The illumination of cellular processes in cancer has revolutionized oncology drug development leading to a shift from non-specific chemotherapy to the selective targeting of tumorigenic signal transduction pathways. Farnesyltransferase inhibitors (FTIs) target proteins needing prenylation for functioning, thus inhibiting a wide variety of molecular targets crucial for cell proliferation and survival. Tipifarnib (R115777, Zarnestra®), a potent and specific inhibitor of Farnesyltransferase, can attain strong inhibition of tumor growth in preclinical models. As a single agent, tipifarnib has demonstrated activity in several hematologic malignancies, namely acute myeloid leukemia, myelodysplastic syndrome, chronic myeloid leukemia and multiple myeloma. However, considering the complexity of the molecular aberrations implicated in the pathogenesis of hematologic neoplasms, it is rather unlikely that monotherapy with tipifarnib will serve as a stand-alone treatment approach. Indeed, improved results have been achieved by combining tipifarnib with other anticancer agents, whereas the first efforts for the identification of molecular predictors of response are reporting intriguing results. Ongoing trials are anticipated to define the exact role of tipifarnib in the treatment of hematologic malignancies.
{"title":"Pharmacotherapy of Hematologic Malignancies with Tipifarnib","authors":"I. Kotsianidis, Evangelia Nakou, Irene Bouchliou","doi":"10.4137/CMT.S1097","DOIUrl":"https://doi.org/10.4137/CMT.S1097","url":null,"abstract":"The illumination of cellular processes in cancer has revolutionized oncology drug development leading to a shift from non-specific chemotherapy to the selective targeting of tumorigenic signal transduction pathways. Farnesyltransferase inhibitors (FTIs) target proteins needing prenylation for functioning, thus inhibiting a wide variety of molecular targets crucial for cell proliferation and survival. Tipifarnib (R115777, Zarnestra®), a potent and specific inhibitor of Farnesyltransferase, can attain strong inhibition of tumor growth in preclinical models. As a single agent, tipifarnib has demonstrated activity in several hematologic malignancies, namely acute myeloid leukemia, myelodysplastic syndrome, chronic myeloid leukemia and multiple myeloma. However, considering the complexity of the molecular aberrations implicated in the pathogenesis of hematologic neoplasms, it is rather unlikely that monotherapy with tipifarnib will serve as a stand-alone treatment approach. Indeed, improved results have been achieved by combining tipifarnib with other anticancer agents, whereas the first efforts for the identification of molecular predictors of response are reporting intriguing results. Ongoing trials are anticipated to define the exact role of tipifarnib in the treatment of hematologic malignancies.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"71 1","pages":"855-869"},"PeriodicalIF":0.0,"publicationDate":"2009-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83206988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zolmitriptan is one of seven triptans available to treat acute migraine attacks. The introduction of these selective serotonin receptor agonists almost 20 years ago has revolutionized acute migraine treatment. Triptans are now first line migraine drugs, and provide acute treatment that is well-tolerated, safe and effective. This commentary reviews the use of zolmitriptan and other triptans, discusses how to maximize their effect, and examines the controversies surrounding this class of medication such as medication-overuse headache, use in migraine aura or prodrome, pediatric use, and important drug interactions.
{"title":"Zolmitriptan and the Triptan Era","authors":"M. Marmura","doi":"10.4137/CMT.S2907","DOIUrl":"https://doi.org/10.4137/CMT.S2907","url":null,"abstract":"Zolmitriptan is one of seven triptans available to treat acute migraine attacks. The introduction of these selective serotonin receptor agonists almost 20 years ago has revolutionized acute migraine treatment. Triptans are now first line migraine drugs, and provide acute treatment that is well-tolerated, safe and effective. This commentary reviews the use of zolmitriptan and other triptans, discusses how to maximize their effect, and examines the controversies surrounding this class of medication such as medication-overuse headache, use in migraine aura or prodrome, pediatric use, and important drug interactions.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"26 1","pages":"781-785"},"PeriodicalIF":0.0,"publicationDate":"2009-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73149659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this article is to review the effectiveness and tolerability of pioglitazone and glimepiride combination treatment for type 2 diabetes, particularly in the context of metabolic control and cardiovascular prevention. We reviewed studies of pioglitazone and glimepiride combination treatment through literature in the internet based Medline. The search was conducted using the search terms pioglitazone, glimepiride, glycemic control, combination therapy, and type 2 diabetes mellitus. The current evidence shows that pioglitazone in association with glimepiride is an effective option in the treatment of type 2 diabetes. Fixed dose combination permits a better compliance to therapy in patients with type 2 diabetes. More studies are needed to establish a role of pioglitazone and glimepiride in atherosclerosis and cardiovascular prevention beyond glycemic control.
