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Internal Medicine News - Generic Lamictal approved

admin — Fri, 02 Jan 2009 11:56:05 +0000

Generic Lamictal (lamotrigine, 5-mg and 25-mg tablets) is approved for adjunctive therapy for partial seizures in adults and pediatric patients aged 2 years and older. The drug is also indicated as adjunctive therapy for the generalized seizures of Lennox-Gastaut syndrome in adult and pediatric patients aged 2 years and older.

Lamictal Acne - Natural Remedies

admin — Tue, 30 Dec 2008 08:01:02 +0000

Suffering From Lamictal Acne? Uncover Some Natural RemediesOne of the side effects or reactions of Lamictal, is Lamictal acne. Lamictal is a drug that is a prescription medication that is used to help treat Bipolar disorder as well as other diseases. What cause a person to get lamictal acne is the lamictal dosage that sometimes get higher (as directed by your doctor) that ultimately will put a strain on a person’s body. As the lamictal dosage goes higher, that is when the lamictal acne really starts. Don’t stop using the drug Lamictal just because you get lamictal acne, there is help out there and you will get some suggestions on how to deal with this problem. There are remedies for acne that you can use and do to help eliminate you acne problem.How to get rid of lamictal acneLet’s now take a few minutes and learn how to get rid of lamictal acne. Kissing that lamictal acne goodbye is not as hard as it seems. There are some kitchen ingredients that can be used for treatments and remedies to help with lamictal acne.How to get rid of acne, drink more waterFirst thing that we need to do to help treat our pimples, zits, acne is to increase the amount of water we consume. Try to drink at least, and I say at least 8 / 8 ounce glasses of water a day. Lamictal and acne seem to go hand in hand. The drug is causing toxins to build up in our body and when this happens one thing that happens is a person suffers from acne.Help get rid of acne by changing your dietOne diet change is eating more fruits and vegetables. If you don’t currently eat plenty of these, then you need to add them to help get rid of your acne. Diet change has been proven to help with acne. Have a diet that is low in fats and processed foods. Fats and processed foods don’t help your body fight acne. What needs to happen next in your new diet is to try and get rid of surgar and caffeine. Removing these items from your diet, will help your body fight the acne you are suffering from.Steam and acneAnother thing that you can try that has worked for many people is to start to steam your face to get rid of the acne, pimple, blackheads. This is a great all natural treatment that you can use. Learn how to correctly steam your face for acne using this procedure. Make sure you click that link to learn what you need to put into the water to really help fight your acne.Rid your acne with kitchen ingredientsSome kitchen ingredients that are known to protect your skin from acne are herbs such as: mint fenugreek turmeric Some other home remedies for acne that can help with lamictal acne are: garlic cinnamon nutmeg radish sesame seeds You don’t want to drop your medication that is working, just because you develop acne. Use some of the remedies above and you won’t have to.The Best All Natural Acne Remedy on the Market TodayWant to rid yourself of your acne once and for all. Then you have to take a moment and click the link that follows. This product is going to change your life forever. It is also guaranteed with your money back. The only thing you can lose is your acne. Becoming acne free in 3 days is an all natural method that is on sale right now for $15 off the original price. You are stealing this product at the current price. Please if you are serious about getting rid of your lamictal acne you must take a minute and learn more about acne free in 3 days.

Chain Drug Review - Study backs Lamictal XR

admin — Fri, 26 Dec 2008 12:01:03 +0000

Once-daily Lamictal XR has been found effective in treating patients with partial epileptic seizures, according to a report presented at the American Academy of Neurology. If approved, Lamictal XR will be the first extended-release, new-generation epilepsy treatment taken once a day. The product is manufactured by GlaxoSmithKline PLC.

Clinical Psychiatry News - Top 10 drugs prescribed by psychiatrists in 2005

admin — Sat, 20 Dec 2008 14:21:03 +0000

Top 10 Drugs Prescribed by Psychiatrists in 2005

Millions

Lexapro 4,893
Zoloft 4,671
Seroquel 4,232
Effexor XR 4,032
Risperdal 3,493
Wellbutrin XL 3,379
Adderall XR 2,759
Ambien 2,405
Concerta 2,248
Lamictal 2,074

Note: Estimated data based on prescription drugs dispensed by retail
pharmacies throughout the United States.
Source: Verispan
ELSEVIER GLOBAL MEDICAL NEWS

Note: Table made from bar graph.

