Neurological and Psychiatric Adverse Effects of Antimicrobials
AbstractAntimicrobials are a widely used class of medications, but several of them are associated with neurological and psychiatric side effects. The exact incidence of neurotoxicity with anti-infectives is unknown, although it is estimated to be  
Source: CNS Drugs - July 18, 2019 Category: Neurology Source Type: research

Branched-Chain Amino Acids and Seizures: A Systematic Review of the Literature
ConclusionsThe contradictory effects of BCAAs on seizure activity likely reflect differences in the complex mechanisms that underlie seizure disorders. Some of these mechanisms are likely mediated by BCAA ’s effects on glucose, glutamate, glutamine, and ammonia metabolism, activation of the mechanistic target of rapamycin signaling pathway, and their effects on aromatic amino acid transport and neurotransmitter synthesis. We propose that a better understanding of mechanisms by which BCAAs affect se izures and neuronal viability is needed to advance the field of BCAA supplementation in epilepsy. (Source: CNS Drugs)
Source: CNS Drugs - July 16, 2019 Category: Neurology Source Type: research

Temporal Trends and Predictors of Drug Utilization and Outcomes in First-Ever Stroke Patients: A Population-Based Study Using the Singapore Stroke Registry
AbstractIntroductionDrug utilization and outcomes research in multi-ethnic Asian stroke populations is lacking.ObjectivesOur objective was to examine temporal trends and predictors of drug utilization and outcomes in a multi-ethnic Asian stroke population.MethodsThis registry-based study included ischemic and hemorrhagic first-ever stroke patients hospitalized between 2009 and 2016. Utilization of medications included in-hospital thrombolytic agents, early antithrombotics (antiplatelets, anticoagulants) within 48  h of admission, and antithrombotics and statins at discharge. Outcomes analyzed were in-hospital all-caus...
Source: CNS Drugs - July 16, 2019 Category: Neurology Source Type: research

Drug Treatment of Clinically Isolated Syndrome
AbstractMultiple sclerosis (MS) is an autoimmune disease of the central nervous system (CNS) that leads to inflammation, demyelination and ultimately axonal degeneration. In most cases, it is preceded by its precursor, clinically isolated syndrome (CIS) with conversion rates to clinically definite MS (CDMS) of roughly 20 –75%. Neurologists are therefore faced with the challenge of initiating a disease-modifying therapy (DMT) as early as possible to favorably influence the course of the disease. During the past 20 years, a multitude of drugs have been incorporated into our therapeutic armamentarium for MS and CIS...
Source: CNS Drugs - July 9, 2019 Category: Neurology Source Type: research

Objective Derivation of the Morphology and Staging of Visual Field Loss Associated with Long-Term Vigabatrin Therapy
ConclusionThe model exhibited a consistent pattern of VAVFL. The staging of the loss could assist the risk:benefit analysis of vigabatrin for the treatment of epilepsy. (Source: CNS Drugs)
Source: CNS Drugs - June 27, 2019 Category: Neurology Source Type: research

Rotigotine Transdermal Patch: A Review in Parkinson ’s Disease
AbstractRotigotine (Neupro®), a non-ergolinic dopamine agonist (DA), is administered once daily via a transdermal patch (TP) that delivers the drug over a 24-h period. In the EU, the rotigotine TP is approved as monotherapy for the treatment of early Parkinson ’s disease (PD) and as combination therapy with levodopa throughout the course of the disease. It is also approved for the treatment of PD in numerous other countries, including Australia, the USA, China and Japan. Rotigotine TP effectively improved motor and overall functioning in clinical trials in Caucasian and Asian patients with early PD (as monotherap...
Source: CNS Drugs - June 26, 2019 Category: Neurology Source Type: research

Outcome Assessment in Trials of Pharmacological Treatments for Alcohol Use Disorders: Fair and Strict Testing
AbstractOutcome assessment in the pharmacological treatment of alcohol use disorders (AUDs) faces specific challenges resulting from low adherence to treatment, high rates of dropout, and the susceptibility of patient self-reports to bias. This review discusses methodological issues in planning, conducting, and interpreting clinical trials on AUD treatment against the background of the principle of ‘strictness and fairness’ of testing. Threats to fairness include factors that limit the implementation of an intervention, such as low compliance and early treatment termination. In turn, fairness of testing is incr...
Source: CNS Drugs - June 25, 2019 Category: Neurology Source Type: research

