Matching articles for "bupropion"

Drugs for COPD

   
The Medical Letter on Drugs and Therapeutics • September 2, 2024;  (Issue 1710)
The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce...
The main goals of treatment of chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, prevent disease progression, and reduce mortality. GOLD (Global Initiative for Chronic Obstructive Lung Disease) guidelines for treatment of COPD were updated recently. Treatment of acute exacerbations is not discussed here. Drugs available for treatment of COPD are listed in Tables 1 and 3.
Med Lett Drugs Ther. 2024 Sep 2;66(1710):137-44 | Show Full IntroductionHide Full Introduction

Gepirone (Exxua) for Depression

   
The Medical Letter on Drugs and Therapeutics • June 24, 2024;  (Issue 1705)
The FDA has approved an oral extended-release formulation of gepirone (Exxua – Fabre-Kramer), a selective 5-HT1A receptor agonist, for treatment of major depressive disorder (MDD) in adults. Gepirone was...
The FDA has approved an oral extended-release formulation of gepirone (Exxua – Fabre-Kramer), a selective 5-HT1A receptor agonist, for treatment of major depressive disorder (MDD) in adults. Gepirone was originally developed decades ago for treatment of anxiety and depression, but it was not approved by the FDA for such use. Gepirone is structurally related to buspirone, which is FDA-approved for treatment of anxiety.
Med Lett Drugs Ther. 2024 Jun 24;66(1705):97-9 | Show Full IntroductionHide Full Introduction

Drugs for Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • April 1, 2024;  (Issue 1699)
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder...
Bipolar disorder is characterized by episodes of mania, hypomania, and depression. Recurrences of manic or (more frequently) depressive symptoms are common. About 15-20% of patients with bipolar disorder die by suicide.
Med Lett Drugs Ther. 2024 Apr 1;66(1699):49-54 | Show Full IntroductionHide Full Introduction

Addendum: Bupropion Safety in Pregnancy

   
The Medical Letter on Drugs and Therapeutics • April 1, 2024;  (Issue 1699)
Our December 11, 2023 article on Drugs for Depression included a single sentence on the safety of bupropion use during pregnancy: "The safety of bupropion during pregnancy has not been established; data from...
Our December 11, 2023 article on Drugs for Depression included a single sentence on the safety of bupropion use during pregnancy: "The safety of bupropion during pregnancy has not been established; data from a bupropion pregnancy registry suggested a possible increase in cardiac malformations." A reader asked us to provide more information.
Med Lett Drugs Ther. 2024 Apr 1;66(1699):56 | Show Full IntroductionHide Full Introduction

Drugs for Depression

   
The Medical Letter on Drugs and Therapeutics • December 11, 2023;  (Issue 1691)
A selective serotonin reuptake inhibitor (SSRI) is generally used for initial treatment of major depressive disorder (MDD). A serotonin-norepinephrine reuptake inhibitor (SNRI), bupropion (Wellbutrin SR,...
A selective serotonin reuptake inhibitor (SSRI) is generally used for initial treatment of major depressive disorder (MDD). A serotonin-norepinephrine reuptake inhibitor (SNRI), bupropion (Wellbutrin SR, and others), and mirtazapine (Remeron, and others) are reasonable alternatives. Improvement in symptoms can occur within the first two weeks of treatment with these drugs, but a substantial benefit may not be achieved for 4-8 weeks.
Med Lett Drugs Ther. 2023 Dec 11;65(1691):193-200 | Show Full IntroductionHide Full Introduction

Drugs for Depression

   
The Medical Letter on Drugs and Therapeutics • December 11, 2023;  (Issue 1691)
A selective serotonin reuptake inhibitor (SSRI) is generally used for initial treatment of major depressive disorder (MDD). A serotonin-norepinephrine reuptake inhibitor (SNRI), bupropion (Wellbutrin SR,...
A selective serotonin reuptake inhibitor (SSRI) is generally used for initial treatment of major depressive disorder (MDD). A serotonin-norepinephrine reuptake inhibitor (SNRI), bupropion (Wellbutrin SR, and others), and mirtazapine (Remeron, and others) are reasonable alternatives. Improvement in symptoms can occur within the first two weeks of treatment with these drugs, but a substantial benefit may not be achieved for 4-8 weeks.
Med Lett Drugs Ther. 2023 Dec 11;65(1691):193-200 | Show Full IntroductionHide Full Introduction

Brexpiprazole (Rexulti) for Agitation in Alzheimer's Dementia

   
The Medical Letter on Drugs and Therapeutics • June 26, 2023;  (Issue 1679)
The FDA has approved the oral second-generation antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated with dementia due to Alzheimer's disease...
The FDA has approved the oral second-generation antipsychotic drug brexpiprazole (Rexulti – Otsuka/Lundbeck) for once-daily treatment of agitation associated with dementia due to Alzheimer's disease (AD). Brexpiprazole is the first drug to be approved in the US for this indication. It is also approved for treatment of schizophrenia and as an adjunct to antidepressants for treatment of major depressive disorder.
Med Lett Drugs Ther. 2023 Jun 26;65(1679):99-101 | Show Full IntroductionHide Full Introduction

Dextromethorphan/Bupropion (Auvelity) for Depression

   
The Medical Letter on Drugs and Therapeutics • December 26, 2022;  (Issue 1666)
The FDA has approved an extended-release fixed-dose combination of dextromethorphan and bupropion (Auvelity – Axsome) for treatment of major depressive disorder (MDD) in...
The FDA has approved an extended-release fixed-dose combination of dextromethorphan and bupropion (Auvelity – Axsome) for treatment of major depressive disorder (MDD) in adults.
Med Lett Drugs Ther. 2022 Dec 26;64(1666):201-3 | Show Full IntroductionHide Full Introduction