Epilepsy Drugs Get Suicide Risk Warning

admin — Wed, 17 Dec 2008 10:51:04 +0000

Dec. 16, 2008 — The FDA today announced that it will require makers of epilepsy drugs to add a warning about increased risk of suicidal thoughts and behaviors to the products’ prescribing information or labeling.
The warning — which won’t be a “black box” warning — applies to all antiepileptic medications, including those used to treat psychiatric disorders, migraines, and other conditions, as well as epilepsy.
Here is a list of the medications required to add the warning:

Carbamazepine (marketed as Carbatrol, Equetro, Tegretol, Tegretol XR)

Clonazepam (marketed as Klonopin)
Clorazepate (marketed as Tranxene)
Divalproex sodium (marketed as Depakote, Depakote ER, Depakene)
Ethosuximide (marketed as Zarontin)
Ethotoin (marketed as Peganone)
Felbamate (marketed as Felbatol)

Gabapentin (marketed as Neurontin)
Lamotrigine (marketed as Lamictal)
Lacosamide (marketed as Vimpat)
Levetiracetam (marketed as Keppra)
Mephenytoin (marketed as Mesantoin)
Methosuximide (marketed as Celontin)
Oxcarbazepine (marketed as Trileptal)
Phenytoin (marketed as Dilantin Suspension)
Pregabalin (marketed as Lyrica)
Primidone (marketed as Mysoline)
Tiagabine (marketed as Gabitril)
Topiramate (marketed as Topamax)
Trimethadione (marketed as Tridione)
Zonisamide (marketed as Zonegran)

Some of those drugs are also sold generically.
Monitor Patients
“Patients being treated with antiepileptic drugs for any indication should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior,” Russell Katz, MD, says in an FDA news release.
Katz, who directs the Division of Neurology Products in the FDA’s Center for Drug Evaluation and Research, says that “patients who are currently taking an antiepileptic medicine should not make any treatment changes without talking to their health care professional.”
The FDA also issued a public health alert about the risk and asked health care professionals to notify patients, their families, and caregivers about the risk, so that patients may be closely observed. And the FDA has ordered epilepsy drugmakers to create a risk evaluation and management strategy, including a medication guide for patients, addressing the risk.
Epilepsy Drugs and the FDA
Today’s FDA actions are based on the agency’s review of 199 clinical trials of 11 epilepsy drugs. The review, which the FDA released in January, showed that patients taking those drugs had almost twice the risk of suicidal behavior or thoughts than patients taking a placebo.
That difference was about one additional case of suicidal thoughts or behaviors for every 500 patients treated with antiepileptic drugs instead of placebo.
Four patients who were randomly assigned to take one of the epilepsy drugs committed suicide. There were no suicides in the placebo group. But the results weren’t sufficient to make conclusions about drugs’ effects on completed suicides.
The biological reasons for the increased risk of suicidal thoughts and behavior observed in patients being treated with antiepileptic drugs are unknown, notes the FDA.
In July, the FDA held a public meeting of an independent committee of experts who reviewed the data. The committee agreed with the FDA about the increased risk of suicidality and recommended warning about that risk in the drugs’ labels and in medication guides, rather than requiring a “black box” warning, which is the FDA’s sternest warning.

GSK delivers Q3 business performance EPS of 25.2p and increased dividend of 14p

admin — Thu, 11 Dec 2008 02:16:02 +0000

For full reports, see attachment
LONDON, Oct. 22, 2008-Chief Executive Officer’s Review: We are managing a considerable transition to our product portfolio this year as several mature pharmaceutical brands encounter generic competition in the USA. In the short-term, this is having a significant impact on pharmaceutical sales, although we continue to see good growth from other areas of the pharmaceuticals portfolio, including a recent improvement in prescription volumes for Advair in the United States. Also helping offset the generic impact has been growth in other parts of our business, such as vaccines, emerging markets and consumer healthcare.
This diversification in sales is an inherent strength for GSK and one we are actively nurturing, through delivery and investment in our new strategic priorities. Ultimately, we are aiming to create a more balanced healthcare business with a lower overall risk profile.
Grow a diversified global business In Pharmaceuticals, we are making good progress to renew our product line, with 10 product launches so far this year in critical growth areas, such as oncology, and in existing franchises.
In the future, we want our portfolio to be more balanced with a lower concentration of sales in any one or two products. Clearly, our agenda must then be to maximise the value of this broader portfolio and we are therefore deliberately taking a more global approach to commercialisation than ever before.
The success of Advair in Japan is a good example of driving growth outside our more traditional markets. Advair is at the vanguard of multiple future product opportunities in Japan, with the next product launch expected to be Lamictal, following its approval last week.
Overall, we have the potential for more than 40 launches over the next 5 years in this market.
In emerging markets, we are starting to make some early progress in building a more tailored portfolio for patients and consumers. We have now formalised our trading agreement with Aspen Pharmaceuticals and have so far identified around 60 assets for prospective commercialisation.
We also recently acquired a broad range of pharmaceutical brands from BMS in Egypt. This is a fast growing market and we are now the market leader. Importantly, this acquisition also provides us with the opportunity to grow incremental sales in other markets in the Middle East and North Africa, through export of these products.
The dynamics of emerging markets are wholly different to traditional western pharmaceutical markets as there is less distinction between pharmaceutical, over-the-counter and retail market structures. Our capability to supply products and operate across this spectrum is, I believe, a competitive advantage for GSK.
On this basis, we are determined to globalise further our Consumer Healthcare business. In September, for example, we introduced Sensodyne – the fastest growing global toothpaste brand – into the Chinese market, our first major consumer product to launch there for a decade.
We also see multiple opportunities to build our consumer business through the switch of prescription products and the acquisition of new brands, which can complement and drive the growth of our key franchises. Our recent acquisition of Biotene, a dynamic oral healthcare brand, is evidence of this.

