Olanzapine
Other drugs are given in addition, and the importance of seeking medical advice in the event of unusual bleeding or bruising. The CSM welcomes reports of serious reactions to, or interactions with, well known drugs, even if such reactions are well documented.
Of family and preventive medicine, working with a number of ivf centers, tried to assess the impact of patient worries on their ivf outcomes konoff-cohen et al, fert ster: vol 81, no 4, 982-988, for example, olanzapine anxiety.
Olanzapine recreational use
Hands down, no other medicine can handle a migraine so quickly, for example, antipsychotic olanzapine.
MEDINCE CABINET CHECKUP About 69% of Americans don't clean out their medicine cabinets every year. Nearly half have taken an out-of-date drug, which can be ineffective and even dangerous. Source: Harris Interactive survey. Olanzapine drug insertAmong patients in a state psychiatric hospital. Schizophr Res 53: 1 6. Chengappa KN, Levine J, Ulrich R, Parepally H, Brar JS, Atzert R, Brienzo R, Gopalani A. 2000. Impact of risperidone on seclusion and restraint at a state psychiatric hospital. Can J Psychiatry 45 9 ; : 827 832. Chiu E, Burrows G, Stevenson J. 1976. Double-blind comparison of clozapine with chlorpromazine in acute schizophrenic illness. Aust NZ J Psychiatry 10: 343 347. Chiu NY, Yang YK, Chen PS, Chang CC, Lee IH, Lee JR. 2003. Olaznapine in Chinese treatment-resistant patients with schizophrenia: An open-label, prospective trial. Psychiatry Clin Neurosci 57: 478 484. Chouinard G, Jones B, Remington G, Bloom D, Addington D, MacEwan GW, Labelle A, Beauclair L, Arnott W. 1993. A Canadian multicenter placebo-controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic patients. J Clin Psychopharmacol 13: 25 40. Citrome L, Volavka J. 2002. Optimal dosing of atypical antipsychotics in adults: A review of the current evidence. Harv Rev Psychiatr 10 5 ; : 280 291. Citrome L, Casey DE, Daniel DG, Wozniak P, Kochan LD, Tracy KA. 2004. Adjunctive divalproex and hostility among patients with schizophrenia receiving olanzapine or risperidone. Psychiatr Serv 55 3 ; : 290 294. Clark RE. 2001. Family support and substance use outcome for persons with mental illness and substance use disorders. Schizophr Bull 27: 93 101. Claus A, Bollen J, De Cuyper H, Eneman M, Malfroid M, Peuskens J, Heylen S. 1992. Risperidone versus haloperidol in the treatment of chronic schizophrenic inpatients: A multicentre double-blind comparative study. Acta Psychiatr Scand 85: 295 305. Cohen LS, Rosenbaum JF. 1998. Psychotropic drug use during pregnancy: Weighing the risks. J Clin Psychiatry 59 Suppl 2 ; : 18 28. Colonna L, Saleem P, Dondey-Nouvel L, Rein W, Amisulpride Study Group. 2000. Long-term safety and efficacy of amisulpride in sub-chronic or chronic schizophrenia. Int J Clin Psychopharmacol 15 1 ; : 22. Conley RR, Buchanan RW. 1997. Evaluation of treatmentresistant schizophrenia. Schizophr Bull 23: 663 674. Conley RR, Carpenter WT, Tamminga CA. 1997. Time to clozapine response in a standardized trial. J Psychiatry 154: 1243 1247. Conley RR, Kelly DL, Gale EA. 1998. Olamzapine response in treatment-refractory schizophrenic patients with a history of substance abuse. Schizophr Res 33: 95 101. Conley RR, Mahmoud R. 2001. A randomized double-blind study of risperidone and olanzapine in the treatment of schizophrenia or schizoaffective disorder. J Psychiatry 158: 765 774. Cooper SJ, Tweed J, Raniwalla J, Butler A, Welch C. 2000a. A placebo-controlled comparison of zotepine versus chlorpromazine in patients with acute exacerbation of schizophrenia. Acta Psychiatr Scand 101: 218 225. Cooper SJ, Butler A, Tweed J, Welch C, Raniwalla J. 2000b. Zotepine in the prevention of recurrence: a randomised, double-blind, placebo-controlled study for chronic schizophrenia. Psychopharmacology Berlin ; 150: 237 243. Copolov DL, Link CG, Kowalcyk B. 2000. A multicentre, double-blind, randomized comparison of quetiapine ICI 204, 636, `Seroquel' ; and haloperidol in schizophrenia. Psychol Med 30: 95 105. Cormac I, Jones C, Campbell C. 