{"title":"Glimepiride-pioglitazone Hydrochloride in the Treatment of Type 2 Diabetes","authors":"G. Derosa, S. Salvadeo","doi":"10.4137/CMT.S2016","DOIUrl":"https://doi.org/10.4137/CMT.S2016","url":null,"abstract":"The purpose of this article is to review the effectiveness and tolerability of pioglitazone and glimepiride combination treatment for type 2 diabetes, particularly in the context of metabolic control and cardiovascular prevention. We reviewed studies of pioglitazone and glimepiride combination treatment through literature in the internet based Medline. The search was conducted using the search terms pioglitazone, glimepiride, glycemic control, combination therapy, and type 2 diabetes mellitus. The current evidence shows that pioglitazone in association with glimepiride is an effective option in the treatment of type 2 diabetes. Fixed dose combination permits a better compliance to therapy in patients with type 2 diabetes. More studies are needed to establish a role of pioglitazone and glimepiride in atherosclerosis and cardiovascular prevention beyond glycemic control.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"694 9","pages":"835-845"},"PeriodicalIF":0.0,"publicationDate":"2009-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91520631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fibromyalgia (FM) is a chronic complex pain disorder that is multidimensional and exhibits heterogeneity requiring a long-term multidisciplinary approach to management. Many of the drugs used in the treatment of FM have been focused to the management of single symptoms; often such drugs fail to demonstrate acceptable efficacy in the majority of the patient population. Pregabalin is an α2-δ ligand that regulates the release and postsynaptic actions of neurotransmitters related to analgesic, anticonvulsant and anxiolytic properties. In randomized, double-blind, placebo-controlled studies, pregabalin has demonstrated an improvement in pain, sleep and fatigue symptoms associated with FM, as well as offering an improvement in parameters related to quality of life. Although the positive outcomes obtained with pregabalin support its use as an option for the management of FM, the efficacy was restricted to a selected patient population outside of the usual care setting. Current data do not allow an explanation where there are any limitations of pregabalin as a treatment of patients with FM, as to whether this is a deficiency of the drug or the process of assessment (e.g. assessment tools of FM, clinical trial design).
{"title":"Pregabalin and Fibromyalgia Syndrome: A Treatment Option","authors":"K. Lawson","doi":"10.4137/CMT.S1094","DOIUrl":"https://doi.org/10.4137/CMT.S1094","url":null,"abstract":"Fibromyalgia (FM) is a chronic complex pain disorder that is multidimensional and exhibits heterogeneity requiring a long-term multidisciplinary approach to management. Many of the drugs used in the treatment of FM have been focused to the management of single symptoms; often such drugs fail to demonstrate acceptable efficacy in the majority of the patient population. Pregabalin is an α2-δ ligand that regulates the release and postsynaptic actions of neurotransmitters related to analgesic, anticonvulsant and anxiolytic properties. In randomized, double-blind, placebo-controlled studies, pregabalin has demonstrated an improvement in pain, sleep and fatigue symptoms associated with FM, as well as offering an improvement in parameters related to quality of life. Although the positive outcomes obtained with pregabalin support its use as an option for the management of FM, the efficacy was restricted to a selected patient population outside of the usual care setting. Current data do not allow an explanation where there are any limitations of pregabalin as a treatment of patients with FM, as to whether this is a deficiency of the drug or the process of assessment (e.g. assessment tools of FM, clinical trial design).","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"1 1","pages":"809-824"},"PeriodicalIF":0.0,"publicationDate":"2009-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89195046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Due to the growing rate of multi-drug resistant bacteria in complicated infections, the need for new broad-spectrum antimicrobials is paramount. Doripenem, a new addition to the intravenous carbapenem class, has recently been approved for the treatment of complicated lower urinary tract infections and/or pyelonephritis (cUTI) and complicated intra-abdominal infections (cIAI) in adult patients. Doripenem exhibits potent in vitro and in vivo bactericidal activity against an assortment of Gram-positive and Gram-negative aerobic and anaerobic organisms, including Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae that produce extended spectrum beta-lactamases (ESBL). Relative to other available carbapenems, doripenem typically displays MICs that are 1–2 dilutions lower than meropenem and 2–4 dilutions lower than imipenem against P. aeruginosa. Since the kidneys primarily excrete doripenem as whole drug, dose adjustments are needed in patients with renal impairment. Doripenem 500 mg q8 h demonstrated non-inferiority to levofloxacin 250 mg q24 h in clinical trials of patients with cUTI; it was non-inferior to meropenem 1000 mg q8 h in patients with cIAI. Doripenem’s broad spectrum of activity, in vitro potency against particularly difficult to treat organisms, and desirable safety profile make it an attractive option in the treatment of cUTI and cIAI.