global economy will have on consumer demand for products. To date, we have seen only modest impact on GSK’s consumer products in certain territories. The strength of our diversified business model is that it helps to mitigate any potential impact on GSK as our multiple franchises operate in very different economic cycles.
In Vaccines, our sales continue to be dynamic with growth powered by a broad range of brands. We continue to expand this business and this quarter launched two new vaccines in the USA, Rotarix and Kinrix.
The potential of this business is significant, given our pipeline; the opportunity for global expansion, and payer needs that are increasingly directed towards preventative healthcare.
At the same time, we must compete effectively for what are often binary tender orders and supply agreements. This may produce some volatility in the vaccines sales line as this business grows. Regarding recent tenders we have made good progress, in particular with Cervarix, which has been successful in approximately 60% of competitive tenders, notably in the UK for the largest vaccination programme against HPV in Europe.
Deliver more products of value In R&D, we are continuing to make the changes necessary to deliver our pipeline going forward.
We have seen a step-change in the number of launches for GSK, and importantly we are replenishing these with new phase III entries. At present, we are maintaining a level of around 30 assets in late-stage development and our strategies in R&D are focused on sustaining this type of productivity.
Moreover, GSK continues to deliver innovative products with 6 novel medicines and vaccines either launched or filed in 2008. In fact, around 75% of assets in our pipeline are entirely new compounds or vaccines. By any standard, this is a strong bias towards innovation and demonstrates the value GSK can bring to patients and to payers.
We have seen good progress in our late-stage biopharmaceutical portfolio this quarter. New data for ofatumumab, a treatment for patients with chronic lymphocytic leukaemia, will be used to support a licence application planned for the end of the year. Our first in-house developed biopharmaceutical product, Bosatria, was filed for approval in Europe this quarter.
We hope this will be a valuable new treatment for patients with the rare, but potentially fatal disease, hypereosinophilic syndrome. Finally, otelixizumab, a new potential treatment for Type I diabetes, entered phase III development in August.
Data on several other important assets this quarter further highlighted the potential of GSK’s pipeline. New data for cancer treatments, Armala and Tykerb, demonstrated positive effects against several tumour types with high, unmet medical need. In addition, we presented results from a clinical imaging study of darapladib. These data support our belief that Lp-PLA2 inhibition may be an important therapeutic target and we plan to begin phase III clinical studies shortly.
When I outlined our new strategic priorities last quarter, I said that GSK has a very clear ambition to realise value in R&D through better allocation of capital. Here, we have made progress through reshaping our R&D organisation and the introduction of new initiatives such as our Drug Discovery Investment Board. This Board has now reviewed 75% of our 3-year investment plans for drug discovery, with the remainder expected by year-end.

