The profits generated by these activities have gone to an enterprising contractor for the nation's biggest pharmaceutical manufacturers.
E.g. glyburide Oral contraceptives orphenadrine pemoline penicillamine Penicillins phencyclidine polymyxin B pralidoxime primidone procarbazine pyridostigmine quinidine rabies vaccine, globulin retinol Vitamin A ; risperidone selegiline succinylcholine tacrine 0.1-1% ; Tetracyclines e.g. tetracycline tetrahydrocannabinol THC ; thiothixene tocainide tolazamide trazodone trichloroethylene trimethadione tubocurarine valproate divalproex vinblastine Vincristine Vitamin D 1, 12 1, TABLE 5 DRUGS INDUCING MYOPIA THROUGH INCREASED CILIARY BODY CONTRACTION OR LENS HYDRATION DRUG Acetazolamide Alcohol ASA Betaxolol Bromocriptine Carbachol Clofibrate Corticosteroids Diuretics e.g. chlorthalidone, hydrochlorothiazide Droperidol Ethosuximide Haloperidol Hyaluronidase Ibuprofen Isoniazid Isosorbide dinitrate Isotretinoin, etretinate Methacholine Methazolamide Methsuximide Metronidazole Neostigmine Opioids e.g. codeine, morphine Oral contraceptives REFERENCE 1, 5, 6 Penicillamine Phenformin Phenothiazines e.g. chlorpromazine Phensuximide Physostigmine Pilocarpine Prochlorperazine Promethazine Quinine Spironolactone Sulfonamides Tetracyclines rare ; Timolol Trimeprazine.
Simpson SG, Jamison KR 1999 ; The risk of suicide in patients with bipolar disorders. J Clin Psychiatry 60 Suppl 2 ; : 53-56. Small JG 1990 ; Anticonvulsants in affective disorders. Psychopharmacol Bull 26: 25-36. Souza FG, Goodwin GM 1991 ; Lithium treatment and prophylaxis in unipolar depression: a meta-analysis. Br J Psychiatry 158: 666675. Stromgren LS, Boller S 1985 ; Carbamazepine in treatment and prophylaxis of manic-depressive disorder. Psychiatr Dev 3: 349367. Thies-Flechtner K, Mller-Oerlinghausen B, Seibert W, Walther A, Greil W 1996 ; Effect of prophylactic treatment on suicide risk in patients with major affective disorders. Data from a randomized prospective trial. Pharmacopsychiatry 29: 103-107. Tohen M, Jacobs TG, Grundy SL, McElroy SL, Banov MC, Janicak PG, Sanger T, Risser R, Zhang F, Toma V, Francis J, Tollefson GD, Breier A 2000 ; Efficacy of olanzapine in acute bipolar mania: A double-blind, placebo-controlled study. Arch Gen Psychiatry 57: 841-849. van Calker D, Berger M 2000 ; Affektive Erkrankungen. Richtlinienentwurf der DGPPN. Steinkopff, Darmstadt. Vieta E, Martnez-Arn A, Colom F, Benabarre A, Reinares M, Gast C 2000 ; Treatment of bipolar depression: paroxetine vs. venlafaxine. Int J Neuropsychopharmacol 3 Suppl 1 ; : 336-337. Vieta E, Goikolea JM, Corbella B, Benabarre A, Reinares M, Martinez G, Fernandez A, Colom F, Martinez-Aran A, Torrent C 2001a ; Risperidone safety and efficacy in the treatment of bipolar and schizoaffective disorders: results from a 6-month, multicenter, open study. J Clin Psychiatry 62: 818-825. Vieta E, Reinares M, Corbella B, Benabarre A, Gilaberte I, Colom F, Martinez-Aran A, Gasto C, Tohen M 2001b ; Olanzapine as longterm adjunctive therapy in treatment-resistant bipolar disorder. J Clin Psychopharmacol 21: 469-473. Waldman ID, Robinson BF, Feigon SA 1997 ; Linkage disequilibrium between the dopamine transporter gene DAT1 ; and bipolar disorder: extending the transmission disequilibrium test TDT ; to examine genetic heterogeneity. Genet Epidemiol 14: 699-704. Wehr TA, Goodwin FK 1987 ; Can antidepressants cause mania and worsen the course of affective illness? J Psychiatry 144: 1403-1411. Weissman MM 1997 ; Interpersonal psychotherapy: current status. Keio J Med 46: 105-110. Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, Joyce PR, Karam EG, Lee CK, Lellouch J, Lepine JP, Newman SC, Rubio-Stipec M, Wells JE, Wickramaratne PJ, Wittchen H, Yeh EK 1996 ; Cross-national epidemiology of major depression and bipolar disorder. JAMA 276: 293-299. Winsberg ME, DeGolia SG, Strong CM, Ketter TA 2001 ; Divalproex therapy in medication-naive and mood-stabilizer-naive bipolar II depression. J Affect Disord 67: 207-212. Yaroslavsky Y, Grisaru N, Chudakov B, Belmaker RH 1999 ; Is TMS therapeutic in mania as well as in depression? Electroencephalogr Clin Neurophysiol Suppl 51 ; : 299-303. Young LT, Joffe RT, Robb JC, MacQueen GM, Marriott M, PatelisSiotis I 2000 ; Double-blind comparison of addition of a second mood stabilizer versus an antidepressant to an initial mood stabilizer for treatment of patients with bipolar depression. J Psychiatry 157: 124-126. Zaretsky AE, Segal ZV, Gemar M 1999 ; Cognitive therapy for bipolar depression: a pilot study. Can J Psychiatry 44: 491-494. Zornberg GL, Pope HG 1993 ; Treatment of depression in bipolar disorder: new directions for research. J Clin Psychopharmacol 13: 397-408.
Objective: In patients with long-term anorexia nervosa body-image disturbance, thinking about food and anxiety concerning weight gain sometimes shows delusional quality. Five cases gave us reason to treat adolescent anorexic patients age 12 to 17, Body Mass Index 11, 7 to 15, 6 ; with olanzapine. Methods: Effective dosages ranged from 5 to 12, 5 mg daily. We reduced dosages when the maintenance of a satisfactory state of weight and psychopathology appeared possible without medication. Results: Based on our clinical observations, delusional body-image disturbances, aversion of food-intake and rigidity of thinking seem to respond remarkably well to olanzapine treatment. Within a few days only our patients better related to reality, their cooperation increased, and the overall therapeutic process could advance. There were no serious adverse events in these cases. Conclusions: With conventional therapeutic regimes failing, administration of the novel antipsychotic olanzapine helped to decrease paranoid ideation in chronic anorexia nervosa. Inner tensions and phobia with respect to food intake were reduced. Olanzapine therefore might represent an important therapeutic tool in severely anorexic patients. References: J. Newman-Toker 2000 ; : Risperidone in anorexia nervosa, J Acad Child Adolesc Psychiatry Letter ; 39: 941f M.C. La-Via et al. 2000 ; : Case reports of olanzapine treatment of anorexia nervosa, Int J Eat Disord 27 3 ; : 363. Contrast, if a patient has highly symptomatic hyperprolactinemia that, along with amenorrhea, causes decreased libido, bothersome galactorrhea, impotence, or osteoporosis, then a more active treatment strategy is necessary. Assuming that the patient needs to continue taking medication for an underlying disorder, switching to another drug in the same class that does not cause hyperprolactinemia is the easiest way to correct the problem. Thus, for a patient with antipsychotic-induced hyperprolactinemia, switching to drugs such as olanzapine, clozapine, or quetiapine may eliminate hyperprolactinemia.17, 27, 113 Similarly, for a patient with antidepressant-induced hyperprolactinemia, switching to an alternative antidepressant may be successful. Again, all such medication changes must be done under the supervision of the patient's psychiatrist, and consideration must be given to other potential adverse effects of these alternative medications. There are many antihypertensive agents; therefore, switching a patient from verapamil to an alternative generally should not be a problem. However, for a patient with gastroparesis, no good alternatives to metoclopramide exist currently in the United States, although erythromycin has been used in some studies. Because of its association with cardiac dysrhythmias, cisapride is no longer available in the United States. If a patient has symptomatic hyperprolactinemia and cannot be switched from his or her medication, other treatments could be considered. If the major concern is decreased estrogen or testosterone levels, then simple substitution with estrogen or testosterone can be done. If the concern is osteoporosis, a bisphosphonate could be used. The most difficult treatment modality is to treat a patient with a dopamine agonist while continuing current medication. This modality has been used primarily in small numbers of patients with antipsychotic-induced hyperprolactinemia; there is a small risk of the dopamine agonist exacerbating the underlying psychosis, and the