Post-Hoc Analyses of the Effects of Baseline Sleep Quality on SHP465 Mixed Amphetamine Salts Extended-Release Treatment Response in Adults with Attention-Deficit/Hyperactivity Disorder
AbstractObjectiveSleep problems are common in adults with attention-deficit/hyperactivity disorder (ADHD). The presence of sleep problems at the time of presentation for ADHD treatment could impact the level of improvement in ADHD symptoms or executive function occurring with ADHD pharmacotherapy. Therefore, we examined the influence of baseline sleep quality on the effects of SHP465 mixed amphetamine salts (MAS) extended-release.MethodsAdults (18 –55 years) withDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision-defined ADHD and baseline ADHD Rating Scale IV (ADHD-RS-IV) total s...
Source: CNS Drugs - June 21, 2019 Category: Neurology Source Type: research

Long-Term Neuropsychological Outcomes from an Open-Label Phase I/IIa Trial of 2-Hydroxypropyl- β-Cyclodextrins (VTS-270) in Niemann-Pick Disease, Type C1
ConclusionIn conjunction with previous findings, these results provide support for the slowing of disease progress up to 36  months post-initiation of intrathecal VTS-270.RegistrationClinicalTrials.gov identifier NCT01747135: Hydroxypropyl Beta Cyclodextrin for Niemann-Pick type C1 Disease. (Source: CNS Drugs)
Source: CNS Drugs - June 11, 2019 Category: Neurology Source Type: research

Endolysosome and Autolysosome Dysfunction in Alzheimer ’s Disease: Where Intracellular and Extracellular Meet
AbstractDisturbed proteostasis as reflected by a massive accumulation of misfolded protein aggregates is a central feature in Alzheimer ’s disease. Proteostatic disturbances may be caused by a shift in protein production and clearance. Whereas rare genetic causes of the disease affect the production side, sporadic cases appear to be directed by dysfunction in protein clearance. This review focusses on the involvement of lysosome-m ediated clearance. Autophagy is a degradational system where intracellular components are degraded by lysosomal organelles. In addition, “outside-to-inside” trafficking through ...
Source: CNS Drugs - June 4, 2019 Category: Neurology Source Type: research

Methylene Blue in the Treatment of Neuropsychiatric Disorders
AbstractMethylene blue is a long-established drug with complex pharmacology and multiple clinical indications. Its diverse mechanisms of action are most likely responsible for the large variety of its clinical effects. Of interest to psychiatrists, methylene blue has antidepressant, anxiolytic, and neuroprotective properties documented by both animal and human studies. Its stabilizing effect on mitochondrial function and dose-dependent effect on the generation of reactive oxygen species are of significant heuristic value. For these reasons, methylene blue holds promise as a proof-of-concept treatment of organic/neurodegene...
Source: CNS Drugs - May 29, 2019 Category: Neurology Source Type: research

Potential Role of Vitamin D for the Management of Depression and Anxiety
AbstractVitamin D, a fat-soluble vitamin, plays a role not only in calcium and phosphate homeostasis but also in several other functions, including cell growth and neuromuscular and immune function. The deficiency of vitamin D is highly prevalent throughout the world and has been suggested to be associated with an enhanced risk of major depressive disorder (MDD) and anxiety disorders. Therefore, vitamin D supplementation has been investigated for the prevention and treatment of these disorders. This review presents preclinical and clinical evidence of the effects of vitamin D supplementation in these disorders. Although pr...
Source: CNS Drugs - May 15, 2019 Category: Neurology Source Type: research

Safety, Pharmacokinetics and Pharmacodynamics of TNHH, a Novel Targeted Neutrophil-Inhibitory Hirulog Hybrid Glycoprotein, in Healthy Volunteers
ConclusionTNHH was well-tolerated following IV infusion. The pharmacokinetic and pharmacodynamic characteristics of TNHH indicate that it merits clinical trials. It is recommended that the single dose of TNHH should be 1.0  mg/kg in future studies, and the expected effect may be achieved after 5–7 days of continuous administration.Trial RegistrationThe study is registered athttp://www.chictr.org.cn as ChiCTR-TQR-14004752. (Source: CNS Drugs)
Source: CNS Drugs - May 15, 2019 Category: Neurology Source Type: research