2004. Cognitive behaviour therapy for schizophrenia. Cochrane Review ; . In: The Co. Olanzapine withdrawal syndromeAbstract: Introduction: Despite the increasing body of published reports on pharmacological interventions in Huntington's disease HD ; , an evidence based review EBR ; of treatment studies has not yet been published. Method: Systematic literature searches were done using Medline 1965 August 2005 ; , the central database in the Coch- rane Library 1969 August 2005 ; , and reference lists published in review articles and other clinical reports. Randomized controlledrials RCTs ; were classified t as level-I-studies in this paper. Level-II evidence was assigned to non- randomized, controlled clinical studies. Level-III-studies comprised open label trials excluding case reports. Measures of efficacy as well as safety and tolerability were considered for each compound. Results: We identified 218 publications on pharmacological interventions in HD since 1965. Among them were 20 level-I, 55 level-II, 54 level-III trials, and 89 case reports. All these papers are listed and analyzed. Chorea was the primary end point in all level-I and level-II symptomatic intervention trials. There is some evidence for treating chorea with haloperi- dol or fluphenazine, and less evidence for olanzapine. These three drugs have been considered "possibly useful" for the treatment of chorea in this analysis. Other substances e.g. amantadine, riluzole, and tetrabenazine ; are considered "inves- tigational" for chorea. There is very low evidence for the treatment of other problems: "possibly useful" drugs are L-dopa and pramipexole for rigidity; amitryptiline and mirtazapine for depression; risperidone for psychosis; and olanzapine, haloperidol, and buspirone for behavioral symptoms in HD. Three substances are considered "investigational" for possible neuroprotection: coenzyme Q10, minocycline, and unsaturated fatty acids. Conclusion: There is poor evidence in management of HD today. The analysis of the twenty level-I studies fails to result in any treatment recommendation of clinical relevance. High-quality RCT are highly warranted to advance HD treatment in clinical practice and trileptal. Following is a list of terms that reflect treatment-emergent adverse events reported by patients treated with intramuscular olanzapine for injection at one or more doses 2.5 mg injection ; in clinical trials 722 patients ; . This listing may not include those events already listed in previous tables or elsewhere in labeling, those events for which a drug cause was remote, those event terms which were so general as to be uninformative, and those events reported only once which did not have a substantial probability of being acutely life-threatening. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring in at least 1 100 patients only those not already listed in the tabulated results from placebo-controlled trials appear in this listing infrequent adverse events are those occurring in 1 100 to 1 1000 patients. Body as a Whole -- Frequent: injection site pain; Infrequent: abdominal pain and fever. Cardiovascular System -- Infrequent: AV block, heart block, and syncope. Digestive System -- Infrequent: diarrhea and nausea. Hemic and Lymphatic System -- Infrequent: anemia. Metabolic and Nutritional Disorders -- Infrequent: creatine phosphokinase increased, dehydration, and hyperkalemia. Musculoskeletal System -- Infrequent: twitching. Nervous System -- Infrequent: abnormal gait, akathisia, articulation impairment, confusion, and emotional lability. Skin and Appendages -- Infrequent: sweating. Postintroduction Reports Adverse events reported since market introduction that were temporally but not necessarily causally ; related to ZYPREXA therapy include the following: allergic reaction e.g., anaphylactoid reaction, angioedema, pruritus or urticaria ; , diabetic coma, jaundice, neutropenia, pancreatitis, priapism, rhabdomyolysis, and venous thromboembolic events including pulmonary embolism and deep venous thrombosis ; . Random cholesterol levels of 