We are also seeking to improve productivity and value through externalisation of R&D. This enables us to capture scientific diversity and balance expenditure with risk. We believe new alliances formed this quarter with Cellzome and the Harvard Stem Cell Institute will provide competitive advantage in researching areas such as inflammatory disease, neuroscience and oncology.
With all its option-based collaborations, GSK now has access to products and pipelines of 16 companies, bringing further significant breadth and scale to our R&D activities. Combining this capacity with our own organic efforts provides us opportunities for complementary and synergistic research.
Staying with this theme, Sirtris, our recent R&D acquisition is now effectively integrated into our discovery organisation. Like Domantis, it will continue to operate as an independent unit, but we have also established numerous research collaborations in the field of sirtuins across GSK, including in our new R&D China organisation.
Simplify GSK’s operating model
Activities to improve our overall efficiency and create a new operating model for our business are well underway. Our current operational excellence programme is progressing well and we are on track to realise annual savings of at least 350 million in 2008 and 700 million by 2010. We have also commenced a series of reviews to simplify further our business, in particular, with attention to our above-country support infrastructure.
Financial strategy
We continue to benefit from strong cash generation with net cash inflow from operating activities of over 5 billion, up 6% in sterling terms in the first nine months of this year.
Our financial strategy is focused on maintaining an efficient balance sheet, retaining flexibility to invest in our strategic priorities and increasing returns to our shareholders through our progressive dividend policy. This quarter’s dividend increased by 8% to 14 pence and we have completed share repurchases of 3.3 billion in the 9 months to 30th September 2008.
We expect to have completed around 4 billion of repurchases by the year-end, subject to market conditions.
With the recent changes in financial markets we now expect more investment opportunities to arise that will allow us to invest in support of our strategic priorities. To ensure we have sufficient flexibility to take advantage of these opportunities we do not currently expect to make significant share repurchases in 2009. Investment opportunities will continue to be assessed against strict financial criteria.
Outlook
In summary then, our performance is in line with our expectations and I am pleased with how we have so far responded to what is undoubtedly a challenging year for GSK. Nevertheless, we remain focused on improving our short-term performance. We have also, I believe, started to take some initial steps in the right direction to deliver our strategic agenda to improve longterm sales growth and reduce risk for the company.
Andrew Witty Chief Executive Officer
Trading Update
Turnover and key product movements impacting turnover growth for the Quarter Total pharmaceutical turnover for the quarter declined 4% to 4.9 billion, with US turnover down 13% to 2.1 billion, impacted by generic competition to mature brands. In Europe, sales grew 6% to 1.6 billion, emerging markets sales grew 9% to 581 million and Asia Pacific/Japan sales grew 5% to 464 million.
Seretide/Advair sales were up 7% to 982 million for the quarter, with sales up 5% in the USA to 515 million and in Japan sales more than doubled to 25 million. Sales growth was also driven by Valtrex, up 21% to 303 million and Lovaza, with US sales of 75 million.
Sales of Avandia products were 191 million, a decline of 23% compared with 2007. There continues to be controversy surrounding the appropriate use of Avandia and consequently the sales outlook for the product remains negative. Lamictal sales declined 59% to 136 million following introduction of generic competition in the US market in July. Sales of Wellbutrin (down 67% to 53 million) and Coreg IR (down 93% to 9 million) also declined due to generic competition in the US market.
Vaccines sales grew 12% to 730 million, with hepatitis vaccines up 11% to 174 million, Infanrix/Pediarix up 9% to 168 million and Fluarix/FluLaval up 11% to 144 million. In the USA, this quarter’s performance reflected a difficult comparison to particularly strong sales growth in Q3 2007. Cervarix generated 43 million of sales for the quarter.
Consumer Healthcare sales grew 3% to 994 million during the quarter, compared with 16% growth in Q3 2007, which benefited from launch-stocking of alli. Excluding sales of alli, Consumer Healthcare sales grew 5% this quarter.
Sales of oral care brands, Aquafresh and Sensodyne, grew 5% and 8% respectively during the quarter, contributing sales of 206 million. Sales of Panadol grew 9% to 82 million, whilst sales of Tums declined 17% to 21 million. Sales of Horlicks grew 10% to 53 million and sales of Lucozade grew 2% to 100 million, principally due to a poor summer in the UK.
Operating profit and earnings per share commentary Business performance Business performance operating profit for Q3 2008 was 1,979 million, a 10% decline in CER terms. This was greater than the turnover decline of 3% in CER terms, primarily due to higher cost of sales as a percentage of turnover.
Cost of sales increased to 24.8% of turnover (Q3 2007: 22.5%), principally reflecting the anticipated generic competition to higher margin products in the USA. SG&A costs as a percentage of turnover fell 1.2 percentage points to 28.3% compared with Q3 2007, reflecting the benefits of the current operational excellence programme and other ongoing cost control.
R&D expenditure at 14.2% of turnover was broadly unchanged from last year.
Pharmaceuticals R&D expenditure in the quarter was 16.4% (Q3 2007: 16.1%) of pharmaceutical turnover.
In the quarter, gains from assets disposals were 21 million (Q3 2007: 22 million), costs for legal matters were 58 million (Q3 2007: 64 million), fair value movements on financial instruments, principally the Quest collar which was closed out in the quarter, resulted in a charge of 37 million (Q3 2007: 32 million) and charges related to previous restructuring programmes were 7 million (Q3 2007: 13 million). The impact of these items on business performance operating profit was broadly neutral, compared with Q3 2007.