Medication-Induced Akathisia with Newly Approved Antipsychotics in Patients with a Severe Mental Illness: A Systematic Review and Meta-Analysis
AbstractBackgroundAkathisia is a common and distressing movement disorder that can be associated with the use of antipsychotics. It is characterized by a subjective (inner restlessness) and an objective (excessive movements) component. Akathisia can have a negative impact on clinical outcome and even lead to treatment discontinuation. Although medication-induced akathisia is more commonly associated with the use of first-generation antipsychotics (FGAs), it also occurs with second-generation antipsychotics (SGAs), including the newly approved antipsychotics (NAPs) asenapine, lurasidone, iloperidone, cariprazine, and brexpi...
Source: CNS Drugs - May 7, 2019 Category: Neurology Source Type: research

Association Between Statin Use and Depressive Symptoms in a Large Community-Dwelling Older Population Living in Australia and the USA: A Cross-Sectional Study
ConclusionThis study in a large community-dwelling older population did not show any association of statins with late-life depressive symptoms, after accounting for important socioeconomic and demographic factors. Confounding by indication is an important issue to be addressed in future pharmacoepidemiologic studies of statins. (Source: CNS Drugs)
Source: CNS Drugs - May 6, 2019 Category: Neurology Source Type: research

Buprenorphine Treatment for Opioid Use Disorder: An Overview
AbstractOpioid use disorder affects over 26 million individuals worldwide. There are currently three World Health Organization-recommended and US Food and Drug Administration-approved medication treatments for opioid use disorder: the full opioid agonist methadone, the opioid partial agonist buprenorphine, and the opioid receptor antagonist naltrexone. We provide a review of the use of buprenorphine for the treatment of opioid use disorder and discuss the barriers, challenges, risks, and efficacy of buprenorphine treatment vs. other treatments. Although evidence from numerous studies has shown buprenorphine to be effective...
Source: CNS Drugs - May 6, 2019 Category: Neurology Source Type: research

Correction to: A Multi ‑Center, Open‑Label, Pharmacokinetic Drug Interaction Study of Erenumab and a Combined Oral Contraceptive in Healthy Females
The authors would like to correct the error in the publication of the original article. The correction detail is given below: (Source: CNS Drugs)
Source: CNS Drugs - May 6, 2019 Category: Neurology Source Type: research

Pharmacokinetics and Tolerability of Multiple Doses of Pharmaceutical-Grade Synthetic Cannabidiol in Pediatric Patients with Treatment-Resistant Epilepsy
ConclusionsInter-individual variability in systemic cannabidiol exposure after pediatric patient treatment with cannabidiol oral solution was observed but decreased with multiple doses. Short-term administration was generally safe and well tolerated.Trial RegistrationClinicalTrials.gov (NCT02324673). (Source: CNS Drugs)
Source: CNS Drugs - May 2, 2019 Category: Neurology Source Type: research

Authors ’ Reply to Diener: “Phytomedicines in the Treatment of Migraine”
(Source: CNS Drugs)
Source: CNS Drugs - April 30, 2019 Category: Neurology Source Type: research

Comment on: “Phytomedicines in the Treatment of Migraine”
(Source: CNS Drugs)
Source: CNS Drugs - April 30, 2019 Category: Neurology Source Type: research

Revisiting Tramadol: A Multi-Modal Agent for Pain Management
AbstractTramadol —an atypical opioid analgesic—has a unique pharmacokinetic and pharmacodynamic profile, with opioidergic, noradrenergic, and serotonergic actions. Tramadol has long been used as a well-tolerated alternative to other drugs in moderate pain because of its opioidergic and monoaminergic activities. However, cumulative evidence has been gathered over the last few years that supports other likely mechanisms and uses of tramadol in pain management. Tramadol has modulatory effects on several mediators involved in pain signaling, such as voltage-gated sodium ion channels, transient receptor potenti al V...
Source: CNS Drugs - April 19, 2019 Category: Neurology Source Type: research

