The U.S. Food and Drug Administration has issued a safety announcement that the risk of progressive multifocal leukoencephalopathy (PML) increases with the number of infusions received of Tysabri (natalizumab) (www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm199872.htm).
Neurology
SSRIs in Alzheimers disease: mixed results
March 30, 2010Major depression has been reported to occur in 25% of patients with Alzheimers disease but the role of antidepressants in patient management is unclear. An Italian study of patients receiving a cholinesterase inhibitor + an SSRI reported a reduction in depressed symptoms and improvements in quality of life for patients and caregivers with SSRI use (Moretti et al. Am J Alzheimers Dis Other Demen 2002; 17: 338-344).
Caution needed when discontinuing dopamine agonists
March 30, 2010A retrospective cohort study has reported that a withdrawal syndrome is common in PD patients who discontinue treatment with a dopamine agonist (Rabinak & Nirenberg. Arch Neurol 2010; 67: 58-63).
Ginkgo ineffective at preventing cognitive decline
March 30, 2010Ginkgo biloba is often taken by older adults to prevent cognitive decline but the herbal product appears to be ineffective, according to the Gingko Evaluation of Memory (GEM) study (Snitz et al. JAMA 2009; 302: 2663-2670).
Behavioural symptoms appear improved with prazosin
March 2, 2010Prazosin is an alpha-adrenergic blocker used to treat hypertension and benign prostatic hypertrophy. The drug also antagonizes norepinephrine at brain postsynaptic alpha-1 adrenoreceptors, and a pilot study has investigated its possible use to treat agitation and aggression in Alzheimers disease (Wang et al. Am J Geriatr Psychiatry 2009; 17: 744-751). Prior studies have suggested that an increased number of alpha-1 adrenoreceptors is correlated with aggressive behaviour (Sharp et al. Am J Geriatr Psychiatry 2007; 15: 435-437).
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