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Poor adherence to migraine prophylaxis

October 8, 2014

…% for propranolol, 55% for amitriptyline, and 57% for topiramate. The most common reason for treatment discontinuation was adverse effects. A previous study of patient preferences reported that adverse effects commonly associated with discontinuation of migraine prophylactic drugs were cognitive effects (topiramate), somnolence (propranolol, amitriptyline) and weight gain (divalproex) (Kowacs et al. Headache 2009;49:1022-1027). Comment Dr. Daniel…

Combining drug and psychotherapy more effective for depression, anxiety

September 24, 2014

…ent evidence with respect to dysthymia, PTSD and GAD. The dropout rate was comparable with combined treatment and drug treatment alone. In examining either therapy alone and combined treatment versus placebo, the analysis found that the effects of psychotherapy and pharmacotherapy were largely independent of one another, with each contributing about 50% of the total treatment effect. Thus, there appears to be an additive benefit when a combination…

Dietary salt may worsen MS

September 12, 2014

…n humans (Kleinewietfeld et al. Nature 2013;496:518-522; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3746493/pdf/nihms500370.pdf). This effect is specific to Th17, with little or no effect on Th1 or Th2 differentiation or proliferation. Moreover, salt-induced Th17 cells demonstrate increased production of pro-inflammatory cytokines, such as TNF-alpha and IL-2. A new study reports that higher salt consumption is associated with increased…

Atacicept: the aftermath

September 3, 2014

…g, 75 mg or 150 mg) or placebo for 36 weeks (Kappos 2014). Ninety patients completed the week 36 visit prior to early termination of the study. Atacicept reduced the number of mature B cells and serum Ig levels. However, the annualized relapse rate was higher in all three treatment groups (25 mg, 0.86; 75 mg, 0.79; 150 mg, 0.98) compared to placebo (0.38). The time to first relapse was also significantly shorter with atacicept 150 mg versus placeb…

Cognitive function in PD: gender effect?

August 20, 2014

…tion and emotions (Heller et al. Aging Dis 2013;5:63-75; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3901615/pdf/ad-5-1-63.pdf). Overall, cognitive dysfunction appeared to be more common in males, although the authors noted that test results are inconsistent. Males with PD were less accurate than females in identifying fearful expression, which is the opposite of what is found in healthy subjects. Women generally reported poorer quality…