{"title":"Pharmacotherapy of Complicated Urinary Tract and Intra-abdominal Infections with Doripenem","authors":"Anthony M. Nicasio, J. Kuti, D. Nicolau","doi":"10.4137/CMT.S2062","DOIUrl":"https://doi.org/10.4137/CMT.S2062","url":null,"abstract":"Due to the growing rate of multi-drug resistant bacteria in complicated infections, the need for new broad-spectrum antimicrobials is paramount. Doripenem, a new addition to the intravenous carbapenem class, has recently been approved for the treatment of complicated lower urinary tract infections and/or pyelonephritis (cUTI) and complicated intra-abdominal infections (cIAI) in adult patients. Doripenem exhibits potent in vitro and in vivo bactericidal activity against an assortment of Gram-positive and Gram-negative aerobic and anaerobic organisms, including Pseudomonas aeruginosa, Acinetobacter baumannii, and Enterobacteriaceae that produce extended spectrum beta-lactamases (ESBL). Relative to other available carbapenems, doripenem typically displays MICs that are 1–2 dilutions lower than meropenem and 2–4 dilutions lower than imipenem against P. aeruginosa. Since the kidneys primarily excrete doripenem as whole drug, dose adjustments are needed in patients with renal impairment. Doripenem 500 mg q8 h demonstrated non-inferiority to levofloxacin 250 mg q24 h in clinical trials of patients with cUTI; it was non-inferior to meropenem 1000 mg q8 h in patients with cIAI. Doripenem’s broad spectrum of activity, in vitro potency against particularly difficult to treat organisms, and desirable safety profile make it an attractive option in the treatment of cUTI and cIAI.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"52 1","pages":"787-799"},"PeriodicalIF":0.0,"publicationDate":"2009-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84968053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the 1970s, pharmacological therapy interrupting the renin-angiotensin system was considered beneficial for patients with high-renin hypertension. Angiotensin-converting enzyme (ACE) inhibitors proved to be effective not only in patients with high renin and elevated blood pressure, but also in many hypertensive patients with normal levels of plasma renin activity. ACE inhibitors are used in a wide range of chronic illnesses such as atherosclerosis, hypertension, myocardial infarction, heart failure, diabetic complications, and stroke. To date, more than ninety controlled clinical trials evaluating the beneficial effects of 14 different ACE inhibitors were conducted. Moreover, data from experimental studies showed that ACE inhibitors can attenuate the development of atherosclerosis, oxidative stress, and vascular inflammation in a wide range of species indicating that ACE inhibition also favourably affects the vasculature. More than fifteen years ago, the bi-sulfydryl ACE-inhibitor zofenopril has shown an excellent clinical safety and efficacy in patients with hypertension and in those with myocardial infarction. More recently, this compound exhibited a potent antioxidant and antiatherosclerotic effect indicating a clinical useful vasoprotective action.
{"title":"Safety and Efficacy of the bi-Sulfydryl ACE-Inhibitor Zofenopril in the Management of Cardiovascular Disease","authors":"C. Napoli","doi":"10.4137/CMT.S2796","DOIUrl":"https://doi.org/10.4137/CMT.S2796","url":null,"abstract":"In the 1970s, pharmacological therapy interrupting the renin-angiotensin system was considered beneficial for patients with high-renin hypertension. Angiotensin-converting enzyme (ACE) inhibitors proved to be effective not only in patients with high renin and elevated blood pressure, but also in many hypertensive patients with normal levels of plasma renin activity. ACE inhibitors are used in a wide range of chronic illnesses such as atherosclerosis, hypertension, myocardial infarction, heart failure, diabetic complications, and stroke. To date, more than ninety controlled clinical trials evaluating the beneficial effects of 14 different ACE inhibitors were conducted. Moreover, data from experimental studies showed that ACE inhibitors can attenuate the development of atherosclerosis, oxidative stress, and vascular inflammation in a wide range of species indicating that ACE inhibition also favourably affects the vasculature. More than fifteen years ago, the bi-sulfydryl ACE-inhibitor zofenopril has shown an excellent clinical safety and efficacy in patients with hypertension and in those with myocardial infarction. More recently, this compound exhibited a potent antioxidant and antiatherosclerotic effect indicating a clinical useful vasoprotective action.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"5 1","pages":"847-853"},"PeriodicalIF":0.0,"publicationDate":"2009-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87088763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lung cancer is the most common cause of cancer mortality worldwide and even with current advances in chemotherapy the outcome is disappointing. The advances in molecular biology have enabled us to identify various targets for anticancer treatments. The VEGF-VEGFR signalling pathway plays a significant role in tumor angiogenesis and has been a major target for the development of various anticancer drugs. Bevacizumab is a recombinant humanized monoclonal antibody, which binds to VEGF and has shown efficacy in various tumors. Bevacizumab has been licensed in first line treatment of non-small cell lung cancer (NSCLC) in combination with chemotherapy. We are reviewing the evidence of the benefit and toxicity of Bevacizumab in combination with chemotherapy and other targeted agents in advanced NSCLC.
