Strontium Ranelate Reduces Osteoporosis Fractures: In a DB PC 3-year study of 5091 postmenopausal women with osteoporosis, those given strontium ranelate (2 g/day) had a reduction by 16% for all non-vertebral fractures (P = 0.04), and by 19% for major fragility fractures (hip, wrist, pelvis and sacrum, ribs and sternum, clavicle, humerus) (P = 0.031). Relative risk of vertebral fractures was reduced by 39% (P < 0.001) in the 3640 patients with spinal x-rays. Strontium ranelate increased BMD throughout the study, reaching at 3 yr (P < 0.001): + 8.2% (femoral neck) and + 9.8% (total hip). Side-effects were similar in both groups. Strontium ranelate offers a safe and effective means of reducing the risk of fracture associated with osteoporosis. Reginster JY, Seeman E, et al. University of Liege, Belgium and many other European centers. J Clin Endocrinol Metab. 2005 Feb 22. For more, see Osteoporosis.

Anti-Convulsants: Impulsive Aggression Reduced: In a 6-week DB PC study of 29 impulsive aggressive men, those given phenytoin (n = 7), carbamazepine (n = 7), or valproate (n = 7) showed a significant reduction in impulsive aggression. A comparison of anticonvulsants in the treatment of impulsive aggression. Stanford MS, Helfritz LE, et al. Baylor University. Exp Clin Psychopharmacol. 2005 Feb;13(1):72-7. For more, see Aggression.

Higher Dose Atomoxetine (Strattera) if ADHD Youth has ODD as well: In a large 8-week DB PC study of 293 children ages 8-18 with ADHD with (39%) or without (61%) oppositional defiant disorder (ODD), atomoxetine (0.5, 1.2, or 1.8 mg/kg/day, b.i.d.) was given. Both groups showed similar improvement, but those with ADHD plus ODD needed 1.8 mg/kg/day but not 1.2 mg/kg/day. In contrast, youths without ODD showed improvement at 1.2 mg/kg/day and extra benefit at 1.8 mg/kg/day. Atomoxetine Treatment in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder and Comorbid Oppositional Defiant Disorder. Newcorn JH, Spencer TJ, et al. Mount Sinai, Massachusetts General, and Eli Lilly drug company. J Am Acad Child Adolesc Psychiatry. 2005 Mar;44(3):240-248. Ed: It is sad to see drug companies employees working so closely with academic researchers in studies being funded by the drug companies.  The opportunities for influencing the reported results are vast.  For more, see ADHD.

Lead and Cadmium Hair Levels Reduced by Magnesium Supplementation: Magnesium deficiencies may cause increased accumulation of toxic metals including lead and cadmium. In a study of 124 adults in Szczecin, Poland, 65 had high lead levels and participated in a DB PC study. Those taking slow-Mag-B6 preparation at the total daily dose of five tablets divided into 2-3 doses (535 mg of magnesium chloride and 25 mg of vitamin B6 for 3 months had a decrease of lead and cadmium hair content. Magnesium and chosen bioelements in hair. Kozielec T, Salacka A, Karakiewicz B. Pomeranian Medical University, Szczecin, Poland. Magnes Res. 2004 Sep;17(3):183-8. For more, see Magnesium.

Retinaldehyde: New Oinment for Acne: In a DB PC study of mild to moderate acne patients, a 0.1% retinaldehyde/6% glycolic acid combination (Diacneal((R))) led to 'important/very important' global improvement at month 2 (50.0 vs. 26.3%), and confirmed by patients at month 3 (86.1 vs. 58.8%). Only 1 patient had to stop the treatment. A Multicentre, Double-Blind, Randomized, Vehicle-Controlled Trial. Poli F, Ribet V, et al. Vigoulet-Auzil, France. Dermatology. 2005;210 Suppl 1:14-21. For more, see Acne.

