Efficacy and Safety of Five Broad-Spectrum Antiseizure Medications for Adjunctive Treatment of Refractory Epilepsy: A Systematic Review and Network Meta-analysis
ConclusionsThird-generation drugs (PER and LCM) had no advantages in terms of efficacy and safety for adjunctive treatment of refractory epilepsy compared with several second-generation drugs (LEV and LTG). Levetiracetam was the priority choice for adjunctive treatment of refractory epilepsy. Perampanel and LCM had no advantages in terms of efficacy and safety among the five drugs.RegistrationPROSPERO registration number, CRD42022344153; last edited on December 23, 2022. (Source: CNS Drugs)
Source: CNS Drugs - August 17, 2023 Category: Neurology Source Type: research
Efficacy and Safety of Esketamine Nasal Spray in Patients with Treatment-Resistant Depression Who Completed a Second Induction Period: Analysis of the Ongoing SUSTAIN-3 Study
ConclusionsPatients with TRD benefitted from receiving a second IND and maintenance treatment with ESK and no new safety signals were identified. (Source: CNS Drugs)
Source: CNS Drugs - August 9, 2023 Category: Neurology Source Type: research
GABA-ergic Modulators: New Therapeutic Approaches to Premenstrual Dysphoric Disorder
The objective of this narrative review is to discuss the plausible link between changes in GABAergic transmission secondary to the fluctuation of allopregnanolone during the luteal phase and mood impairment in susceptible individuals. As part of this discussion, we explore promising findings from early clinical trials of several compounds that stabilize allopregnanolone signaling during the luteal phase, including dutasteride, a 5-alpha reductase inhibitor; isoallopregnanolone, a GABA-A modulating steroid antagonist; and ulipristal acetate, a selective progesterone receptor modulator. We then reflect on the implications of...
Source: CNS Drugs - August 5, 2023 Category: Neurology Source Type: research
The Utilization of Low Dose Naltrexone for Chronic Pain
AbstractNaltrexone is a mu-opioid receptor antagonist with a long half-life compared with naloxone. Both of these drugs, along with others, were developed with the intention of reversing the effects of opioid abuse or toxicity. Evidence has also shown that naltrexone has a benefit in preventing relapse by reducing opioid cravings and reducing symptoms of opioid withdrawal. The benefits of this drug were not only shown with opioid abuse. In 1984 this drug was also approved for alcohol abuse. Naltrexone has been proven to decrease alcohol relapse by decreasing the craving. Apart from these approved indications for the use of...
Source: CNS Drugs - July 28, 2023 Category: Neurology Source Type: research
Effectiveness and Safety of Switching from Oral Antipsychotics to Once-Monthly Paliperidone Palmitate (PP1M) in the Management of Schizophrenia: A Systematic Review and Meta-Analysis
ConclusionBased on our findings, this study may support the efficacy and safety of switching from OAPs to PP1M for the treatment of patients with schizophrenia. Future large-scale studies are warranted to confirm our findings. (Source: CNS Drugs)
Source: CNS Drugs - July 25, 2023 Category: Neurology Source Type: research
Number, Duration, and Distribution of Wake Bouts in Patients with Insomnia Disorder: Effect of Daridorexant and Zolpidem
ConclusionDaridorexant reduced the number and duration of longer wake bouts throughout the night compared with placebo, corresponding with improved daytime functioning.Clinical TrialsClinicaltrials.gov NCT02839200 (registered July 20, 2016), NCT03545191 (registered June 4, 2018). (Source: CNS Drugs)
Source: CNS Drugs - July 21, 2023 Category: Neurology Source Type: research
Increased Metabolic Potential, Efficacy, and Safety of Emerging Treatments in Schizophrenia
AbstractPatients with schizophrenia experience a broad range of detrimental health outcomes resulting from illness severity, heterogeneity of disease, lifestyle behaviors, and adverse effects of antipsychotics. Because of these various factors, patients with schizophrenia have a much higher risk of cardiometabolic abnormalities than people without psychiatric illness. Although exposure to many antipsychotics increases cardiometabolic risk factors, mortality is higher in patients who are not treated versus those who are treated with antipsychotics. This indicates both direct and indirect benefits of adequately treated illne...
