Compulsive Disorder
The Medical Letter on Drugs and Therapeutics • November 4, 1988; (Issue 778)
Clomipramine (Anafranil - Ciba-Geigy), a tricyclic antidepressant, is now available for treatment of obsessive compulsive disorder (OCD) in accordance with the new US Food and Drug Administration (FDA)...
Clomipramine (Anafranil - Ciba-Geigy), a tricyclic antidepressant, is now available for treatment of obsessive compulsive disorder (OCD) in accordance with the new US Food and Drug Administration (FDA) procedure for promising investigational drugs (FE Young et al, JAMA, 259:2267, 1988). In other countries, clomipramine has been widely used for many years for treatment of depression.
Treatment of Xerostomia
The Medical Letter on Drugs and Therapeutics • July 29, 1988; (Issue 771)
Xerostomia, dry mouth due to decreased or absent saliva, is a common problem, particularly among elderly patients. Decreased salivary flow can be due to many different conditions, including drug therapy, Sj...
Xerostomia, dry mouth due to decreased or absent saliva, is a common problem, particularly among elderly patients. Decreased salivary flow can be due to many different conditions, including drug therapy, Sj gren's syndrome (keratoconjunctivitis sicca) or radiation of the salivary glands.
Fluoxetine For Depression
The Medical Letter on Drugs and Therapeutics • April 22, 1988; (Issue 764)
Fluoxetine (Prozac - Dista), a phenylpropylamide, is the first serotonin-reuptake blocker introduced in the USA for treatment of . It is being promoted as causing fewer adverse effects than other...
Fluoxetine (Prozac - Dista), a phenylpropylamide, is the first serotonin-reuptake blocker introduced in the USA for treatment of . It is being promoted as causing fewer adverse effects than other antidepressants. Claims of greater safety and patient tolerability have often been made for new non-tricyclic antidepressants in recent years, but unpredicted adverse effects have emerged with widespread use, including priapism with trazodone (Desyrel - Medical Letter, 26:35, 1984) and fatal hemolytic anemia with nomifensine (Merital - Medical Letter, 27:73, 1985).
Choice of Benzodiazepines
The Medical Letter on Drugs and Therapeutics • February 26, 1988; (Issue 760)
Since The Medical Letter last reviewed the choice of benzodiazepines (Volume 23, page 41, 1981), several new drugs have been marketed and some old ones are now available generically. Most of the...
Since The Medical Letter last reviewed the choice of benzodiazepines (Volume 23, page 41, 1981), several new drugs have been marketed and some old ones are now available generically. Most of the benzodiazepines available for oral use in the USA are listed in the table on page 28.