Aliskiren: New Renin Inhibitor for High Blood Pressure: A new anti-hypertensive, aliskiren (300-600 mg/d), which works at the most upstream point of the of the renin-angiotensin system did as well as irbesartan, an established ARB, at lowering blood pressure, but showed very few side-effects in an 8-week DB PC study of 652 patients. Aliskiren, a Novel Orally Effective Renin Inhibitor, Provides Dose-Dependent Antihypertensive Efficacy and Placebo-Like Tolerability in Hypertensive Patients. Gradman AH, Schmieder RE, et al. Western Pennsylvania Hospital, Pittsburgh, PA. Circulation. 2005 Feb 21. For more, see High Blood Pressure.

Fish Oil with Olive Oil Helped Rheumatoid Arthritis: In a 24-week DB PC study of 43 rheumatoid arthritis victims, fish oil omega-3 fatty acids (3 g/d) led to a statistically significant improvement (P < 0.05) in joint pain intensity, right and left handgrip strength after 12 and 24 wk, duration of morning stiffness, onset of fatigue, Ritchie's articular index for pain joints after 24 wk, ability to bend down to pick up clothing from the floor, and getting in and out of a car after 24 wk. However, there was a more precocious and accentuated improvement when fish oil supplements were used in combination with olive oil 9.6 mL. Supplementation of fish oil and olive oil in patients with rheumatoid arthritis. Berbert AA, Kondo CR, et al. Londrina State University, Parana, Brazil. Nutrition. 2005 Feb;21(2):131-6. For more, see Arthritis.

Quetiapine (Seroquel) Increased Dementia Impairment; Neither It Not Rivastigmine Helped Agitation: In a 26-week DB PC study of 93 agitated Alzheimer's patients comparing the atypical antipsychotic (quetiapine), cholinesterase inhibitor (rivastigmine) and placebo, neither medication group showed significant improvement on agitation either at six weeks or 26 weeks. For quetiapine, the worsening in severe impairment battery score from baseline was 14.6 points worse than in the placebo group at six weeks (P=0.009) and 15.4 points (-27.0 to -3.8) worse at 26 weeks (P=0.01). Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial. Ballard C, Margallo-Lana M, et al. King's College, London SE5 8AF. Ed: Since haloperidol increases hyperphosphorylation of tau protein, a critical deterioration in Alzheimer's, perhaps some or all atypical anti-psychotics do as well. For more, see Agitation in Dementia.

Estrogen Didn't Help Schizophrenic Women: In a DB PC cross-over study of 46 hypoestrogenic women hospitalized for schizophrenia with an average age of 38, there was no added advantage to high or low dose estrogen in addition to standard anti-psychotic treatment. Estrogen as an adjuvant therapy to antipsychotics does not prevent relapse in women suffering from schizophrenia: results of a placebo-controlled double-blind study. Bergemann N, Mundt C, et al. Ruprecht-Karls-University of Heidelberg, Germany. Schizophr Res. 2005 May 1;74(2-3):125-34. For more, see Other Treatments for Schizophrenia.

Temporoparietal rRepetitive transcranial magnetic stimulation (rTMS) on the right temporoparietal cortex did better than left-sided of sham stimulation in 39 schizophrenic patients with treatment-refractory auditory hallucinations. rTMS was applied to the TP3 or 4 brain regions with the aid of the electroencephalography 10-20 international system at 1Hz for 20min per day for 10 treatment days. A double blind study showing that two weeks of daily repetitive TMS over the left or right temporoparietal cortex reduces symptoms in patients with schizophrenia who are having treatment-refractory auditory hallucinations. Lee SH, Kim W, et al. Inje University of Korea, Koyang, South Korea. Neurosci Lett. 2005 Mar 16;376(3):177-81. For more, see rTMS for Schizophrenia.

SSRIs Increase Suicide Attempts Initially: In a review of all Medline and the Cochrane Collaboration's registered controlled trials through November 2004, 702 trials involving 87,650 patients met the inclusion criteria. A significant increase in the odds of suicide attempts (odds ratio 2.28, number needed to treat to harm 684) was observed for patients receiving SSRIs compared with placebo. An increase in the odds ratio of suicide attempts was also observed in comparing SSRIs with therapeutic interventions other than tricyclic antidepressants (1.94, 239). In the pooled analysis of SSRIs versus tricyclic antidepressants, no significant difference was found (0.88). Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials. Fergusson D, Doucette S, et al. Ottawa Health Research Institute, Canada. BMJ. 2005 Feb 19;330(7488):396. For more, see SSRIs for Depression.

