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Relapse prevention in first-episode schizophrenia: role of long-acting injectables

…ed with brain volume changes (Andreasen et al. Am J Psychiatry 2013;170:609-615; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3835590/). Inadequate treatment early in the course of illness may be associated with poorer outcomes. A 15-year follow-up study found that two-thirds of patients experienced at least one relapse, and that after each relapse, 17% could no longer achieve remission. Only 26.8% of first-episode patients experienced a…

Serotonergic mechanisms in PD: two reports

…using radiolabelled PET imaging (Politis et al. J Clin Invest 2014;124:1340-1349; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC3934188/pdf/JCI71640.pdf). PD patients with LIDs demonstrate higher synaptic levels of dopamine compared to non-dyskinetic patients due to abnormal release and clearance of striatal dopamine, and it was hypothesized that this may be due in part to dopamine storage and release by non-dopaminergic terminals. Seroto…

Future uncertain for active immunotherapies in AD – Part 1

…cular impairment (Kokjohn & Roher. CNS Neurol Disord Drug Targets 2009;8:88-97; free full text at www.ncbi.nlm.nih.gov/pmc/articles/PMC2742220/pdf/nihms129931.pdf). However, targeting beta-amyloid has raised some concerns, notably that AN1792 was able to mobilize beta-amyloid from senile plaques but did not remove it from the brain (Patton et al. Am J Pathol 2006;169:1048–1063). Moreover, it has been suggested that mobilized beta-amyloid may depos…

Toward a new standard in MS disease control

…with alemtuzumab and 0.40 with IFNb-1a; the proportion of patients relapse-free was 76.2% and 50.4%, respectively (hazard ratio 0.40). Patients in the alemtuzumab group were also more likely to be free of enhancing T1 lesions (90.3% vs. 66.1%), new/enlarging T2 lesions (71.2% vs. 45.6%), and hypointense T1 lesions (“black holes”; 90.4% vs. 68.4%). While there was not a substantial difference in NEDA in this group with highly active disease (25.5%…

Poor adherence to migraine prophylaxis

…iptyline) and weight gain (divalproex) (Kowacs et al. Headache 2009;49:1022-1027). Comment Dr. Daniel Selchen: This interesting analysis of multiple studies suggests that both adherence and persistence are poor with migraine prophylactic agents, particularly beyond six months. What it does not do, however, is sort out to what extent the adherence and persistence issues relate to efficacy failure as opposed to other factors. Not surprisingly, the s…