dopamine agonist is not always successful in normalizing PRL levels. In 1 series of 7 patients with hyperprolactinemia and galactorrhea from various antipsychotic medications who were treated with bromocriptine, 2 achieved normal PRL levels, 4 experienced considerable decreases in PRL levels, and galactorrhea improved in all.114 In another series of 9 patients with hyperprolactinemia from thioridazine, 4 achieved normal PRL levels with bromocriptine with no worsening of psychiatric status.115 In a third series of 6 women with hyperprolactinemia and amenorrhea or oligomenorrhea from various antipsychotics, 4 achieved normal PRL levels and experienced menstrual irregularity with bromocriptine, but in 1 of these 4, mental status worsened.116 In a more recent series of 4 patients with risperidone-induced hyperprolactinemia, bromocriptine or cabergoline reduced. Dillon is Different: Fragile X Syndrome. To talk to 10-year-old Dillon Kelly, it is not readily apparent that he has a form of mental retardation. But that does not stop his 4th-grade classmates, who discern that he is unlike them without understanding why, from teasing and shunning him. In this program, ABC News anchor Ted Koppel compassionately presents Dillon's story as an opportunity to better understand the genetic disorder called Fragile X Syndrome. Through anecdotes, Dillon's family members describe aspects of his behavior, the ostracism he faces, and the time when, in a bold and unusual step, they went to his school to explain to his peers why he is different. Produced and distributed by Films for the Humanities and Sciences. 23 minutes. 2004. Discovery: Pathways to Better Speech for Children with Down Syndrome. This DVD offers practical advice, examples, and expertise for parents and professionals to follow as they help children with Down syndrome from infancy to age seven become the best talkers they can be. It covers the what, when, and how of speech development, including: communication milestones, hearing issues, encouragement of speech, making speech understandable when talking begins, building vocabulary and grammar, and connections between reading and speech. Produced and distributed by Woodbine House. 81 minutes, 2006. Down Syndrome: The First 18 Months. Thirteen leading medical and developmental experts on Down syndrome, experienced parents, and infants and toddlers with Down syndrome are brought together in this heartwarming DVD to inform, inspire, guide, and support. Produced and distributed by Woodbine House. 108 minutes, 2004. Emma's Gifts. Emma's Gifts is a film about differences--how they matter and how they don't. Emma was born with Down syndrome which makes her different from her twin sister, Abigale. In telling Emma's story through the eyes of her parents, the film challenges our perception of difference. As we experience this family's journey through the preschool years, we see the power of advocating for a child's rights and the importance of early intervention. As we experience the strategies used to mainstream Emma in the school environment and witness the grueling process of the Individual Education Plan meeting, we see that anything is possible, that everyone benefits from including children with special needs in their community and educational environments. Produced and distributed by Emma's Gifts Productions. 2005. Graduating Peter. Graduating Peter is the thought-provoking follow-up to the 1992 Academy Awardwinning documentary, Educating Peter, which highlights the experiences of Peter Gwasdauskis, a child with Down syndrome, in the sixth grade, eighth grade, and high school as he adds speech therapy and life skills classes and on-the-job training to his academic coursework. Interviews with Peter's parents, teachers, fellow students, aids, and doctors demonstrate the broad-based, ongoing support mobilized to help him fight depression, improve his ability to communicate, and move ahead in building a meaningful life for himself. Distributed by Films for the Humanities and Sciences. 75 minutes, 2001. Also see the videotape, Educating Peter. Passport to=176>