Risperidone Helped Autism and Pervasive Developmental Disorders: In an 8-week DB PC study of 79 children ages 5-12 with autism and other pervasive developmental disorders (PDD), risperidone (0.01-0.06 mg/kg/day) led to a significant decrease in irritability (64% vs. 31% for placebo). Significantly greater decreases were also found on conduct problems, insecure/anxious, hyperactive and overly sensitive test subscales.  More risperidone-treated subjects showed global improvement (87% vs. 40%). Somnolence was noted in 72% vs. 8% of children. Risperidone led to more weight gain (6 pounds vs. 2 pounds), pulse rate and systolic blood pressure. Risperidone in the treatment of disruptive behavioural symptoms in children with autistic and other pervasive developmental disorders. Shea S, Turgay A, et al. (2004) Pediatrics, 114, e634-e641. Ed: If using an atypical anti-psychotic, ziprasidone (Geodon) seems a better first choice in view of its lack of weight gain and much lower cost. For more, see Autism.

Rofecoxib (Vioxx) Increased Thrombotic Events: In a planned 3-year DB PC study of the effect of rofecoxib on the risk of recurrent neoplastic polyps of the large bowel in 2,586 patients with a history of colorectal adenomas, 46 patients in the rofecoxib group had a confirmed thrombotic event during 3,059 patient-years of follow-up, as compared with 26 patients in the placebo group during 3,327 patient-years of follow-up, a 92% increase with rofecoxib; P=0.008). Overall and cardiovascular mortality was similar in the two groups. Conclusions Among patients with a history of colorectal adenomas, the use of rofecoxib was associated with an increased cardiovascular risk. Cardiovascular Events Associated with Rofecoxib in a Colorectal Adenoma Chemoprevention Trial. Bresalier RS, Sandler RS, et al. N Engl J Med. 2005 March 17. Ed: As everyone knows, Vioxx was pulled from the market shortly after this study.

Celecoxib (Celebrex) Increased Death, Heart Attacks, Strokes, and Heart Failure: In a 3-year DB PC study of 2035 patients with a history of colorectal neoplasia given celecoxib (200 mg or 400 mg twice daily) with placebo for the prevention of colorectal adenomas, a composite cardiovascular end point of death from cardiovascular causes, myocardial infarction, stroke, or heart failure was reached in 7 of 679 patients in the placebo group (1.0 percent), as compared with 16 of 685 patients receiving 200 mg of celecoxib twice daily (130% increase)(2.3%; HR = 2.3) and with 23 of 671 patients receiving 400 mg of celecoxib twice daily (240% increase)(3.4%; HR = 3.4). Celecoxib use was associated with a dose-related increase in the composite end point of death from cardiovascular causes, myocardial infarction, stroke, or heart failure. Cardiovascular Risk Associated with Celecoxib in a Clinical Trial for Colorectal Adenoma Prevention. Solomon SD, McMurray JJ, et al. N Engl J Med. 2005 March 17. Ed: Eventhough Celebrex appears to have done worse than Vioxx, it has not ben removed from the market. For more, see Coronary Heart Disease Risk Factors.

Benign Prostatic Hypertrophy Increases Erectile Dysfunction: In the 4-year DB PC Proscar Long-Term Efficacy and Safety Study of 3,040 men with moderate to severe lower urinary tract symptoms and an enlarged prostate gland, at baseline every 1 point increase in benign prostatic hypertrophy urinary symptom score was associated with a 2% increased risk of erectile dysfunction (ED) even after controlling for age (p <0.001). At 48 months in placebo but not in finasteride treated men a 1-unit decrease in quasi-AUASS was associated with a slight but statistically significant decrease in ED. No association existed between increasing PSA and ED. The relationship among lower urinary tract symptoms, prostate specific antigen and erectile dysfunction in men with benign prostatic hyperplasia: results from the proscar long-term efficacy and safety study. Paick SH, Meehan A, et al. University of Washington, Seattle. Ed: Since finasteride seems to prevent both BPH and more ED, I expect that saw palmetto would, too. For more, see Erectile Dysfunction.