Business performance EPS of 25.2p decreased 9% in CER terms (a 6% increase in sterling terms) compared with Q3 2007. The favourable currency impact of 15 percentage points reflected a weakening of sterling against most major currencies.
Statutory performance Statutory operating profit for Q3 2008 was 1,657 million, down 13% in sterling terms and down 26% CER compared with Q3 2007. This included 322 million of restructuring charges related to the current operational excellence programme; 130 million was charged to cost of sales, 157 million to SG&A and 35 million to R&D. There were no such charges in Q3 2007. Statutory performance EPS of 20.1p decreased 30% in CER terms (15% in sterling terms) compared with Q3 2007.
Cash flow Net cash inflow from operating activities in Q3 2008 was 1,893 million, up 3% in sterling terms. For the nine months net cash inflow from operating activities was 5,067 million, a 6% increase in sterling terms over the previous year. This was used to fund net interest payable of 55 million, capital expenditure on property, plant and equipment and intangible assets of 1,284 million, and acquisitions of 324 million.
In addition, dividends paid to shareholders totalled 2,250 million (up 6% compared with 2007) and share repurchases amounted to 3,324 million.
Net debt Net debt increased by 2.6 billion during the nine month period to 8.6 billion at 30th September 2008, comprising gross debt of 14.2 billion and cash and liquid investments of 5.6 billion.
The Group is well placed financially having completed its debt financing programme earlier in the year. At 30th September 2008, GSK had short-term borrowings (including overdrafts) repayable within 12 months of only 1.4 billion with a further 0.6 billion repayable in the subsequent 12-month period.
Dividends The Board has declared a third interim dividend of 14 pence per share (Q3 2007: 13p). The equivalent interim dividend receivable by ADR holders is 47.4796 cents per ADS based on an exchange rate of 1/$1.6957. The ex-dividend date will be 29th October 2008, with a record date of 31st October 2008 and a payment date of 8th January 2009.
Currency impact If exchange rates were to hold at the average Q3 2008 levels for the rest of the year, the positive currency impact on business performance EPS growth for the full year would be around 10 percentage points.
2008 earnings guidance GSK continues to expect a mid-single digit percentage decline in business performance EPS at constant exchange rates.
Philip Thomson
Claire Brough
Alice Hunt
Gwenan White
(020) 8047 5502
(020) 8047 5502
(020) 8047 5502
(020) 8047 5502
US Media
Sarah Alspach
Mary Anne Rhyne
(919) 483 2839
(215) 751 7709
(919) 483 2839
Nancy Pekarek
European Analyst / Investor
Sally Ferguson
Gary Davies
(020) 8047 5564
(020) 8047 5543
(020) 8047 5503
David Mawdsley
US Analyst / Investor
Tom Curry (215) 751 5419
Brand names
Brand names appearing in italics throughout this document are trademarks of GSK or associated companies with the
exception of
Corporation in the USA and
Pharmaceuticals in certain countries, all of
Levitra, a trademark of Bayer, Bonviva/Boniva, a trademark of Roche, Entereg, a trademark of AdolorVesicare, a trademark of Astellas Pharmaceuticals in many countries and of Yamanouchiwhich are used under licence by the Group.
Cautionary statement regarding forward-looking statements
Under the safe harbor provisions of the US Private Securities Litigation Reform Act of 1995, the company cautions
investors that any forward-looking statements or projections made by the company, including those made in this
Announcement, are subject to risks and uncertainties that may cause actual results to differ materially from those
projected. Factors that may affect the Group’s operations are described under ‘Risk Factors’ in the ‘Business Review’
in the company’s Annual Report on Form 20-F for 2007.
GlaxoSmithKline plc, 980 Great West Road, Brentford, Middlesex TW8 9GS, United Kingdom
Registered in England and Wales. Registered number: 3888792

GlaxoSmithKline (GSK) together with its subsidiary undertakings, the ‘Group’ – one of the
world’s leading research-based pharmaceutical and healthcare companies – is committed to
improving the quality of human life by enabling people to do more, feel better and live longer.
GlaxoSmithKline’s website www.gsk.com gives additional information on the Group.
Information made available on the website does not constitute part of this document.
Enquiries:
UK Media

