Clinical neuropharmacology
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Clin Neuropharmacol · Nov 2007
ReviewDosing and therapeutic monitoring of phenytoin in young adults after neurotrauma: are current practices relevant?
Anticonvulsant drugs are commonly used to treat and prevent seizures after neurotrauma. However, many physiological changes occur in the neurotrauma patient, which alter the pharmacokinetics of drugs such as phenytoin. This raises concerns relating to the dosage and monitoring of phenytoin in these patients compared with its routine use in epileptic patients. ⋯ Many studies have reported that neurotrauma patients often present with either subtherapeutic or highly variable phenytoin serum concentrations. When phenytoin doses recommended for the epileptic patient are used in the neurotrauma patient, efficacy is limited to early posttraumatic seizures, with no effect on morbidity, mortality, or the onset of late posttraumatic seizures. This review examines the effect of neurotrauma on the pharmacokinetics of phenytoin alongside clinical outcomes and questions the current dosing and therapeutic monitoring practices within this area.
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Clin Neuropharmacol · Sep 2007
Multicenter StudyOvernight switch from oral dopaminergic agonists to transdermal rotigotine patch in subjects with Parkinson disease.
To assess safety, tolerability, and efficacy outcomes of an overnight switch from oral ropinirole, pramipexole, or cabergoline to rotigotine, a dopaminergic agonist with transdermal delivery over 24 hours in subjects with established Parkinson disease (PD). ⋯ Subjects and clinicians found the overnight switch to rotigotine convenient, well tolerated, and effective for control of PD signs and symptoms for subjects previously receiving low-to-moderate doses of oral dopaminergic agonists.
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Clin Neuropharmacol · May 2007
Case ReportsRefractory hiccup: successful treatment with gabapentin.
To report a patient with intractable hiccup which improved with gabapentin. ⋯ Gabapentin should be considered as a possible therapy for refractory hiccup.
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Clin Neuropharmacol · Sep 2006
Randomized Controlled Trial Comparative Study Clinical TrialTopiramate and triptans revert chronic migraine with medication overuse to episodic migraine.
This is a randomized, double-blind versus placebo study aimed at evaluating the efficacy of topiramate (TPM) in reducing the number of days with headache and the amount of acute medication taken monthly in patients with chronic migraine with medication overuse. We also studied the efficacy of single triptans available in Italy in interrupting headache crises during preventive treatment. ⋯ Topiramate proved to be well tolerated and effective in reverting chronic migraine with medication overuse to episodic migraine.