Pain Pills Increase Blood Pressure: In a review of 19 DB studies before May, 2004, with 45,451 participants, COX-2 inhibitors caused an increase in systolic and diastolic BP compared with placebo (3.85/1.06 mm Hg) while nonselective NSAIDs caused an increase as well (2.83/1.34 mm Hg). COX-2 inhibitors caused a 61% increase in hypertension vs a 25% increase with other NSAIDs. Meta-analysis of Cyclooxygenase-2 Inhibitors and Their Effects on Blood Pressure. Aw TJ, Haas SJ, et al. Monash University, Melbourne, Australia. Arch Intern Med. 2005 Feb 14. Ed: While these increases are small, physician refusal to recommend non-prescription alternatives such as glucosamine with chondroitin for arthritis is difficult to understand. For more, see High Blood Pressure.

Saffron Might Help Depression: Saffron is used for depression in Persian traditional medicine. In a 6-week DB PC study of 40 adults with mild to moderate depression, a hydro-alcoholic extract of Crocus sativus (stigma) 30 mg/day did as well as fluoxetine 20 mg/day (BD). Hydro-alcoholic extract of Crocus sativus L. versus fluoxetine in the treatment of mild to moderate depression: a double-blind, randomized pilot trial. Noorbala AA, Akhondzadeh S, et al. Tehran University, Tehran, Iran. J Ethnopharmacol. 2005 Feb 28;97(2):281-4. Ed: Unfortunately, in such a small study without a control group, it is hard to tell if either group would have done better than placebo.

St. John's Wort as Good as SSRI for Depression: In a 6-week DB PC study of 251 adults with acute moderate to severe major depression, hypericum extract WS 5570 (St John's wort; 300 mg three times a day) did as well as paroxetine (Paxil). In initial non-responders doses were increased to 1800 mg/day hypericum or 40 mg/day paroxetine after two weeks. The Hamilton depression total score decreased by mean 14.4 points, corresponding to 57% of baseline with hypericum vs. 11.4 points (45%) with paroxetine (intention to treat analysis). Hypericum had fewer side-effects. Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John's wort): randomised controlled double blind non-inferiority trial versus paroxetine. Szegedi A, Kohnen R, et al. Charite-Universitatsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. BMJ. 2005 Feb 11. Ed: With dozens of such studies, it is surprising that American physicians don't encourage St. John's wort. Some people do take it on their own, although probably many of these don't really need it. For more, see Herbal Treatments for Depression.

Amsterdam Drug Users Die at High Rate: In a 17 year follow-up of 899 participants in the Amsterdam Cohort Study among Drug Users, at least 27% had died within 20 years after starting regular drug use; for half, death had been due to causes unrelated to human immunodeficiency virus. Among those still alive, the estimated prevalence of abstinence for at least 4 months from the above drugs and methadone was only 27% at 20 years since initiation. A higher age at initiation, a calendar year of initiation before 1980, and a Western European ethnic origin were associated with higher prevalence of abstinence.  "Maturing out" to a drug-free state does not apply to the majority of drug users. Long-term outcome of chronic drug use: the Amsterdam Cohort Study among Drug Users. Termorshuizen F, Krol A, et al. Amsterdam, the Netherlands. Am J Epidemiol. 2005 Feb 1;161(3):271-9. For more, see Substance Abuse.

Adderall XR Banned in Canada: Because of reports of a relatively small number of sudden deaths reported to the FDA in American children being given Adderall XR for ADHD, Canada has decided to ban the drug.  The U.S. FDA says that the rate of sudden death based on the 30 million prescriptions written between 1999 and 2003 does not appear to be increased over the expected rate without Adderall.  The manufacturer has notified physicians.  Unfortunately, the manufacturer doesn't say how many deaths have been reported to the FDA. Adderall already carries a warning of sudden death in patients with structural cardiac abnormalities and a warning about misuse of amphetamines.  For more, see ADHD Treatment. 