Symptoms of Epilepsy

admin — Tue, 09 Dec 2008 16:46:02 +0000

Epilepsy is a chronic disorder of the brain that causes a tendency to have recurrent seizures. Two or more seizures must occur before a person can receive the diagnosis of epilepsy, also known as a seizure disorder. Seizures occur when there’s a sudden change in the normal way your brain cells communicate through electrical signals. During a seizure, some brain cells send abnormal signals, which stop other cells from working properly. This abnormality may cause temporary changes in sensation, behavior, movement or consciousness.
The onset of epilepsy is most common during childhood and after age 65, but the condition can occur at any age. Treatments may be able to leave you free of seizures, or at least reduce their frequency and intensity.
Signs and symptoms of epilepsy
Because abnormal brain cell activity causes seizures, having a seizure can result in the sudden occurrence of any activity that’s coordinated by your brain. This can include slight temporary confusion, complete loss of consciousness, a staring spell, muscle spasms, or uncontrollable, jerking movements of the arms and legs. Seizures originating in your brain’s temporal lobe can be associated with a sense of deja vu, anxiety and panic, or simply an uneasy sensation in your stomach, which can be followed by loss of consciousness.
Signs and symptoms may vary depending on the type of seizure. Most people with epilepsy experience the same type of seizure, with similar symptoms, each time they have a seizure, but others may experience a wide range of types and symptoms.
Doctors classify seizures as either partial or generalized, based on how the abnormal brain activity begins. When seizures appear to result from abnormal activity in just one part of the brain, they’re called partial seizures. When seizures seem to involve most or all of the brain, the seizures are called generalized.
What can cause epilepsy?
The onset of epilepsy can often be traced to an accident, disease or medical trauma –such as a stroke — that injures your brain or deprives it of oxygen, often causing a small scar in your brain. In rare occasions, epilepsy may be caused by a tumor in your brain. However, in many cases there’s no identifiable cause for the disease.
Epilepsy isn’t a mental disease, although mental health can influence the control of seizures in epilepsy. Epilepsy doesn’t cause psychiatric problems or mental retardation, but people with epilepsy may also be afflicted with those conditions.
Are there any risk factors?
Research suggests that genetic abnormalities contribute significantly to epilepsy. If you have a family history of the disease, you may be at increased risk.
Head injuries are responsible for many cases of epilepsy. You can reduce your risk by always wearing a seat belt while riding in a car and by wearing a helmet while bicycling, skiing, riding a motorcycle, or engaging in other activities with a high risk of head injury.
Stroke and other diseases that affect your vascular system can lead to brain damage that may trigger epilepsy. You can take a number of steps to reduce your risk of these diseases, including limiting your intake of alcohol, following a healthy diet, managing your weight, exercising regularly and avoiding cigarettes.
Diagnosis of epilepsy.
Because the possible causes of seizures are many, doctors may need to ask detailed questions and perform several tests to diagnose epilepsy, including:
Medical history. Descriptions of your past seizures — from yourself or others who have observed your seizures — may help your doctor identify the type and cause of your problem. Your physician may also need to know about your current and past medical conditions and how they’ve been treated.
Physical and neurologic examination. A neurologic examination may include testing your reflexes, muscle tone and strength, the function of your senses, and your gait, posture, coordination and balance. Your doctor may also ask questions to test your thinking, judgment and memory.
Blood tests. Your doctor may want to take samples of your blood to be tested for chemical imbalances that may be the cause of your seizures.
Electroencephalogram (EEG). This procedure records the electrical activity of your brain. An EEG helps determine what type of seizures or epilepsy you have and from which part of the brain seizures may start. During the procedure, which takes about a half-hour, you lie down. Between 16 and 30 small electrodes may be attached to your scalp with paste or an elastic cap. You remain still during the test, but at times you may be asked to breathe deeply and steadily for several minutes or to stare at a patterned board. At times a light may be flashed in your eyes. These actions are intended to stimulate your brain in ways that might be seen on the EEG. The electrodes pick up the electrical impulses from your brain and send them to the EEG machine, which records your brain waves on a moving sheet of paper or digitally on a computer screen.
Computerized tomography (CT). A CT scan produces detailed cross-sectional images of your brain. The images may reveal abnormalities in brain structure, including tumors, cysts, strokes or tangled blood vessels.
Magnetic resonance imaging (MRI). An MRI scan uses a powerful magnetic field and radio waves to produce images of your brain. Like CT scans, MRI images may reveal abnormalities in brain structure.
Medications for the treatment of epilepsy.
Finding the right medication and dosage can be complex. It might take more than one drug, or trying several different drugs until the right one is found. Medications available for the treatment of seizures include:
Dilantin
Tegretol
Depakene
Depakote
Keppra
Neurontin
Zarontin Trileptal
Lamictal
Topamax
All of these medications have some side effects, which may include mild fatigue, dizziness and weight gain. More severe side effects include depression, skin rashes, loss of coordination, speech problems and extreme fatigue. Discuss any of these side effects with your doctor as soon as possible. Many people with epilepsy use these medications for years without significant problems. Ask your doctor to explain these issues to you when you receive the prescription.
To achieve the best seizure control possible, take medications exactly as prescribed. Some seizure medications increase the risk of birth defects, so if you’re a woman with epilepsy tell your doctor if you’re considering becoming pregnant.
Online Pharmacies Canada, a Canadian Internet-based pharmacy intermediary (license #BC Q37),offers long term prescription drugs for low cost canadian online pharmacy prices. Online Pharmacies Canada facilitates the review of your Canadian prescription drugs and your general health. We forward all prescriptions to affiliated CIPA certified licensed Canada pharmacies to be filled. A professionally registered pharmacist fills all discount canadian prescriptions.

