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Breastfeeding not a sustainable therapy

July 11, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – Studies to determine if exclusive breastfeeding reduces relapse frequency postpartum have produced conflicting results (Langer-Gould et al. Arch Neurol 2009;66:958-963; Portaccio et al. Neurology 2011;77:145-150; Nelson et al. JAMA 1988;259:3441-3443).

Langer-Gould and colleagues have now followed 72 women with MS through their pregnancy and for 12 months postpartum to examine this issue further (Hellwig et al. AAN 2012; abstract P06.186).

Exploratory study of higher carbidopa dosing

July 11, 2012

REPORT FROM THE AMERICAN ACADEMY OF NEUROLOGY (AAN) ANNUAL MEETING, NEW ORLEANS LA, APRIL 21-28, 2012 – The recommended doses of carbidopa (CD) to increase levodopa availability are in the range of 75-200 mg/day. A small double-blind crossover trial has explored whether higher carbidopa doses are clinically useful (Nutt et al. AAN 2012; abstract S02.006).

The caveat is that higher carbidopa doses have the potential to inhibit amino acid decarboxylase and reduce dopamine formation in the striatum.

Flunarizine, topiramate effective in migraine prophylaxis

June 6, 2012

A one-year study reports that topiramate and flunarizine are both effective in migraine prophylaxis, although combining the two agents does not produce significantly greater efficacy (Luo et al. Pain Med 2012;13:80-86).

Internet-based CBT an option for social anxiety disorder

June 6, 2012

A Swedish study recently reported that cognitive-behavioural therapy (CBT) administered via the Internet was as effective as conventional cognitive-behavioural group therapy (CBGT) in the treatment of social anxiety disorder (Hedman et al. PLoS One 2011;6:e18001; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3070741/pdf/pone.0018001.pdf).

In that study, 126 subjects with social anxiety disorder received either iCBT or CBGT for 15 weeks, then assessed with the Liebowitz Social Anxiety Scale. A total of 64% of subjects in the iCBT group and 45% in the CBGT group were classified as responders (non-inferior).

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