Placebo Did Better Than Fludrocortisone Plus Salt for Childhood Syncope: In a 1-year DB PC study of 33 children with syncope or severe presyncope, fludrocortisone 0.1 mg/day and salt 1 g/day, a commonly recommended treatment, did worse than placebo. At one-year follow-up, symptoms recurred in 10 of 18 children on fludrocortisone and salt and in 5 of 14 children on placebo (p < 0.04). Children on placebo had no symptoms until they discontinued their study medications. Effectiveness of fludrocortisone and salt in preventing syncope recurrence in children: a double-blind, placebo-controlled, randomized trial. Salim MA, Di Sessa TG. University of Tennessee. J Am Coll Cardiol. 2005 Feb 15;45(4):484-8. Ed: Syncope, i.e. fainting, is a side-effect of a couple psychiatric medications.  The same treatment has been recommended, without proof, in such cases. v

Topical BCG Works Well for Genital Warts: In a 6-month DB PC study of 50 patients with genital warts (condylomata acuminata), topical application of viable bacille Calmette-Guerin (BCG) weekly for 6 consecutive weeks, and, if need, another intensive three-times-a-week course for 3 consecutive weeks was given. Disappearance of all condylomata acuminata was achieved in 20 (80%) of the 25 patients after a maximum of six BCG applications. Three patients (12%) needed another, more extensive, course, resulting in complete clearance 3 weeks later. Only 2 patients (8%) did not achieve a full response. No response was detected in the placebo group. Minimal side effects, such as transient erythema and fever, were recorded. No recurrence during follow-up. Application of viable bacille Calmette-Guerin topically as a potential therapeutic modality in condylomata acuminata: a placebo-controlled study. Metawea B, El-Nashar AR, et al. Cairo University Hospital, Egypt. Urology. 2005 Feb;65(2):247-50. v

Kothala Himbutu Tea Said to Help Diabetes: In a 6 month DB PC crossover study of 51 stable type II diabetics being treated with exercise, diet, medication, and lifestyle modification, an herbal tea containing Salacia reticulata (Kothala Himbutu tea) for three months results in the HbA(1)C being significantly lower (6.29 versus 6.65; P=0.008). A statistically significant fall in HBA1c was seen with the active tea compared to a rise in HbA(1)C with the placebo tea (0. 54 versus -0.3; P<0.001). The daily mean dose of Glibenclamide fell by 1.89 mg in the drug treated group but rose by 2.25 mg in the placebo treated group (P=0.07). The differences in the metformin dose were not significantly significant in the two groups. We conclude that Kothala Himbutu tea is an effective and safe treatment for type 2 diabetes. A double blind randomised placebo controlled cross over study of a herbal preparation containing Salacia reticulata in the treatment of type 2 diabetes. Jayawardena MH, de Alwis NM, et al. University of Sri Jayawardanapura, Sri Lanka. J Ethnopharmacol. 2005 Feb 28;97(2):215-8. For more, see Diabetes.

Sperm Motility Helped by Carnitine in Half of Men: In a study of 30 asthenozoospermic men given placebo for 3 months, L-cartinine 2 g/day for 3 months and against placebo for 3 months, only the half with normal phospholipid hydroperoxide glutathione peroxidase (PHGPx) levels showed an improvement of mean sperm motility. Oral carnitine supplementation increases sperm motility in asthenozoospermic men with normal sperm phospholipid hydroperoxide glutathione peroxidase levels. Garolla A, Maiorino M, et al. University of Padova, Italy. Fertil Steril. 2005 Feb;83(2):355-61. Ed: I like the carnitines. For more, see The Carnitines.

Venlafaxine (Effexor) Helped Migraines: In a 2-month DB PC study of 60 migraine patients without aura, venlafaxine XR 150 mg resulted in a lower rate of migrain attacks than placebo (P= .006). Patient satisfaction was better with both venlafaxine XR 75 and 150 (P= .001 at visit 2 and visit 6). 80% of patients on 75-mg and 88.2% on 150-mg rated treatment benefits as either good or very good. The efficacy and safety of venlafaxine in the prophylaxis of migraine. Ozyalcin SN, Talu GK, et al. Headache 2005;45:144-152. For more, see Migraines.