240 mg dL and random triglyceride levels of 1000 mg dL have been reported. DRUG ABUSE AND DEPENDENCE Controlled Substance Class 9lanzapine is not a controlled substance. Physical and Psychological Dependence In studies prospectively designed to assess abuse and dependence potential, olanzapine was shown to have acute depressive CNS effects but little or no potential of abuse or physical dependence in rats administered oral doses up to 15 times the maximum recommended human! Impact on the results of meta-analyses.2, 3 The olanzapine studies are not complete, but the 3 studies included are the largest comparisons of olanzapine with haloperidol and they were used for registration at the FDA. We want to emphasize that we did not specifically select favorable studies. Tollefson et al12 was especially important for our purposes. It has recently been argued by Rosenheck4 that in contrast to their own trial, 28 olanzapine was more efficacious than haloperidol in Tollefson et al12 because in the latter, prophylactic antiparkinson medication was not used. Therefore, Rosenheck4 speculated that many patients in the haloperidol group dropped out due to adverse events, and LOCF biased the results. However, the results in Tollefson et al12 were virtually identical irrespective of the model we used. Only 4.5% olanzapine ; vs 7.3% haloperidol ; patients dropped out to adverse events so that this factor did not explain olanzapine's efficacy superiority. Another reason explaining the different results of Rosenheck et al28 and Tollefson et al12 may be that the population in the latter study was more chronic, which finds its expression in the minimal reduction of symptoms about 10 PANSS points ; during the 1-year course of the study. We hasten to emphasize that our analysis focused solely on the effects of dropouts in combination with LOCF. A number of other biases might have potentially and oxytetracycline. ANTIRETROVIRALS NRTIs- abacavir Ziagen ; , abacavir lamivudine zidovudine Trizivir ; , didanosine ddI, Videx , Videx EC ; , lamivudine Epivir, 3TC ; , lamivudine zidovudine Combivir ; , stavudine d4T, Zerit ; , tenofovir Viread ; , zalcitabine ddC, HIVID ; , zidovudine AZT, Retrovir ; . PIs- amprenavir Agenerase ; , indinavir Crixivan ; , lopinavir ritonavir Kaletra ; , nelfinavir Viracept ; , ritonavir Norvir ; , saquinavir Fortovase, Invirase ; . NnRTIs- delavirdine Rescriptor ; , efavirenz Sustiva ; , nevirapine Viramune ; . Other- hydroxyurea Hydrea ; . OI DRUGS PHS "A1 OI"s- acyclovir Zovirax ; , azithromycin Zithromax ; , cidofovir Vistide ; , clarithromycin Biaxin ; , famciclovir Famvir ; , fluconazole Diflucan ; , foscarnet Foscavir ; , ganciclovir Cytovene ; , isoniazid generic ; , itraconazole Sporonox ; , leucovorin calcium Wellcovorin ; , pyrazinamide generic ; , pyrimethamine Daraprim ; , rifampim generic ; , sulfadiazine oral generic ; , TMP SMX Bactrim, Septra ; . Other OIs- albendazole Albenza ; , amikacin sulphate generic injection ; , amoxicillin trihydrate oral generic ; , amphotericin B Fungizone ; , atovaquone Mepron ; , bleomycin sulfate Blenoxane ; , ciprofloxacin Cipro ; , clindamycin Cleocin ; , clofazimine Lamprene ; , clotrimazole Lotrimin, Mycelex ; , cyclophosphamide Cytoxan ; , dapsone Avlosulfon ; , dexamethasone Decadron ; , doxorubicin Adriamycin ; , epoetin alpha Procrit ; , ethambutol Myambutol ; , filgrastim Neupogen ; , flucytosine 5FC, Ancobon ; , fomivirsen Vitravene ; , ketoconazole Nizoral ; , isoniazid rifampin generic ; , liposomal duanorubicin DaunoXome ; , methotrexate oral, injection ; , metronidazole oral generic ; , nystatin Mycostatin ; , paclitaxel Taxol ; , paromomycin Humatin ; , pentamidine Nebupent, Pentam ; , prednisone oral generic ; , rifabutin Mycobutin ; , trimethoprim Trimpex, Proloprim ; , trimetrexate glucuronate NeuTrexin ; , valacyclovir Valtrex ; , vinblastine sulfate Velban ; , vincristine sulfate Oncovin ; . Hepatitis C- interferon alfacon 1 Infergen ; , interferon A-2A Intron-A, Roferon-A ; , ribavirin generic ; , ribavirin interferon alpha 2B Rebetron ; . TREATMENTS