{"title":"Bevacizumab: Its Place in the Treatment of Advanced Non-small Cell Lung Cancer","authors":"V. Agarwal, R. Prasad, M. Butt","doi":"10.4137/CMT.S1949","DOIUrl":"https://doi.org/10.4137/CMT.S1949","url":null,"abstract":"Lung cancer is the most common cause of cancer mortality worldwide and even with current advances in chemotherapy the outcome is disappointing. The advances in molecular biology have enabled us to identify various targets for anticancer treatments. The VEGF-VEGFR signalling pathway plays a significant role in tumor angiogenesis and has been a major target for the development of various anticancer drugs. Bevacizumab is a recombinant humanized monoclonal antibody, which binds to VEGF and has shown efficacy in various tumors. Bevacizumab has been licensed in first line treatment of non-small cell lung cancer (NSCLC) in combination with chemotherapy. We are reviewing the evidence of the benefit and toxicity of Bevacizumab in combination with chemotherapy and other targeted agents in advanced NSCLC.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"59 1","pages":"715-725"},"PeriodicalIF":0.0,"publicationDate":"2009-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74335499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Most patients with hereditary or chronic acquired anemias are dependent on regular red cell transfusions. Untreated iron overload from transfusions is responsible for morbidity and mortality in patients with thalassemia major. However, clinical consequences of parenchymal iron overload have been reported not only in thalassemia major but also in patients with myelodysplastic syndrome. The current standard in iron chelation therapy is deferoxamine mesylate (Desferal®). Deferasirox is the first oral iron chelator approved in the Europe Union for use in patients with transfusional iron overload with different diseases. The aim of this review is to examine the properties and management of Deferasirox.
{"title":"Management of Transfusional chronic Iron Overload: Focus on Deferasirox","authors":"F. Pilo, A. Tucci, Laura Dessì, E. Angelucci","doi":"10.4137/CMT.S1970","DOIUrl":"https://doi.org/10.4137/CMT.S1970","url":null,"abstract":"Most patients with hereditary or chronic acquired anemias are dependent on regular red cell transfusions. Untreated iron overload from transfusions is responsible for morbidity and mortality in patients with thalassemia major. However, clinical consequences of parenchymal iron overload have been reported not only in thalassemia major but also in patients with myelodysplastic syndrome. The current standard in iron chelation therapy is deferoxamine mesylate (Desferal®). Deferasirox is the first oral iron chelator approved in the Europe Union for use in patients with transfusional iron overload with different diseases. The aim of this review is to examine the properties and management of Deferasirox.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"69 1","pages":"735-745"},"PeriodicalIF":0.0,"publicationDate":"2009-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85707851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tipranavir (TPV) is a selective nonpeptidic HIV-1 protease inhibitor (PI) which is used in the treatment of treatment-experienced adults with HIV-1 infection. Tipranavir is administered orally twice daily in combination with low-dose ritonavir. The durable efficacy of tipranavir, in combination with low-dose ritonavir (tipranavir/ritonavir 500 mg/200 mg twice daily), has been demonstrated in well designed trials in treatment-experienced adults infected with multidrug-resistant strains of HIV-1. In treatment-experienced adults with HIV-1 infection receiving an optimized background regimen, viral suppression was greater and immunological responses were better with regimens containing tipranavir/ritonavir than with comparator ritonavir-boosted PI-containing regimens. The efficacy appeared to be more marked in patients receiving two fully active drugs in the regimen, with the combination of tipranavir/ritonavir and enfuvirtide (for the first time) appearing to be the most successful. Although tipranavir is generally well tolerated, clinical hepatitis and hepatic decompensation, and intracranial hemorrhage have been associated with the drug. Tipranavir also has a complex drug interaction profile. Thus, tipranavir, administered with ritonavir, is an effective treatment option for use in the combination therapy of adults with HIV-1 infection who have been previously treated with other antiretroviral drugs.
