Five-Year Effects of Rivastigmine on Cognitive Performance

Author: Mary Sano, MD, Professor of Medicine, Mount Sinai School of Medicine, New York, New York

Alzheimer’s disease (AD) is characterized by a relentless decline in cognitive performance and in the ability to perform normal daily tasks. Untreated or placebo-treated patients with AD show an average annual deterioration of about three points on the Mini-Mental State Examination (MMSE) or, depending on baseline levels, five to seven points on the Cognitive sub-scale of the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog). Short-term symptomatic treatments, such as cholinesterase inhibitors, are available for mild-to-moderate AD, but achieving further delay in cognitive decline or slowing long-term deterioration of symptoms would be clinically meaningful.

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Duloxetine generic Versus Placebo in Preventing Relapse of Major Depressive Disorder

Author: Michael J. Detke, MD, PhD, Indiana University School of Medicine, Indianapolis, and Medical Director for Cymbalta, Lilly Research Laboratories

It has been well established for more than a decade that major depressive disorder (MDD) is characterized by several distinct stages:

• an acute phase for 12 weeks, followed by remission after treatment
• a continuation phase of four to nine months, during which time relapses sometimes occur
• a maintenance phase of a year or more, with a potential for recurrence

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Effects of Atomoxetine generic and Methylphenidate on Sleep in Children with Attention-Deficit/ Hyperactivity Disorder

Author: R. Bart Sangal MD, Clinical Neurophysiology Services PC, Troy, Michigan

Presenter: Virginia Sutton, PhD, Lilly Research Laboratories, Indianapolis, Indiana

Attention-deficit/hyperactivity disorder (ADHD) affects approximately 3% to 7% of school-aged children. It is characterized by inattention and/or hyperactivity and impulsivity. The disorder is thought to be caused by a dysregulation of nore-pinephrine and dopamine in the prefrontal cortex and associated brain structures.

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Manufacturer: Ortho-McNeil Johnson & Johnson) Indication: To treat multidrug-resistant strains of Streptococcus pneumoniae (MDRSP) in community acquired pneumonia (CAP).

Drug Class: Levofloxacin generic is a fluoroquinolone (a chiral flu-orinated carboxyquinolone).

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Manufacturer: Allergan Pharmaceuticals

Indication: To treat severe underarm sweating (primary axillary hyperhidrosis) that cannot be managed by topical agents such as prescription antiperspirants.

Drug Class: Botulinum toxin type A is a protein that is produced by the bacterium Clostridium botulinum. Sterile, vacuum-dried, and purified, it is made from fermentation of Hall strain C. botulinum type A, which is grown in a medium containing casein hydrolysate, glucose, and yeast extract.

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Ezetimibe/Simvastatin (Vytorin tablet) Manufacturer: Merck & Co./Schering-Plough Corp.

Indication: To treat elevated levels of low-density lipoprotein-cholesterol (LDL-C) (the “bad” cholesterol) in patients with primary hypercholesterolemia or mixed hyperlipidemia as adjunctive therapy to diet when diet alone is not enough to reduce LDL-C levels.

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Black Box Warning

Suicidality in Children and Adolescents. Antidepressants increase the risk of suicidal thinking and behavior (suicidality) in children and adolescents with major depressive disorder (MDD) and other psychiatric disorders. Anyone considering the use of [Drug Name] or any other antidepressant in a child or adolescent must balance this risk with the clinical need. Patients who are started on therapy should be observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. [Drug Name] is not approved for use in pediatric patients except for patients with [any approved pediatric claims here]. (See Warnings and Precautions: Pediatric Use.)

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