Andy Health blog

A coroner has linked an anti-smoking drug to the death of a television editor who killed himself.
Omer Jama, 39, who worked for Sky Sports, was found dead at his home two months after being prescribed Champix to help him quit smoking.
An inquest in Bolton was told that Mr Jama had slashed his wrists and stabbed himself in the thigh and stomach.
However, the coroner, Jennifer Leeming, said she could not record a verdict of suicide and instead recorded an open verdict.
She said: "For me to register that he took his own life I would have to be satisfied he did the act which led to his death and he knew what he was doing."
"On the evidence before me I cannot say that was the case."
She said that she would write to the European Medicines Agency (EMA), which has been monitoring Champix since it was authorised in the EU in September 2006, to register the death as an "adverse event."
Julie Evans, a forensic toxicology expert, told the inquest that traces of the drug in Mr Jama’s blood did not indicate an overdose. But she said reports from the United States had recorded "suicidal" thoughts in patients.
She said: "There is a possibility he could have been influenced by the side effects of the drug."
The EMA, which licensed the drug, issued guidance on its active ingredient, varenicline, to doctors two months after Mr Jama’s death last October.
generic diflucan online buy It said "updated warnings" were needed to raise awareness of cases of suicide attempts reported in patients after the drug was allegedly linked to 37 US suicide cases.
Last year, the EMA received 839 reports of adverse reactions, of which 46 were linked to depression and 16 to patients claiming to have suffered suicidal thoughts.
His brother, Ali Jama, 41, said: "It is clear from the evidence of the toxicologist that Champix’s influence could have played a part. I would like to see more investigation done."
A spokesman for Pfizer, the makers of Champix, said, no causal link had been established between the drug and depression.
He said: "Depression, rarely including suicidal ideation [suicidal thoughts], has been reported in patients undergoing a smoking cessation attempt. These symptoms have also been reported while quitting with varenicline. A relationship between varenicline and the reported symptoms hasn’t been established but in some reports a link couldn’t be excluded."
In February, the National Institute for Health and Clinical Excellence recommended that the drug should be prescribed to smokers wanting to kick their habit. However, it said the full side effects of Champix were not yet known.

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Forest Laboratories, Inc.
(NYSE: FRX) announced that study results show Lexapro (escitalopram
oxalate) significantly improved symptoms of depression as compared to
placebo treatment and was well tolerated in adolescents, aged 12-17, with
major depressive disorder (MDD), according to phase III data presented at
the 2008 Annual Meeting of the American Psychiatric Association. These
results suggest that Lexapro has potential as a useful treatment option for
adolescents with depression. Top-line results of this study were initially
released in November 2007.
"Treating depression in adolescents can be particularly challenging
because few antidepressants have demonstrated efficacy in clinical trials
in this population," said Graham Emslie, MD, Professor of Psychiatry at the
University of Texas Southwestern Medical Center in Dallas. "In this study,
Lexapro significantly improved depressive symptoms in adolescents with MDD,
and was also well tolerated by study participants."
Researchers estimate that up to eight percent of adolescents are
affected by depression. Depression is a chronic disease that requires
medical treatment. However, FDA-approved treatment options for this
population are limited. Lexapro is not currently approved by the FDA for
use in pediatric or adolescent patients.
Based on the results of this study, Forest plans to file for an
adolescent depression indication for Lexapro this year.
Study Results
A double-blind, parallel-group, placebo-controlled phase III study to
evaluate the safety and efficacy of Lexapro in the treatment of depressed
adolescents, aged 12-17, was conducted in multiple centers across the U.S.
A total of 316 patients entered the eight week study, receiving either
Lexapro 10-20 mg (n=158) or placebo (n=158). The primary endpoint was
change from baseline to Week 8 on the Children’s Depression Rating Scale -
Revised (CDRS-R) using last observation carried forward (LOCF) approach.
The CDRS-R is a commonly used clinician-rated instrument that covers 17
symptom areas of depression relevant to adolescents, including impaired
schoolwork, difficulty having fun, social withdrawal, physical complaints,
and low self-esteem. The study showed statistically significant improvement
in patients treated with Lexapro relative to placebo based on the change
from baseline in the Buy generic amoxil CDRS-R score (-22.1 for Lexapro vs. -18.8 for placebo
treatment; p=0.022).
The trial also showed that Lexapro was generally well-tolerated.