Venlafaxine and SSRI Equally Effective for Social AnxietyIn a 12-week DB PC study of 440 adults with social anxiety disorder, venlafaxine hydrochloride ER (75-225 mg/d) did as well as paroxetine (20-50 mg/d) and better than placebo at 26 centers in the United States on the Liebowitz Social Anxiety Scale. Mean daily doses were 201.7 mg of venlafaxine hydrochloride ER and 46.0 mg of paroxetine. Week 12 response rates were significantly greater for the venlafaxine ER and paroxetine groups (58.6% and 62.5%) vs the placebo group (36.1%) (P < .001). Liebowitz MR, Gelenberg AJ, Munjack D. New York State Psychiatric Institute. Arch Gen Psychiatry. 2005 Feb;62(2):190-8. Ed: Both of these drugs have frequent bad withdrawal reactions. Other SSRIs, tricyclics, hydroxyzine, or anti-depressants seem more desirable.

Venlafaxine Helped Social Anxiety: In a 12-week DB PC study of 271 adults with generalized social anxiety disorder, Improvement was significantly greater with venlafaxine ER (75-225 mg/d) than with placebo at weeks 6 through 12 (p < .05, week 6, and p < .001, week 12). The response rate was 44% vs. 30%, and the remission rate: 20% vs. 7%, respectively, p < .01). A Randomized Controlled Trial of Venlafaxine Extended Release in Generalized Social Anxiety Disorder. Liebowitz MR, Mangano RM, et al. New York State Psychiatric Institute. J Clin Psychiatry. 2005 Feb;66(2):238-247. Ed: Many less expensive anti-depressants do just as well, but venlafaxine-XR is still patent-protected so can get large profits by financing such studies. For more, see Social Anxiety.

Stroke Risk High with Olanzapine (Zyprexa), too: Post-hoc analysis by the Eli Lilly drug company of 5 randomized clinical trials using olanzapine in patients with dementia, has shown that patients taking olanzapine have a risk of experiencing a stroke which is 3 times higher than patients taking placebo. van Marum RJ, Jansen PA. Universitair Medisch Centrum Utrecht, Netherlands. Ned Tijdschr Geneeskd. 2005 Jan 22;149(4):165-7. Ed: Strokes in the elderly are doubled by risperidone compared to placebo, but increased only 10% compared to traditional anti-psychotics. For more, see Strokes from Atypicals.

Melatonin as Good or Better than Zolpidem Sleeping Pill and Without Memory or Performance Impairment: In a DB PC study of 80 adults after a good night's sleep, zolpidem 0, 5, 10, or 20 mg was given at 10:00 am and then oral melatonin 0 or 5 mg at 10:30 am (thus, n = 10 per drug combination). Subjects napped from 10:00 am to 11:30 am, at which time they were awakened for cognitive tests. A second nap ensued from 12:45 pm to 4:00 pm, followed by further testing. Melatonin 5 mg plus zolpidem 0 mg enhanced daytime sleep (P < .05) with no memory or performance impairment (P > .05). Zolpidem 20 mg plus melatonin 0 mg also enhanced daytime sleep nonsignificantly, but memory and vigilance were impaired (P < .05). Melatonin's sleep-promoting effects were not evident until the second nap. Daytime sleep and performance following a zolpidem and melatonin cocktail. Wesensten NJ, Balkin TJ, et al. Walter Reed. Sleep. 2005 Jan 1;28(1):93-103. Ed: Melatonin's great. For more, see Melatonin.

DHEA Helped Middle-Aged Depression: In a DB PC crossover study of 46 adults ages 45-65, six weeks of DHEA therapy, 90 mg/d for 3 weeks and 450 mg/d for 3 weeks led to a significant improvement in the 17-Item Hamilton Depression Rating Scale compared to both baseline and placebo (P<.01). A 50% or greater reduction in baseline Hamilton Depression Rating Scale scores was observed in 23 subjects after DHEA and in 13 subjects after placebo treatments. Sexual functioning also improved. Dehydroepiandrosterone monotherapy in midlife-onset major and minor depression. Schmidt PJ, Daly RC, et al. National Institute of Mental Health, Rockville, MD. Arch Gen Psychiatry. 2005 Feb;62(2):154-62. For more, see Hormones for Depression.