The Possible Role of the Angiotensin System in the Pathophysiology of Schizophrenia: Implications for Pharmacotherapy
AbstractA growing body of literature has elucidated the involvement of the central renin –angiotensin system (RAS) in various neuropsychiatric diseases. While consensus on the exact mechanism of the central RAS in schizophrenia pathophysiology does not currently exist, increasing evidence reveals promise in harnessing the therapeutic potential of RAS modulation in the treatment of sch izophrenia. In this review, we examine how the central RAS affects inflammation, glutamate, dopamine, gamma-aminobutyric acid (GABA), and peroxisome proliferator-activated receptor (PPAR)-γ, all of which are associated with schizo...
Source: CNS Drugs - April 16, 2019 Category: Neurology Source Type: research

Pathophysiological Mechanisms in Migraine and the Identification of New Therapeutic Targets
AbstractMigraine is a strongly disabling disease characterized by a unilateral throbbing headache lasting for up to 72  h for each individual attack. There have been many theories on the pathophysiology of migraine throughout the years. Currently, the neurovascular theory dominates, suggesting clear involvement of the trigeminovascular system. The most recent data show that a migraine attack most likely originates in the hypothalamus and activates the trigeminal nucleus caudalis (TNC). Although the mechanisms are unknown, activation of the TNC leads to peripheral release of calcitonin gene-related protein (CGRP), most...
Source: CNS Drugs - April 15, 2019 Category: Neurology Source Type: research

The Potential of Cannabinoid-Based Treatments in Tourette Syndrome
AbstractNovel pharmacological treatments are needed for Tourette syndrome. Our goal was to examine the current evidence base and biological rationale for the use of cannabis-derived medications or medications that act on the cannabinoid system in Tourette syndrome. We conducted a comprehensive literature search of PubMed for randomized controlled trials or clinical trials of cannabis-derived medications in Tourette syndrome. Data regarding the population, intervention, safety profile, and outcomes for each trial were extracted and reported and the evidence supporting use of individual cannabis-derived medications was criti...
Source: CNS Drugs - April 11, 2019 Category: Neurology Source Type: research

Association of Hyponatraemia and Antidepressant Drugs: A Pharmacovigilance –Pharmacodynamic Assessment Through an Analysis of the US Food and Drug Administration Adverse Event Reporting System (FAERS) Database
ConclusionsHyponatraemia is reported at a disproportionately higher level with classes of antidepressant drugs (noradrenergic and specific serotonergic antidepressant [mirtazapine] and serotonin modulators [vortioxetine]) that are in general considered to have a better profile of tolerability in terms of hyponatraemia. With regard to the presented results, the risk of hyponatraemia with mirtazapine appears to be greater than what was reported in the literature; however, confounding by indication cannot be ruled out. Our pharmacovigilance –pharmacodynamic analysis also indicates that inhibition of the serotonin transp...
Source: CNS Drugs - April 11, 2019 Category: Neurology Source Type: research

Long-Acting Injectable Second-Generation/Atypical Antipsychotics for the Management of Bipolar Disorder: A Systematic Review
ConclusionSecond-generation LAI antipsychotics, particularly risperidone and aripiprazole LAI, may be a safe and effective alternative to oral medications in the management of bipolar disorder. (Source: CNS Drugs)
Source: CNS Drugs - April 8, 2019 Category: Neurology Source Type: research

A Multi-Center, Open-Label, Pharmacokinetic Drug Interaction Study of Erenumab and a Combined Oral Contraceptive in Healthy Females
ConclusionErenumab did not alter the pharmacokinetics of the active components of an estrogen/progestin combination oral contraceptive. Thus, no change in contraceptive efficacy is expected with erenumab.Trial RegistrationClinicalTrials.gov NCT02792517. (Source: CNS Drugs)
Source: CNS Drugs - April 8, 2019 Category: Neurology Source Type: research

The Effect of Non-Gabapentinoid Anticonvulsants on Sensorimotor Recovery After Human Spinal Cord Injury
ConclusionNon-gabapentinoid anticonvulsant exposure was not associated with greater or lesser neurological recovery. This suggests that these medications, as administered for the acute management of spinal cord injury, do not impact long-term neurological outcomes. (Source: CNS Drugs)
Source: CNS Drugs - April 4, 2019 Category: Neurology Source Type: research