Chain Drug Review - Foot care medications.(Illustration)

admin — Sun, 07 Dec 2008 17:31:02 +0000

The May 27 deadline for entries to the 2005 MM&M Awards is looming. Don’t miss your chance to participate in the industry’s most prestigious awards for marketing excellence.
Novartis and Deutsch, the agency behind its Lamisil Digger the Dermatophyte and Zelnorm’s “Bellies” ads cleaned up at last year’s MM&M Awards, carting home honors for Best Total Integration Program (large companies), Best TV Campaign and Best Product Launch Ad in Consumer Press. Can anyone top that?

American Family Physician - Carbamazepine for acute and chronic pain

admin — Sun, 30 Nov 2008 21:51:03 +0000

Clinical Scenario
A 52-year-old man with diabetic neuropathic pain has read on the Internet that some seizure medicines are helpful, and he asks for your recommendation.
Clinical Question
How effective is carbamazepine (Tegretol) in controlling pain?
Evidence-Based Answer
Two small trials have shown carbamazepine to be beneficial in the treatment of diabetic neuropathic pain. Carbamazepine shows similar clinical effect to gabapentin (Neurontin) and phenytoin (Dilantin), but there have been no head-to-head trials directly comparing these drugs. Carbamazepine is effective in the treatment of trigeminal neuralgia and may be effective for other types of neuropathic pain, but the data are limited. Carbamazepine is not beneficial for the treatment of acute pain. (1)

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Many drugs are used for the treatment of neuropathic pain syndromes, including opioid analgesics, tricyclic antidepressants, seizure medicines, capsaicin (Zostrix), clonidine (Catapres), tramadol (Ultram), mexiletine (Mexitil), and lidocaine (Xylocaine). Seizure medicines used for neuropathic pain include carbamazepine, gabapentin, duloxetine (Cymbalta), lamotrigine (Lamictal), clonazepam (Klonopin), oxcarbazepine (Trileptal), phenytoin, valproate (Depacon), and pregabalin (Lyrica). (2-5)
After reviewing trials for various neuropathic pain syndromes, Wiffen and colleagues I found that carbamazepine was effective for pain control. However, the largest study in this review included only 77 patients. There was no evidence that carbamazepine causes more serious adverse effects than placebo. Although the number of patients was small, studies in those given the drug for seizures confirm its overall safety.
In the treatment of trigeminal neuralgia, many consider a positive response to carbamazepine to be diagnostic for the condition. However, only seven controlled studies met inclusion criteria for the Cochrane review, and only two studies included data that could be used to calculate the number needed to treat (NNT), which was 1.8. From the data in these small studies, slightly more than 50 percent of patients with trigeminal neuralgia can be expected to have pain relief from carbamazepine.
In the treatment of postherpetic neuralgia, one study reported improvement in pain compared with transcutaneous electronic nerve stimulation. One study of carbamazepine in poststroke pain found that the drug was more effective than placebo and was as effective as amitriptyline. There is little evidence for the use of carbamazepine in other chronic, nonneuropathic pain syndromes, and carbamazepine is not effective in the treatment of acute pain.
Although diabetic neuropathy is a common problem in primary care practice, there are few data evaluating the effectiveness of carbamazepine for diabetic neuropathic pain. Two studies met criteria for inclusion in this review, and although they showed evidence of decreased pain with the use of carbamazepine, they were too small to calculate an NNT. A meta-analysis3 conducted in 2005 also reviewed the use of antiepileptic drugs in chronic diabetic neuropathic pain. This review (3) included a double-blind, placebo-controlled, one-week crossover trial comparing carbamazepine with placebo that was not included in the Cochrane analysis. The NNT reported for the use of carbamazepine in diabetic neuropathy was 3.3 (95% confidence interval, 2 to 9.4).
Two drugs were approved by the U.S. Food and Drug Administration in 2004 for treating diabetic neuropathic pain. Duloxetine, an antidepressant, was approved for the treatment of peripheral diabetic neuropathic pain; initial short-term studies show an NNT of approximately 4. (4) Pregabalin, an antiepileptic drug, was approved for the treatment of pain associated with diabetic neuropathy. (5) Pregabalin is classified by the U.S. Drug enforcement Administration as a Schedule V controlled substance because of concerns about potential physical dependence. (5,6)
REFERENCES
(1.) Wiffen PJ, McQuay HJ, Moore RA. Carbamazepine for acute and chronic pain. Cochrane Database Syst Rev 2005;(3):CD005451.
(2.) Tremont-Lukats IW, Challapalli V, McNicol ED, Lau J, Carr DB. Systemic administration of local anesthetics to relieve neuropathic pain: a systematic review and metaanalysis. Anesth Analg 2005;101:1738-49.
(3.) Vinik A. Clinical review: use of antiepileptic drugs in the treatment of chronic painful diabetic neuropathy. J Clin Endocrinol Metab 2005;90:4936-45.
(4.) Duloxetine (Cymbalta) for diabetic neuropathic pain. Med Lett Drugs Ther 2005;47:67-8.
(5.) New drug: Lyrica (pregabalin). Pharmacist’s Lett/ Prescriber’s Lett 2005;21:210809.
(6.) Lyrica (pregabalin). Product information. New York, N.Y.: Pfizer, 2005.
JENNIFER J. BUESCHER, M.D., M.S.P.H., is a faculty physician at Clarkson Family Medicine Residency, a community-based residency program associated with the Nebraska Medical Center in Omaha, Neb. Dr. Buescher completed her residency and a faculty development fellowship at the University of Missouri-Columbia.