FOR METABOLIC DISORDERS Diabetic- glipizide Glucotrol ; , rosiglitazone maleate Avandia ; . Hyperlipidemia- atorvastatin Lipitor ; , gemfibrozil generic only ; , pravastatin Pravachol ; , simvastatin Zocor ; . Wasting- dronabinol Marinol ; , megestrol acetate Megace ; , nandrolone Durabolin, Deca-Duranbolin ; , oxandrolone Oxandrin ; , somatropin Serostim ; , testosterone generic injection, transdermal ; . ALL OTHERS alitretinoin gel Panretin Gel ; , alprazolam Xanax ; , amitriptyline hydrochloride generic ; , bupropion HCL Wellbutrin ; , buspiron HCL BuSpar ; , cephalexin oral generic ; , citalopram hydrobromide Celexa ; , codeine w wo ASA, APAP oral generic ; , desipramine HCL oral generic ; , dicloxacillin sodium oral generic ; , diphenoxylate HCL Lomotil ; , divalproex sodium Depakote ; , doxycycline hyclate oral generic ; , erythromycin oral generic ; , famotidine generic ; , fenoprofen calcium oral generic ; , fentanyl Duragesic, hospice clients only ; , fluoxetine HCL Prozac ; , gabapentin Neurontin ; , hepatitis A vaccine, hepatitis B vaccine, hydrocodone w wo APAP oral generic ; , ibuprofen-prescription strength generic ; , imiquimod Aldara ; , indomethacin oral generic ; , ketoprofen oral generic ; , ketorolac tromethamine Toradol injection ; , lamotrigine Lamictal ; , lansoprazole Prevacid ; , levorphenol tartrate Levo-Dromoran ; , loperamide HCL generic ; , lorazepam oral generic ; , methadone HCL oral generic ; , metoclopramide Reglan, Clopra ; , minocycline HCL oral generic ; , morphine sulfate oral generic ; , naproxen oral generic ; , nefazodone HCL Serzone ; , neomycin sulfate oral generic ; , nortriptyline HCL oral generic ; , lanzapine Zyprexa ; , omeprazole Prilosec ; , opium, tincture of, oxycodone w wo ASA, APAP oral generic ; , pancrelipase Ultrase ; , paroxetine HCL Paxil ; , penicillin V potassium oral generic ; , pneumococcal vaccine Pneumovax, Pnu-Immune ; , probenecid generic ; , prochlorperazine Compazine ; , promethazine Phenergan ; , quetiapine fumarate Seroquel ; , ranitidine HCL prescription strength generic ; , risperidone Risperdal ; , sertraline Zoloft ; , sulindac oral generic ; , tetracycline HCL oral generic ; , trazodone HCL oral generic ; , vancomycin HCL oral generic ; , venlafaxine HCL Effexor. The atypical antipsychotic drugs chosen were clozapine, olanzapine, loxapine, sertindole, risperidone, ziprasidone, quetiapine, and aripiprazole and paroxetine. Fig. 2. The policy development process NGOs are working with IDUs and want to start distributing clean needles and syringes. Public security and police are arresting people carrying needles and registering them as drug users. Yes Government sets up a committee of public health officials, NGOs and international advisers to examine the issue and allocates a government employee to assist Government decides that the current informal arrangement should continue Committee meets, briefs employee on the research required, identifies key groups with which to consult and identifies key people who will support or oppose the policy Consultation with key stakeholders: workshop held to discuss problem and issues Employee assists committee in drafting a position paper that summarizes the evidence for various approaches to HIV prevention among IDUs and summarizes the issues involved in setting up harm reduction and needle and syringe programmes Discussion paper with options and recommendations circulated for comment Comments collected and incorporated into final policy Policy launched along with education materials, an implementation plan and the identification of resources to implement Data collected on the effectiveness of the policy Policy reviewed and revised. Hallucinations. His family history was relevant for paternal ethanol and cocaine use and extensive ethanol use in his extended family. He had been functional in society, holding a management position in a restaurant. Although he had a history of arrests for various misdemeanors, he denied any history of imprisonment. He also denied any medical diagnoses. At intake, he reported