Targeting Inflammatory Pathways in Alzheimer ’s Disease: A Focus on Natural Products and Phytomedicines
AbstractStudies of the brains of Alzheimer ’s disease (AD) patients have revealed key neuropathological features, such as the deposition of aggregates of insoluble amyloid-β (Aβ) peptides and neurofibrillary tangles (NFTs). These pathological protein deposits, including Aβ peptides (which form senile plaques) and hyperphosphorylated tau (which aggregates into NFTs), have been assumed to be ‘the cause of AD’. Aβ has been extensively targeted to develop an effective disease-modifying therapy, but with limited clinical success. Emerging therapies are also now targeting further pathologica...
Source: CNS Drugs - March 21, 2019 Category: Neurology Source Type: research

Skin-Picking Disorder: A Guide to Diagnosis and Management
AbstractSkin-picking disorder, also known as excoriation disorder or psychogenic skin excoriations, is an obsessive –compulsive and related disorder that is classified with other body-focused repetitive-behavior disorders in the most recent edition of theDiagnostic and Statistical Manual of Mental Disorders (DSM-5). Skin-picking disorder is associated with significant comorbidity and psychosocial dysfunction. The disorder has a female predominance across studies, and the average age of onset is variable but commonly in adolescence and adulthood. A full clinical and dermatologic examination and multidisciplinary appro...
Source: CNS Drugs - March 15, 2019 Category: Neurology Source Type: research

DFN-02, Sumatriptan 10  mg Nasal Spray with Permeation Enhancer, for the Acute Treatment of Migraine: A Randomized, Double-Blind, Placebo-Controlled Study Assessing Functional Disability and Subject Satisfaction with Treatment
The objective of this study was to assess the efficacy of acute treatment of migraine with DFN-02, including its effect on migraine-related functional disability and patient satisfaction with treatment.MethodsThis was a multicenter, randomized, double-blind, placebo-controlled efficacy and safety study of DFN-02 in adults with episodic migraine. Functional disability and subject satisfaction with treatment were prespecified endpoints, assessed in real-time by subjects, using an electronic diary.ResultsIn total, 107 subjects were randomized. DFN-02 was significantly superior to placebo for the reduction in functional disabi...
Source: CNS Drugs - March 15, 2019 Category: Neurology Source Type: research

Current and Emerging Treatment Strategies for Neuronal Ceroid Lipofuscinoses
AbstractThe neuronal ceroid lipofuscinoses comprise a group of neurodegenerative lysosomal storage disorders caused by mutations in at least 13 different genes and primarily affect the brain and the retina of children or young adults. The disorders are characterized by progressive neurological deterioration with dementia, epilepsy, loss of vision, motor disturbances, and early death. While various therapeutic strategies are currently being explored as treatment options for these fatal disorders, there is presently only one clinically approved drug that has been shown to effectively attenuate the progression of a specific f...
Source: CNS Drugs - March 15, 2019 Category: Neurology Source Type: research

Risk of Acute Liver Injury in Agomelatine and Other Antidepressant Users in Four European Countries: A Cohort and Nested Case –Control Study Using Automated Health Data Sources
AbstractBackgroundAgomelatine is a melatonin receptor agonist and serotonin 5-HT2C receptor antagonist indicated for depression in adults. Hepatotoxic reactions like acute liver injury (ALI) are an identified risk in the European risk management plan for agomelatine. Hepatotoxic reactions have been reported for other antidepressants, but population studies quantifying these risks are scarce. Antidepressants are widely prescribed, and users often have risk factors for ALI (e.g. metabolic syndrome).ObjectiveThe goal was to estimate the risk of ALI associated with agomelatine and other antidepressants (fluoxetine, paroxetine,...
Source: CNS Drugs - March 4, 2019 Category: Neurology Source Type: research

A Close Look at BACE1 Inhibitors for Alzheimer ’s Disease Treatment
AbstractAlzheimer ’s disease (AD), the most common cause of age-dependent dementia, is one of the most significant healthcare problems worldwide. Aggravating this situation, drugs that are currently US Food and Drug Administration (FDA)-approved for AD treatment do not prevent or delay disease progression. Therefor e, developing effective therapies for AD patients is of critical urgency. Human genetic and clinical studies over the past three decades have indicated that abnormal generation or accumulation of amyloid-β (Aβ) peptides is a likely culprit in AD pathogenesis. Aβ is generated from amyloid pre...
Source: CNS Drugs - March 4, 2019 Category: Neurology Source Type: research