Source: CNS Drugs - July 20, 2023 Category: Neurology Source Type: research
Amyloid-Lowering Monoclonal Antibodies for the Treatment of Early Alzheimer ’s Disease
AbstractAlzheimer's disease (AD) is the leading cause of dementia worldwide. Numerous biomarker studies have clearly demonstrated that AD has a long asymptomatic phase, with the development of pathology occurring at least 2 decades prior to the development of any symptoms. These pathological changes include a stepwise development of amyloid- β (Aβ) plaques, followed by tau neurofibrillary tangles and subsequently extensive neurodegeneration in the brain. In this review, we discuss the first class of drugs intended to be disease modifying to be approved by the US Food and Drug Administration (FDA) for AD—anti-Aβ monocl...
Source: CNS Drugs - July 20, 2023 Category: Neurology Source Type: research
Acute Valproate-Induced Encephalopathy in Status Epilepticus: A Registry-Based Assessment
ConclusionPending larger studies, VIE in SE seems relatively frequent and difficult to foresee; clinical alertness to symptoms is mandatory, even without hyperammonemia, and valproate withdrawal should be considered in suspected cases. (Source: CNS Drugs)
Source: CNS Drugs - July 19, 2023 Category: Neurology Source Type: research
Extended-Release Viloxazine Compared with Atomoxetine for Attention Deficit Hyperactivity Disorder
ConclusionsPediatric and adult ADHD patients who have experienced less than optimal response to atomoxetine demonstrate rapid improvement in inattention and in hyperactivity/impulsivity with greater tolerability on extended-release viloxazine. (Source: CNS Drugs)
Source: CNS Drugs - July 10, 2023 Category: Neurology Source Type: research
Correction to: Rimegepant: A Review in the Acute Treatment and Preventive Treatment of Migraine
(Source: CNS Drugs)
Source: CNS Drugs - July 4, 2023 Category: Neurology Source Type: research
The Serotonin 1A (5-HT1A) Receptor as a Pharmacological Target in Depression
We describe how experimental medicine approaches can be helpful in profiling the effects of 5-HT1A receptor modulation on the different clinical domains of depression, and outline some potential neurocognitive models that could be used to test the effects of 5-HT1A biased agonists. (Source: CNS Drugs)
Source: CNS Drugs - June 29, 2023 Category: Neurology Source Type: research
Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System
AbstractEven though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer ’s disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work sho...
Source: CNS Drugs - June 21, 2023 Category: Neurology Source Type: research
Clonazepam Loading Dose in Status Epilepticus: Is More Always Better?
ConclusionCLZ high doses were more frequently used for SE treatment in younger patients with healthy weight and were more often associated with intubation for airways protection, probably as an adverse event. Varying CLZ dose did not alter outcome in SE, raising the possibility that commonly recommended doses are above what is needed, at least in some patients. Our results suggest that CLZ doses in SE may be individualized depending on the clinical setting. (Source: CNS Drugs)
Source: CNS Drugs - June 8, 2023 Category: Neurology Source Type: research
Adverse Event Profiles of Antiseizure Medications and the Impact of Coadministration on Drug Tolerability in Adults with Epilepsy
ConclusionASMs have characteristic AE profiles that are highly reproducible and must be considered in therapeutic decision-making. Therapy using perampanel as an AMPA modulator should be considered cautiously due to its relatively high AE profile. Drugs acting via VGSCs and SV2A receptors are significantly better tolerated than other ASM categories or substances (e.g., topiramate, zonisamide, and valproate). Switching to brivaracetam is advisable in patients with psychobehavioral AEs who take levetiracetam. Because CDs frequently pharmacokinetically interact with ASMs, the cumulative AE profile must be considered.Trial reg...
Source: CNS Drugs - June 4, 2023 Category: Neurology Source Type: research