Discontinuation rates due to adverse events were 2.6 percent and 0.6
percent for patients receiving Lexapro and placebo, respectively. Serious
adverse events were reported by 2.6 percent of patients receiving Lexapro
and 1.3 percent for patients receiving placebo. The most commonly reported
adverse events (greater than 10 percent in either group) were headache (25
percent in Lexapro patients vs. 26 percent with placebo), menstrual cramps
(11 percent vs. 15 percent placebo), nausea (10 percent vs. 8 percent
placebo), insomnia (10 percent vs. 6 percent placebo) and inflicted injury
(9 percent vs. 13 percent placebo), the majority of which were accidental
in nature. The only adverse event occurring at a frequency of greater than
or equal to 5 percent and with an incidence for Lexapro treated patients
twice that of placebo treated patients was influenza-like symptoms (7
percent vs. 3 percent placebo).
Depression and Adolescents
Adolescent depression is characterized by persistent sadness and loss
of interest in usual activities. While the brain chemistry of depression is
not fully understood, research suggests that depression is caused by an
imbalance of certain chemicals in the brain, most notably serotonin.
Despite advances and progress in identifying and treating mental
disorders in adolescents, depression in this population remains
under-treated. Depression is a chronic disease that requires medical
attention and treatment, and if left untreated, may have serious
consequences. According to the National Alliance on Mental Illness (NAMI),
adolescents with untreated depression are likely to have ongoing problems
in school, at home and with their friends.
For adolescents who suffer from depression, psychotherapy,
cognitive-behavior therapy, interpersonal therapy and medication play an
important role in the management of their illness. Patients on
antidepressant treatment should also be closely monitored by healthcare
providers, family members and other caregivers.
About Lexapro
Lexapro is an SSRI being studied as a treatment for adolescents with
MDD. Lexapro is indicated for the initial and maintenance treatment of
major depressive disorder and generalized anxiety disorder (GAD) in adults.
Lexapro is thought to work by helping to restore the brain’s chemical
balance. It is believed to increase the availability of serotonin, a
substance in the brain believed to influence mood. In adults, Lexapro 10
mg/day is a well-tolerated therapy, with drop-out rates due to adverse
events comparable to placebo treatment in depression trials. Lexapro has
been prescribed to over 16 million people.
Important Lexapro Information
Depression and certain other psychiatric disorders are themselves
associated with increases in the risk of suicide. Antidepressants increased
the risk of suicidality (suicidal thinking and behavior) in children,
adolescents, and young adults in short-term studies of major depressive
disorder (MDD) and other psychiatric disorders. Anyone considering the use
of antidepressants in children, adolescents or young adults must balance
the risk to clinical need. Patients of all ages started on antidepressant
therapy should be closely monitored and observed for clinical worsening,
suicidality or unusual changes in behavior, especially at the beginning of
therapy or at the time of dose changes. This risk may persist until
significant remission occurs. Families and caregivers should be advised of
the need for close observation and communication with the prescriber.
Lexapro is not approved for use in pediatric patients.
Lexapro is contraindicated in patients taking monoamine oxidase
inhibitors (MAOIs), pimozide (see DRUG INTERACTIONS - Pimozide and Celexa),
or in patients with hypersensitivity to escitalopram oxalate. As with other
SSRIs, caution is indicated in the coadministration of tricyclic
antidepressants (TCAs) with Lexapro. SSRIs and SNRIs (including Lexapro)
and other psychotropic drugs that interfere with serotonin reuptake may
increase the risk of bleeding events. Concomitant use of aspirin, NSAIDs,
warfarin and other anticoagulants may add to the risk. Patients should be
cautioned about these risks. SSRIs and SNRIs have been associated with
clinically significant hyponatremia. Elderly patients or patients taking
antidiuretics or who are otherwise volume-depleted appear to be at a
greater risk. Discontinuation of Lexapro should be considered in patients
with symptomatic hyponatremia and appropriate medical intervention should
be instituted. The most common adverse events with Lexapro versus placebo
(approximately 5 percent or greater and approximately twice that of
placebo) were nausea, insomnia, ejaculation disorder, somnolence, increased
sweating, fatigue, decreased libido, and anorgasmia. Further information on
Lexapro is provided in the FDA approved Package Insert.