Correction to: A Phase I, Randomized, Double-Blind, Placebo-Controlled, Single Ascending Dose, Multiple Dose, and Food Effect Trial of the Safety, Tolerability and Pharmacokinetics of Highly Purified Cannabidiol in Healthy Subjects
Discussion, Single and Multiple Dose CBD PK, column 2 - the equation that read: (Source: CNS Drugs)
Source: CNS Drugs - March 4, 2019 Category: Neurology Source Type: research

Expanding Role of NMDA Receptor Antagonists in the Management of Pain
AbstractPain management is complex regardless of whether the pain is acute or chronic in nature or non-cancer or cancer related. In addition, relatively few pain pharmacotherapy options with adequate efficacy and safety data currently exist. Consequently, interest in the role of NMDA receptor antagonists as a pharmacological pain management strategy has surfaced. This narrative review provides an overview of the NMDA receptor and elaborates on the pharmacotherapeutic profile and pain management literature findings for the following NMDA receptor antagonists: ketamine, memantine, dextromethorphan, and magnesium. The literat...
Source: CNS Drugs - March 2, 2019 Category: Neurology Source Type: research

Authors ’ Reply to Tsivgoulis et al.: “Oral Disease-Modifying Treatments for Relapsing Multiple Sclerosis: A likelihood to Achieve No Evidence of Disease Activity or Harm Analysis”
(Source: CNS Drugs)
Source: CNS Drugs - February 26, 2019 Category: Neurology Source Type: research

Comment on: “Oral Disease-Modifying Treatments for Relapsing Multiple Sclerosis: A Likelihood to Achieve No Evidence of Disease Activity or Harm Analysis”
(Source: CNS Drugs)
Source: CNS Drugs - February 26, 2019 Category: Neurology Source Type: research

Correction to: Quantitative Pharmaco-Electroencephalography in Antiepileptic Drug Research
The Open Access license, which previously read: (Source: CNS Drugs)
Source: CNS Drugs - February 26, 2019 Category: Neurology Source Type: research

Efficacy and Safety of Valproic Acid for Spinal Muscular Atrophy: A Systematic Review and Meta-Analysis
ConclusionsOur study suggests that VPA treatment results in an improvement in gross motor functions for SMA patients, but not in other assessments of motor function or, possibly, in respiratory function. Furthermore, VPA appears to be a relatively safe drug, although treatment may be associated with a wide range of AEs (including body weight increase, fatigue, fever, flu-like symptoms, irritability, and pain). Double-blind, randomized, controlled trials are required to confirm these findings. (Source: CNS Drugs)
Source: CNS Drugs - February 22, 2019 Category: Neurology Source Type: research

Pharmacotherapy of Postpartum Depression: Current Approaches and Novel Drug Development
AbstractPostpartum depression is one of the most common complications of childbirth. Untreated postpartum depression can have substantial adverse effects on the well-being of the mother and child, negatively impacting child cognitive, behavioral, and emotional development with lasting consequences. There are a number of therapeutic interventions for postpartum depression including pharmacotherapy, psychotherapy, neuromodulation, and hormonal therapy among others, most of which have been adapted from the treatment of major depressive disorder outside of the peripartum period. Current evidence of antidepressant treatment for...
Source: CNS Drugs - February 21, 2019 Category: Neurology Source Type: research

A Preliminary Study Evaluating the Safety and Efficacy of Bumetanide, an NKCC1 Inhibitor, in Patients with Drug-Resistant Epilepsy
ConclusionsBumetanide might be an effective and relatively tolerable drug in patients with drug-resistant TLE. Downregulation of NKCC1 protein following bumetanide treatment may be responsible for its antiepileptic effects.Iranian Registry of Clinical Trials IdentifierIRCT 201012115368N1. (Source: CNS Drugs)
Source: CNS Drugs - February 19, 2019 Category: Neurology Source Type: research

Treatment Strategies for Clozapine-Induced Sialorrhea: A Systematic Review and Meta-analysis
ConclusionClozapine-induced sialorrhea is a potentially serious adverse event. Included studies in this meta-analysis were limited by poor study quality. Diphenhydramine, chlorpheniramine and benzamide derivatives appear to have the best supporting evidence and lowest reported adverse events. Caution should be exercised when using propantheline given its increased risk of constipation. (Source: CNS Drugs)
Source: CNS Drugs - February 13, 2019 Category: Neurology Source Type: research

