The Annals of pharmacotherapy
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There have been many proposed uses for gabapentin, including midscapular pain secondary to radiation myelopathy, RSD, neuropathic pain, postherpetic neuralgia, and migraine prophylaxis. However, the published reports consist of a small number of patients and limited data. ⋯ Therefore, randomized, double-blind, placebo-controlled, prospective studies are warranted to further elucidate gabapentin uses beyond what is recommended by the Food and Drug Administration. Gabapentin should only be considered for pain management after well-established therapies have failed to produce desired outcomes.
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The role of guanfacine in ADHD remains unclear. It may be reasonable to initiate a trial of guanfacine in a patient who has not responded to or cannot tolerate other agents due to adverse effects or drug dependence, or in a patient who develops motor tics. ⋯ Pharmacologic intervention or a combination of pharmacotherapy and behavioral modification should be tried in patients who cannot be adequately controlled with nonpharmacologic treatment. The stimulants still are considered first-line pharmacotherapy; however, guanfacine may have a role as a second- or third-line agent in patients who do not respond to or cannot tolerate stimulants or TCAs.
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To report a nonfatal intentional overdose of amlodipine. ⋯ Amlodipine overdose produces prolonged hemodynamic effects and may lead to pulmonary edema. Due to a long elimination half-life and delayed onset of effects, patients with amlodipine overdose should receive aggressive decontamination therapy and may require extended clinical monitoring and supportive care if they are hemodynamically unstable.