About Forest Laboratories and Its Products
Forest Laboratories is a US-based pharmaceutical company dedicated to
identifying, developing, and delivering products that make a positive
difference in people’s lives. Forest Laboratories’ growing product line
includes Lexapro(R) (escitalopram oxalate), an SSRI indicated for adults
for the initial and maintenance treatment of major depressive disorder and
generalized anxiety disorder; Namenda(R) (memantine HCl), an N-methyl-D-
aspartate (NMDA)-receptor antagonist indicated for the treatment of
moderate to severe Alzheimer’s disease; Campral(R)* (acamprosate calcium),
indicated in combination with psychosocial support for the maintenance of
abstinence from alcohol in patients with alcohol dependence who are
abstinent at treatment initiation; and Bystolic(TM) (nebivolol), a
beta-adrenergic receptor blocking agent indicated for the treatment of
hypertension. In addition to our growing product line, Forest also
co-promotes the Daiichi Sankyo, Inc. product Azor(TM) (amlodipine and
olmesartan medoxomil), a calcium channel blocker and angiotensin receptor
blocker combination product indicated for the treatment of hypertension.
For more information, visit
Azor is a trademark of Daiichi Sankyo, Inc. and Campral is a
registered trademark of Merck Sante s.a.s., a subsidiary of Merck KGaA,
Darmstadt, Germany.
Except for the historical information contained herein, this release
contains forward-looking statements within the meaning of the Private
Securities Litigation Reform Act of 1995. These statements involve a number
of risks and uncertainties, including the difficulty of predicting FDA
approvals, the acceptance and demand for new pharmaceutical products, the
impact of competitive products and pricing, the timely development and
launch of new products, and the risk factors listed from time to time in
the Forest Laboratories’ Annual Report on Form 10-K, Quarterly Reports on
Form 10-Q, and any subsequent SEC filings.
Forest Laboratories, Inc.

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The post-university years can start out tough. The good news: it gets better.
A new University of Alberta study of almost 600 of its graduates (ages 20-29 years old) tracked mental health symptoms in participants for seven years post-graduation and looked at how key events like leaving home and becoming a parent were related to depression and anger. Graduates showed a significant decrease in depressive symptoms over the seven years. Expressed anger also declined over time after graduation, suggesting improved mental health.
The researchers also found that while home may be a haven for young people in the early years of adulthood, the longer they stay at home, or if they return home, the more likely they are to experience symptoms of depression. Previous research has found that more than half of students under 25 in four-year university programs lived with their parents.
In this study, it was shown that younger participants were more depressed at times when they lived on their own, while older participants were more depressed while they lived with their parents.
"Generic soma pills no prescription Some key events, such as leaving home, may throw emerging adults a little off kilter, depending on the timing of the transition," said Nancy Galambos, University of Alberta psychology professor. "Leaving home too soon can be challenging in ways that have the potential to affect mental health."
It was revealed that women were more depressed and angry at the start of the study than men. Also, anger increased when participants became parents.
"Although we generally welcome parenthood as a positive experience, we found that people who became parents became angrier, and this was especially pronounced for mothers," said Harvey Krahn, University of Alberta chair of sociology. "The transition to parenthood produces a new set of demands on the couple that may be difficult to cope with as parents have to negotiate a whole new set of family responsibilities."
—————————-
Article adapted by Medical News Today from original press release.
—————————-
The study was conducted by Nancy Galambos, University of Alberta psychology professor, and Harvey Krahn, University of Alberta chair of sociology. It appears in the Journal of Marriage and Family.
Source: Kris Connor
University of Alberta
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Researchers from the Cleveland Clinic, Brown University, and Massachusetts General Hospital will present results of a long-term outcome study that builds on previous promising research, which has shown that deep brain stimulation (DBS) is a potentially effective treatment option for people with treatment resistant major depression.
The World Health Organization rates major depression as the top cause of disability worldwide. While many patients with major depression find relief through a combination of psychotherapy and medication, some people are left severely disabled. Patients who are most resistant to medications, psychotherapies, and electroconvulsive therapy (ECT) have little hope of recovery, and suffer a heightened risk of suicide and mortality. Sadly, statistics show that the suicide rate in people with major depression is as high as 15 percent.
DBS surgery involves the placement of tiny implantable electrodes into specific parts of the brain that are functioning abnormally. These electrodes emit tiny pulses of electrical stimulation to block the abnormal activity in the brain, which causes a variety of symptoms such as pain, tremors, movement problems; as well as obsessions, moods and anxieties associated with psychiatric disorders. The success of DBS is dependent on the surgical team’s ability to precisely pinpoint the specific brain area for stimulation. The advantage of DBS is that it is reversible, nondestructive, and can be modified by adjustment of the stimulator settings after implantation.