bothersome nightmares with trazodone. He denied all allergies to medications. His psychiatric history included many years of depressive episodes. These episodes were associated with psychotic symptoms when accompanied by concurrent cocaine usage. Three years prior to presentation, he had a 30day admission in another hospital for depression, which was followed by treatment in an 8-month inpatient and outpatient substance abuse program. He had since relapsed repeatedly, with short periods of abstinence. His last cocaine use was within a week of presentation. He had been using 0.5 g per week for over a decade. He also had used marijuana and consumed alcohol within a week prior to admission. Although he reported that he once took an antidepressant in the past, he was not taking any medications at the time of his presentation. Upon admission, Mr. A had significant psychomotor retardation, decreased speech rate and tone, and poor eye contact. He reported suicidal ideation with thoughts of setting himself on fire or taking an overdose of pills, and he had second-person auditory pseudohallucinations telling him to execute these plans. He denied any symptoms of anxiety. The results of a physical examination and laboratory studies were unremarkable. His condition was treated with fluoxetine, 20 mg orally each day, and olanzapine, 2.5 mg orally each night. Because of his difficulty sleeping, which was refractory to diphenhydramine, an on-call resident wrote an order for trazodone at bedtime because of its antidepressant and sedating properties, although this medication had not been ordered by the treatment team because of his complaint of nightmares. Four hours after his first dose of 100 mg of trazodone, Mr. A noticed a persistent, painful erection but declined to tell the nurse because of embarrassment. Seven hours after taking the trazodone, Mr. A experienced increasingly excruciating pain, and he notified his nurse. Intravenous fluids and analgesics were given, and the urology team was consulted expeditiously. The condition failed to resolve spontaneously, but it was successfully controlled by saline irrigation and phenylephrine under lidocaine local analgesia. The patient reported having normal morning tumescence by the next day and prandin. The evidence from three double blind trials supported by evidence from a fourth which was of poorer quality indicates that olanzzapine is an effective and safe antipsychotic drug. In a short term trial with titrated doses of both drugs, olanzwpine performed better than haloperidol with respect to mean changes in clinical rating scores and numbers of responders, and this was confirmed in a metanalysis that included two smaller trials with doses with limited titration. Olanzapjne also has a better EPS side effects profile than haloperidol, and a superior effect on negative symptoms although the clinical importance of the latter might be debated ; . There is some evidence from one trial to indicate that olanzapine performs better than haloperidol in treatment of first episode schizophrenia and from extension phases of the trials that olanzapine is associated with a better maintenance of response. One trial indicated that olanzapine is superior to haloperidol in treating depressive symptoms. The evidence on these topics is based on sub-group analyses of the main trials and is somewhat weaker than evidence on overall efficacy. Although these results come from good quality studies, firm conclusions, in particular on the superiority of olanzapine to 24. Difficulties for physicians. Inexperience of medical corps officers with the disease led to long delays in diagnosis and inappropriate treatments. Although only one death was due to VL, the morbidity was considerable; most of the men lost over 1 year of active duty time and had prolonged hospitalizations. In a well-studied cohort of 30 individuals, 15 cases originated in India and 15 in the Mediterranean.608 The shortest incubation period was 3 weeks and the longest was 19 months. The average interval from onset of acute symptoms to