Treatment of Juvenile Myoclonic Epilepsy in Patients of Child-Bearing Potential
AbstractJuvenile myoclonic epilepsy (JME) is both a frequent and a very characteristic epileptic syndrome with female preponderance. Treatment of JME in women of childbearing potential must consider multiple factors such as desire for pregnancy, use of contraception, seizure control and previously used antiepileptic drugs (AEDs). Approximately 85% of cases are well controlled with valproate, which remains the reference AED in JME but is nowadays considered unsafe for the expecting mother and her fetus. The prescription of valproate is now severely restricted in women of childbearing potential but may still be considered, a...
Source: CNS Drugs - February 11, 2019 Category: Neurology Source Type: research

Tranexamic Acid in Cerebral Hemorrhage: A Meta-Analysis and Systematic Review
ConclusionsTreatment with tranexamic acid could reduce rebleeding and hematoma expansion in cerebral hemorrhage without an increase in single ischemic adverse events, but it could increase the risk of combined ischemic events; however, the lack of improvement in mortality and the poor functional outcomes limit the value of clinical application. These findings indicate that the most pertinent issue is the risk-to-benefit ratio with tranexamic acid treatment in cerebral hemorrhage. (Source: CNS Drugs)
Source: CNS Drugs - February 11, 2019 Category: Neurology Source Type: research

Mixed States: Modelling and Management
AbstractOur current conceptualisation of mixed states, defined as co-occurring manic and depressive symptoms, is unlikely to advance our knowledge or inform clinical practice. Episodes of mixed states can no longer be coded in theDiagnostic and Statistical Manual of Mental Disorders (DSM-5), and the ‘mixed features specifier’ fails to capture the most common mixed state presentations. This reflects a lack of understanding of both the importance of mixed states and their underlying pathophysiology. Indeed, research into the nature of mixed states is scarce and uninformative, and most clinica l practice guideline...
Source: CNS Drugs - February 2, 2019 Category: Neurology Source Type: research

Correction to: Cladribine Tablets: A Review in Relapsing MS
The article Cladribine Tablets: A Review in Relapsing MS, written by Emma D. Deeks, was originally published Online First without open access. (Source: CNS Drugs)
Source: CNS Drugs - January 30, 2019 Category: Neurology Source Type: research

Novel Treatment Opportunities Against Cognitive Impairment in Parkinson ’s Disease with an Emphasis on Diabetes-Related Pathways
AbstractCognitive impairment is highly prevalent in patients with Parkinson ’s disease (PD) and causes adverse health outcomes. Novel procognitive therapies are needed to address this unmet need. It is now established that there is an increased risk of dementia in patients with type 2 diabetes mellitus (T2DM) and, moreover, T2DM and PD may have common underlying biologica l mechanisms. As such, T2DM medications are emerging as potential therapies in the context of PD dementia (PDD). In this review, we provide an update on pathophysiological mechanisms underlying cognitive impairments and PDD, focusing on diabetes-rel...
Source: CNS Drugs - January 28, 2019 Category: Neurology Source Type: research

Combination Therapy with Dipyridamole and Clopidogrel for Secondary Stroke Prevention in Aspirin-Intolerant Patients After Myocardial Infarction: Results of a Nationwide Case-Control Study
ConclusionNo differences were observed in the 12-year survival rate between clopidogrel and clopidogrel –dipyridamole groups. The two groups had balanced event-free survival in recurrent stroke, ICH, GI bleeding, and myocardial infarction. (Source: CNS Drugs)
Source: CNS Drugs - January 16, 2019 Category: Neurology Source Type: research

The Topographical Relationship between Visual Field Loss and Peripapillary Retinal Nerve Fibre Layer Thinning Arising from Long-Term Exposure to Vigabatrin
ConclusionsFunctional and structural abnormality is strongly related in individuals with vigabatrin toxicity and no evidence of visual pathway comorbidity, thereby implicating retinal ganglion cell dysfunction. OCT affords a limited measurement range compared with perimetry: severity cannot be directly assessed when the PPRNFL quadrant thickness is less than approximately 65  µm, depending on the tomographer. This limitation can be overcome by transformation of thickness to remaining axons, an outcome requiring input from perimetry. (Source: CNS Drugs)
Source: CNS Drugs - January 12, 2019 Category: Neurology Source Type: research