Fluoxetine (Prozac) as Good as Mirtazapine (Remeron): In an 8-week DB PC study of 297 severely depressed adults, mirtazapine 15-60 mg/day did as well as fluoxetine 20-40 mg/day and both did better than placebo. No statistically significant differences were noted between the two groups in change from baseline HDRS-17 score at any time point; both treatments were associated with large (~15 points) decreases by study end. No significant between-group differences were observed for the majority of quality-of-life measures. Mirtazapine produced better improvements on 'sleeping assessment 1' (14.9 vs 13.7, p = 0.028) and 'sleeping assessment 2' (p = 0.013) than fluoxetine. Mirtazapine-treated patients experienced a mean weight gain of w pounds compared with a mean decrease in weight of 1 pound for fluoxetine-treated patients (p < 0.001). Some gained much more. Comparison of the effects of mirtazapine and fluoxetine in severely depressed patients. Versiani M, Moreno R, et al. Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. CNS Drugs. 2005;19(2):137-46. Ed: Both are inexpensive and good anti-depressants which are quite different from each other. For more, see Mirtazapine. 

Antibiotics Minor Benefit for Sinusitis: In a 2-week DB PC study of 135 adult patients with a complaint of sinusitis and with pus in the nasal cavity, facial pressure, or nasal discharge lasting longer than 7 days, the half given the standard antibiotic amoxicillin for 10 days showed slightly faster improvement (8 vs. 12 days) but improvement was not significantly different at the end of two weeks, e.i. 30% more in the amoxicillin group felt complete improvement, or 48% vs. 37%. Are antibiotics beneficial for patients with sinusitis complaints? A randomized double-blind clinical trial. Merenstein D, Whittaker C, et al. Johns Hopkins. J Fam Pract. 2005 Feb;54(2):144-51. For more, see Sinusitis.

Iron Deficiency Common in ADHD: Iron deficiency causes abnormal dopaminergic neurotransmission. In a study of 53 French children with ADHD ages 4-14 and 27 controls, serum ferritin levels were lower in the children with ADHD (23 ng/mL) than in the controls (44 ng/mL; P < 0.001). Serum ferritin levels were abnormal (<30 ng/mL) in 84% of children with ADHD and 18% of controls (P < 0.001). Low serum ferritin levels were correlated with more severe general ADHD symptoms (P < 0.02) and greater cognitive deficits (P < 0.01). Iron deficiency in children with attention-deficit/hyperactivity disorder. KonofalE, LecendreuxM, et al. Archives of Pediatrics and Adolescent Medicine, 2004:158:1113-1115. 

Eye Contact and Staring After Parental Commands Helps ADHD Children: In a randomized study of 76 parents of ADHD boys, eye contact was effective in reducing ADHD children's problems with non-compliance to their parents' commands. In addition, those parents who subsequently used a stare technique for 20 to 30 seconds following the command reported even greater reduction in problems with compliance. It is possible that the additional time following the command allows the child to process the situation and decide whether compliance or non-compliance is the better option. Longer eye contact improves ADHD children's compliance with parents' commands. Kapalka GM. Monmouth University, New Jersey. J Atten Disord. 2004 Aug;8(1):17-23.

Four Genes Some Link to Increased ADHD: Dopamine D4 and D5 Receptors, Dopamine and Serotonin Transporters: ADHD is highly heritable but is a complex disorder involving multiple genes. Over 100 studies have examined the genetics of ADHD by linkage or association. Evidence for association exists for four genes in ADHD: the dopamine D4 and D5 receptors, and the dopamine and serotonin transporters; others possibilities include the dopamine D2 and serotonin 2A receptors. All candidate gene give only modest odds ratios for even the best replicated studies. Molecular genetic studies of ADHD: 1991 to 2004. Bobb AJ, Castellanos FX, et al. NIMH. Am J Med Genet B Neuropsychiatr Genet. 2005 Jan 5;132(1):109-25. For more, see ADHD.

35

Thomas E. Radecki, M.D., J.D.

 modern-psychiatry.com