definitive diagnosis and specific treatment was 10 weeks range: 2 to 23 weeks ; , reflecting the unfamiliarity of physicians with the disease. The abrupt onset of fever and chills was seen in 29 of 96% ; cases, leading to an initial diagnosis of malaria. Splenomegaly was found in 27 of 90% ; patients on first examination and developed later in the other three. In other servicemen stationed in the Mediterranean region, localized lymphadenopathy was described.609 The British experience in East Africa during World War II with VL was more sobering. An outbreak occurred in 30 native troops of the King's African Rifles. The troops were from a nonendemic area of Kenya and were training in an endemic area of northern Kenya in 1941. 610 Fourteen soldiers died--specific treatment was not available--and the rest suffered prolonged illness and hospitalization. Similarly, an outbreak of VL was described in 23 native troops raised in a nonendemic area of the Sudan when they trained and fought in endemic areas of Ethiopia.611 Initially, medical officers suspected malaria, but later the diagnosis of VL was confirmed. It was thought that the stress of battle activated latent VL in these troops. Leishmaniasis was not a problem in the Korean War or the Vietnam conflict, as the parasite is not endemic to the Korean peninsula or Southeast Asia. The Middle East Both CL and VL were reported in British Marines serving in Aden from 1963 to 1965, 612, 613 and systemic syndromes with lymphadenopathy have been described in soldiers from Cyprus and Malta.614 An epidemic of CL occurred in 95 Israeli soldiers while they trained in the Jordan valley for 30 days during the summer of 1967. The incidence of CL was 50%, with an average of 7.4 lesions per soldier.615 Another outbreak of CL in 20% ; of 296 Israeli soldiers occurred during 6 months in the Negev desert.616 Well over 100 cases of CL have occurred in soldiers of 211 nationalities of the Multinational Force and Observers in the east Sinai since its operations be and repaglinide and olanzapine, for example, risperidone olanzapine. Olanzapine pregnancy category
Dufresne et al., 1993]. More recently, data from shortterm trials have also demonstrated that quetiapine and other atypical antipsychotics are effective in treating anxiety and depressive symptoms, although differences exist between individual agents [Azorin et al., 2001; Conley and Mahmoud, 2001; De Nayer et al., 2003; Purdon et al., 2001]. For example, greater reductions in the severity of anxiety and depressive symptoms were demonstrated with risperidone compared with olanzapine among patients completing an 8-week, doubleblind study in 377 patients with schizophrenia or schizoaffective disorder [Conley and Mahmoud, 2001]. Formal clinical trial data to support the long-term efficacy of the atypical antipsychotics in the treatment of anxiety and depressive symptoms are lacking. A possible explanation for this is that there are limitations of such long-term analyses, one of which is that patients are invariably lost to follow-up, or withdraw from treatment for various reasons. Because the OLE treatment phase had less rigorous objectives than the acute phase of each of the three trials, patients were not monitored as frequently in the present study, and it is considered that they were therefore more likely to discontinue treatment. In summary, it would seem that quetiapine is effective in improving anxiety and depressive symptoms associated with schizophrenia. Although data to show that this ef fect is maintained with long-term therapy are limited, it is apparent from the results of short-term studies that there are differences in ef ficacy between the various atypical antipsychotics. The results from the present analysis indicate that the improvement effect of quetiapine in anxiety and depressive symptoms is maintained in the long-term treatment of patients with schizophrenia; this may therefore impact favorably upon patient compliance with antipsychotic treatment and pravastatin.
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