Archives for Pharmacotherapy

Case: Antidepressant agents. Questions – Answers

Posted By Kelly On Thursday, June 3rd 2010   under:  Pharmacotherapy   Tags: , , ,    
Questions Which of the following agents is contraindicated in a patient with epilepsy? A. Bupropion B. Fluoxetine C. Mirtazapine D. Venlafaxine The antidepressant action of imipramine is thought to be caused by which of the following? A. Blockade of prejunctional α2-adrenoceptors B. Blockade of prejunctional neuronal norepinephrine and serotonin uptake transporters in the CNS C. Increased numbers of β-adrenoceptors D. Inhibition of monoamine oxidase Which of the following antidepressant agents inhibits hepatic microsomal enzymes to cause clinically significant ... Read More

Case: Antidepressant agents. Discussion

Posted By Kelly On Wednesday, June 2nd 2010   under:  Pharmacotherapy   Tags: , ,    
Class Drugs used to treat depression are classified as TCAs, atypical heterocyclic (second- and third-generation) agents, SSRIs, and monoamine oxidase inhibitors (MAOIs). Other conditions for which certain antidepressant agents are used include panic disorder, obsessive-compulsive disease (OCD), bipolar affective disorder, chronic pain, and enuresis. SSRIs are the most extensively prescribed antidepressant agents because, unlike tricyclic and heterocyclic agents, they produce less sedation, have fewer antimuscarinic cholinoreceptor effects, and are safer in overdose. ... Read More

Case: Antidepressant agents

Posted By Kelly On Tuesday, June 1st 2010   under:  Pharmacotherapy   Tags:    
A 30-year-old woman presents to your office for the evaluation of fatigue. For the past 2 months she has felt run down. She says that she doesn't feel like participating in activities that she previously enjoyed, such as her weekly softball games. She has not been sleeping well and has not had much of an appetite. On questioning, she admits to feeling "down in the dumps" most of the time ... Read More

Treatment-Resistant Schizophrenia May Respond to High-Dose Atypical

Posted By Kelly On Tuesday, April 6th 2010   under:  Pharmacotherapy   Tags: , ,    
Results from a recent study suggest that olanzapine (Zyprexa) given in moderate to high doses may be useful in treating schizophrenia in patients who have shown resistance to trials with other antipsychotic medications. Published in the September 1999 issue of the Canadian Journal of Psychiatry, the prospective, open-label study by Serdar Dursun et al. reported on 16 patients (11 male, five female; mean age 40±7 years) having a documented history of ... Read More

Treating Dementia With Atypical Antipsychotics. Part 2

Posted By Kelly On Tuesday, January 5th 2010   under:  Pharmacotherapy   Tags: , , , , , ,    
Atypical Antipsychotics Most initial published data on atypical antipsychotic drugs in the elderly are clinical trials in nondemented patients with schizophrenia or Parkinson's disease. In the last two to three years, controlled trials evaluating risperidone (Risperdal) and olanzapine (Zyprexa) in patients with dementia have been published. There is now evidence that these two atypical antipsychotic drugs offer efficacy in this patient population with fewer adverse effect concerns than the typical antipsychotic ... Read More

Treating Dementia With Atypical Antipsychotics. Part 1

Posted By Kelly On Monday, January 4th 2010   under:  Pharmacotherapy, Uncategorized   Tags: , , , ,    
Patients with dementia display a broad range of cognitive impairments and behavioral and psychotic symptoms. Common behavioral symptoms include verbal and physical aggression, hyperactivity, disinhibition, and pacing and wandering; common psychotic symptoms include paranoia, delusions and hallucinations. These behavioral and psychotic symptoms are the leading cause for the use of more restrictive supervised environments, including institutionalization. Effective pharmacologic and nonpharmacologic treatment of these symptoms is desirable and, in addition, might delay ... Read More

Pharmacological treatment of depression

Posted By Kelly On Monday, October 5th 2009   under:  Pharmacotherapy   Tags: , , , , ,    
Major depression affects 5% to 10% of patients seen by primary care physicians. Despite the advent of new antidepressant drugs, up to 20% of patients remain fully resistant to treatment and a further 20% to 30% only partly respond to treatment. Therapy should aim at eradicating depressive symptoms completely (i.e., complete remission) because incomplete recovery is associated with continued functional impairment and a greater ... Read More

Panic Disorder

Posted By Kelly On Friday, October 2nd 2009   under:  Pharmacotherapy   Tags: , , , ,    
Though panic disorder and panic disorder with agoraphobia or phobic avoidance (PDA) are common (the mean lifetime prevalence of panic disorder is 1.5%), the diagnosis is frequently missed: 70% of patients with PDA in one large study had more than ten medical consultations before receiving the correct diagnosis and treatment. The "classic" presentation of panic disorder consists of sudden, unexpected, discrete attacks of intense fear or discomfort without a recognizable precipitant, ... Read More

The Pharmacotherapy of Depression

Posted By Kelly On Sunday, September 27th 2009   under:  Pharmacotherapy   Tags: , , ,    
Over the years, most of the research into the pharmacotherapy of major depression has focused on the treatment of the acute depressive episode. There is a vast literature which documents the efficacy of the tricyclic antidepressants, monoamine oxidase inhibitors and, more recently, the serotonin reuptake inhibitors in the acute management of unipolar major depressive disorder. Recently however, there has been an effort to define ... Read More
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