{"title":"Tipranavir: A Review of its Use in Therapy of HIV Infection","authors":"R. Winzer, P. Langmann","doi":"10.4137/CMT.S2668","DOIUrl":"https://doi.org/10.4137/CMT.S2668","url":null,"abstract":"Tipranavir (TPV) is a selective nonpeptidic HIV-1 protease inhibitor (PI) which is used in the treatment of treatment-experienced adults with HIV-1 infection. Tipranavir is administered orally twice daily in combination with low-dose ritonavir. The durable efficacy of tipranavir, in combination with low-dose ritonavir (tipranavir/ritonavir 500 mg/200 mg twice daily), has been demonstrated in well designed trials in treatment-experienced adults infected with multidrug-resistant strains of HIV-1. In treatment-experienced adults with HIV-1 infection receiving an optimized background regimen, viral suppression was greater and immunological responses were better with regimens containing tipranavir/ritonavir than with comparator ritonavir-boosted PI-containing regimens. The efficacy appeared to be more marked in patients receiving two fully active drugs in the regimen, with the combination of tipranavir/ritonavir and enfuvirtide (for the first time) appearing to be the most successful. Although tipranavir is generally well tolerated, clinical hepatitis and hepatic decompensation, and intracranial hemorrhage have been associated with the drug. Tipranavir also has a complex drug interaction profile. Thus, tipranavir, administered with ritonavir, is an effective treatment option for use in the combination therapy of adults with HIV-1 infection who have been previously treated with other antiretroviral drugs.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":"3 1","pages":"747-761"},"PeriodicalIF":0.0,"publicationDate":"2009-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88577864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lamotrigine is an oral well absorbed antiepileptic medication (AED) from the phenyltriazine class approved by the FDA in 1994 for the treatment of epilepsy and in 2003 for the treatment of bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic–clonic seizures, and seizures associated with Lennox-Gastaut syndrome. Lamotrigine is the only AED that treats the depressive as well as the maniac phases of bipolar disorders. It is important to consider lamotrigine adverse reactions and drug-drug interactions such as with other AED’s, psychiatric medications, estrogens, and complementary-alternative medicines. Lamotrigine induces skin reactions as part of the hypersensitivity response (HSR), the actual incidence of skin rash is low (1.8%) providing slow escalation regimens are used when introducing this medication. An especially appealing indication for lamotrigine treatment is elderly epilepsy with depression. The main advantage of lamotrigine for the treatment of this indication in the elderly lies in its favorable and predictive adverse event profile and drug-drug interactions in comparison to other AEDs. Lamotrigine can serve in the elderly as both an antiepileptic and an antidepressant drug with a relatively favorable profile.
{"title":"Safety and Efficacy of Lamotrigine in Older Adults with Epilepsy and Co-Morbid Depressive Symptoms:","authors":"Y. Schiller, N. Krivoy","doi":"10.4137/CMT.S2165","DOIUrl":"https://doi.org/10.4137/CMT.S2165","url":null,"abstract":"Lamotrigine is an oral well absorbed antiepileptic medication (AED) from the phenyltriazine class approved by the FDA in 1994 for the treatment of epilepsy and in 2003 for the treatment of bipolar disorder. For epilepsy it is used to treat partial seizures, primary and secondary tonic–clonic seizures, and seizures associated with Lennox-Gastaut syndrome. Lamotrigine is the only AED that treats the depressive as well as the maniac phases of bipolar disorders. It is important to consider lamotrigine adverse reactions and drug-drug interactions such as with other AED’s, psychiatric medications, estrogens, and complementary-alternative medicines. Lamotrigine induces skin reactions as part of the hypersensitivity response (HSR), the actual incidence of skin rash is low (1.8%) providing slow escalation regimens are used when introducing this medication. An especially appealing indication for lamotrigine treatment is elderly epilepsy with depression. The main advantage of lamotrigine for the treatment of this indication in the elderly lies in its favorable and predictive adverse event profile and drug-drug interactions in comparison to other AEDs. Lamotrigine can serve in the elderly as both an antiepileptic and an antidepressant drug with a relatively favorable profile.","PeriodicalId":10428,"journal":{"name":"Clinical Medicine and Therapeutics","volume":" 44","pages":"825-833"},"PeriodicalIF":0.0,"publicationDate":"2009-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91413177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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