Temporal Lobe Seizure - Causes, Symptoms and Treatment Methods

admin — Thu, 27 Nov 2008 07:46:02 +0000

Temporal lobe seizure is the most frequent cause of partial seizures and aura. During a temporal lobe seizure, you may smack your lips, swallow repeatedly or pick at things with your fingers. Such activities are called automatisms. The temporal lobe is located close to the ear. Temporal lobe seizures can affect people of any age, and can occur as a single episode or can be repeated as part of a chronic (ongoing) condition. The seizures of temporal-lobe epilepsy often start in childhood. Temporal lobe epilepsy is difficult to diagnose because temporal lobe seizures may not show up on an EEG. Sometimes these seizures are caused by an abnormality in the temporal lobe, such as a tiny scar or tumor, but often no identifiable cause is found. A seizure is an episode of abnormal electrical activity in the brain that can involve loss of consciousness or reduction of consciousness, involuntary movements, and overwhelming sensations. Certain patterns of electrical activity can cause seizures, which are episodes when electrical signals spread in abnormal patterns within the brain.

Temporal lobe seizures commonly result from damage to specific areas in the temporal lobe of the brain. This damage includes scarring, called mesial temporal sclerosis. The seizures associated with TLE consist of simple partial seizures without loss of awareness (with or without aura) and complex partial seizures (ie, with loss of awareness). For most people, the seizures of TLE can be completely or at least mostly controlled with the medications for partial seizures. Many seizure medicines can be used, either alone or in combination. Temporal-lobe epilepsy is usually classified as simple or complex partial seizures. Repeated TLE seizures can damage the hippocampus, a part of the brain that is important for memory and learning. Pregnancy, lack of sleep, skipping doses of medications, use of recreational drugs (including alcohol), or illness may cause seizures in a person with a previously well-controlled seizure disorder. Temporal lobe resection may be an option for people with epilepsy whose seizures are disabling and/or not controlled by medication, or when the side effects of medication are severe and significantly affect the person’s quality of life.

Causes of Temporal lobe seizure

The common causes and risk factor’s of Temporal lobe seizure include the following:

Temporal lobe seizures commonly result from damage to specific areas in the temporal lobe of the brain.

Past infections, e.g. herpes encephalitis or bacterial meningitis.

Certain patterns of electrical activity.

Causes can include traumatic injury, infection, brain tumors, genetic syndromes, and lesions of any sort.

Although a brain tumor is an uncommon cause, a seizure may be the first indication of a brain tumor.

Blood vessel disorders, such as arteriovenous malformation (AVM), can be a cause of seizures.

Symptoms of Temporal lobe seizure

Some symptoms of related to Temporal lobe seizure are as follows:

Abnormal sensations.

A sudden sense of unprovoked fear.

Hallucinations or illusions (vision, smells, tastes, or other sensory illusions).

Nausea.

Epigastric sensations (”a funny feeling in my gut,” “stomach rising”).

Forced turning of the eyes.

Abdominal pain or discomfort.

Changes in vision, speech, thought, awareness, personality.

Rapid heart rate/pulse.

Treatment of Temporal lobe seizure

Here is list of the methods for treating Temporal lobe seizure:

Standard medications to control temporal lobe seizures include phenytoin (Dilantin), carbamazepine valproic acid (Depakene), phenobarbital, lamotrigine (Lamictal), topiramate (Topamax), tiagabine (Gabitril) and zonisamide (Zonegran).

Oral anticonvulsants (anti-seizure medications taken by mouth) are used to prevent or reduce the number of future seizures.

Multiple, repeated seizures are usually treated with long-term use of an antiepileptic drug.

For temporal lobe seizure disorders that don’t respond well to medications, surgery may be an option.

The operation (called a temporal lobectomy ) usually removes only the abnormal part of the temporal lobe, not the entire lobe. Many also benefit from vagus nerve stimulation or the ketogenic diet.

Use of informational jewelry or cards (such as Medic-Alert or similar) that indicate a seizure disorder may be advised. These accessories may help in obtaining quick medical treatment if a seizure happens.