Ali R. Rezai, MD, director of Cleveland Clinic’s Center for Neurological Restoration, and a multi-center team of investigators were inspired by the success of DBS in treating the tremors associated with Parkinson’s and movement disorders like dystonia and essential tremor. "Starting in 2001, we began treating patients with obsessive compulsive disorder (OCD) with promising outcomes. These findings resulted in the initiation of a subsequent trial for patients with severe and medication intractable major depression, starting in 2003," stated Dr. Rezai.
"The preliminary results of research undertaken between 2003 and 2005 indicated that bilateral DBS of the anterior limb of the internal capsule holds promise for the treatment of intractable major depression, which led to the more extensive research results being presented today," added Dr. Rezai.
The results of the current study, Deep Brain Stimulation for the Treatment of Depression: Long-Term Outcomes from a Prospective Multi-Center Trial, will be presented by Dr. Rezai, from 10:30 to 10:44 a.m. on Tuesday, April 29, 2008, during the 76th Annual Meeting of the American Association of Neurological Surgeons in Chicago. Co-authors are Linda Carpenter, MD, Darin Dougherty, MD, Emad Eskandar, MD, Gerhard Friehs, MD, Cynthia Kubu, PhD, Andre Machado, MD, PhD, Paul Malloy, PhD, Donald Malone, MD, Lawrence H. Price, MD, Steven Rasmussen, MD, Scott Rauch, MD, Stephen Salloway, MD, and Audrey Tyrka, MD, PhD. This multidisciplinary group consists of close collaboration between neurosurgeons, psychiatrists and psychologists from these institutions.
Fifteen chronic and severely depressed patients were enrolled in this study. These patients had failed multiple medication trials, as well as psychotherapy and electroconvulsive therapy (ECT). These highly intractable and often suicidal patients underwent bilateral DBS implantation in the ventral internal capsule/ventral striatum (VC/VS) at the three institutions.
The Montgomery-Asberg Depression Rating Scale (MADRAS) was the primary outcome scale, among many scales, including those assessing overall quality of life, functioning and cognitive status. The outcome raters were blinded to the DBS status of the patient. Follow-up ranged from six to 48 months, with a duration of one year or longer in 11 of the 15 patients. Responder criteria was defined by this study as a 50 percent decrease in MADRAS scores. The following outcomes were noted:
– Responses were seen in seven (47 percent) of 15 patients at six months, five (45.5 percent) of 11 at 12 months, and eight (53.3 percent) of 15 at last follow-up.
– Long-term improvement in depression severity, functioning, and quality of life were all noted.
– Measures of short-term memory improved.
– There were no hemorrhages, infections or other neurological deficits.
"This research substantiates our earlier findings, which indicate that bilateral DBS of the anterior limb of the internal capsule holds promise and hope for select patients suffering from severe and treatment resistant major depression, stated Dr. Rezai. "While about half of this patient group responded to treatment, I feel that as we learn more about this rather new technology, efficacy will continue to improve. It is important to understand that this treatment is not for everyone with major depression and only for those that have tried various medications, psychotherapy and ECT. But, nevertheless, it is very promising news for the many suffering patients and their family members that have virtually given up hope."
Results of the OCD study, Deep Brain Stimulation of the Ventral Internal Capsule/Ventral Striatum for Obsessive-Compulsive Disorder (OCD): World-Wide Experience, will be presented by Dr. Rezai, one day prior to the depression study, 2:45 to 2:59 p.m., Monday, April 28. While OCD is not as prevalent as depression, it does affect 2 to 3 percent of the United States population, and at least 10 percent of patients have disabling cases that are resistant to treatment. The results reveal meaningful symptom reductions and functional improvement in about two-thirds of highly resistant patients after open treatment. Recent improvements in outcomes have been achieved through refinements in targeting areas. This is a worldwide cooperative prospective study involving the largest number of severe and intractable OCD patients with long-term follow-up with DBS.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 7,200 members worldwide. Buy generic soma The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain and peripheral nerves.
American Association of Neurological Surgeons (AANS)
5550 Meadowbrook Dr.
Rolling Meadows, IL 60008
United States

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