Drugs and Devices for Weight Management

   
The Medical Letter on Drugs and Therapeutics • May 30, 2022;  (Issue 1651)
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a...
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a 5-10% reduction in weight, which has been associated with a reduction in the risk of developing type 2 diabetes, hypertension, and dyslipidemia. Diet, exercise, and behavior modification are the preferred methods for losing weight, but long-term weight maintenance can be difficult. Several drugs and devices are FDA-approved for weight reduction and maintenance of weight loss.
Med Lett Drugs Ther. 2022 May 30;64(1651):81-8 | Show Full IntroductionHide Full Introduction

Comparison Table: Some FDA-Approved Drugs for Weight Management (online only)

   
The Medical Letter on Drugs and Therapeutics • May 30, 2022;  (Issue 1651)
...
View the Comparison Table: Some FDA-Approved Drugs for Weight Management
Med Lett Drugs Ther. 2022 May 30;64(1651):e89-91 | Show Full IntroductionHide Full Introduction

Drugs for COPD

   
The Medical Letter on Drugs and Therapeutics • September 7, 2020;  (Issue 1606)
The main goals of treatment for chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, and prevent disease progression. Several...
The main goals of treatment for chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, and prevent disease progression. Several guidelines and review articles on COPD treatment have been published in recent years. Treatment of acute exacerbations is not discussed here.
Med Lett Drugs Ther. 2020 Sep 7;62(1606):137-44 | Show Full IntroductionHide Full Introduction

Drugs for Depression

   
The Medical Letter on Drugs and Therapeutics • February 24, 2020;  (Issue 1592)
Complete remission of symptoms is the goal of treatment for major depressive disorder; a partial response is associated with an increased risk of relapse. Improvement in symptoms can occur within the first...
Complete remission of symptoms is the goal of treatment for major depressive disorder; a partial response is associated with an increased risk of relapse. Improvement in symptoms can occur within the first two weeks of treatment with an antidepressant, but it may take 4-8 weeks to achieve a substantial benefit. Following successful treatment of a first major depressive episode, antidepressant treatment should be continued at the same dose for at least 4-9 months to consolidate recovery. In patients with recurrent depressive episodes, long-term maintenance treatment can reduce the risk of relapse.
Med Lett Drugs Ther. 2020 Feb 24;62(1592):25-32 | Show Full IntroductionHide Full Introduction

Drugs for Smoking Cessation

   
The Medical Letter on Drugs and Therapeutics • July 15, 2019;  (Issue 1576)
Smoking tobacco remains the primary preventable cause of death in the US. Smoking cessation often requires both pharmacotherapy and behavioral...
Smoking tobacco remains the primary preventable cause of death in the US. Smoking cessation often requires both pharmacotherapy and behavioral support.
Med Lett Drugs Ther. 2019 Jul 15;61(1576):105-10 | Show Full IntroductionHide Full Introduction

Expanded Table: Some Drugs for Smoking Cessation (online only)

   
The Medical Letter on Drugs and Therapeutics • July 15, 2019;  (Issue 1576)
...
View the Expanded Table: Some Drugs for Smoking Cessation
Med Lett Drugs Ther. 2019 Jul 15;61(1576):e112-4 | Show Full IntroductionHide Full Introduction

Diet, Drugs, Devices, and Surgery for Weight Management

   
The Medical Letter on Drugs and Therapeutics • June 4, 2018;  (Issue 1548)
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a...
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. The initial recommendation for any weight loss effort is to achieve a 5-10% reduction in weight, which has been associated with a reduction in the risk of developing type 2 diabetes, hypertension, and dyslipidemia. Diet, exercise, and behavior modification are the preferred methods for losing weight, but long-term weight maintenance can be difficult. Several drugs are FDA-approved for weight reduction and maintenance (see Table 1), and procedures such as endoscopic placement of dilated balloons have produced beneficial short-term results (see Table 2), but bariatric surgery has been the most effective intervention for sustainable long-term weight loss and reduction of obesity-related comorbidities.
Med Lett Drugs Ther. 2018 Jun 4;60(1548):91-8 | Show Full IntroductionHide Full Introduction

Comparison Table: Some FDA-Approved Drugs for Weight Management (online only)

   
The Medical Letter on Drugs and Therapeutics • June 4, 2018;  (Issue 1548)
...
View the Comparison Table: Some FDA-Approved Drugs for Weight Management
Med Lett Drugs Ther. 2018 Jun 4;60(1548):e98-100 | Show Full IntroductionHide Full Introduction

Drugs for COPD

   
The Medical Letter on Drugs and Therapeutics • April 10, 2017;  (Issue 1518)
The main goals of treatment for chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, and prevent disease progression. Updated...
The main goals of treatment for chronic obstructive pulmonary disease (COPD) are to relieve symptoms, reduce the frequency and severity of exacerbations, and prevent disease progression. Updated guidelines for treatment of COPD have been published in recent years.
Med Lett Drugs Ther. 2017 Apr 10;59(1518):57-62 | Show Full IntroductionHide Full Introduction

Drugs for Depression

   
The Medical Letter on Drugs and Therapeutics • July 4, 2016;  (Issue 1498)
Complete remission of symptoms is the goal of antidepressant therapy; partial response is associated with an increased risk of relapse. Improvement can occur within the first two weeks of drug therapy, but...
Complete remission of symptoms is the goal of antidepressant therapy; partial response is associated with an increased risk of relapse. Improvement can occur within the first two weeks of drug therapy, but it may take 4-8 weeks to achieve a substantial benefit. Fewer than 50% of patients with depression respond to first-line pharmacotherapy, and the rate of response decreases with each subsequent drug trial. Following remission after a first episode of depression, many experts recommend continuing antidepressant treatment at the same dose for at least 6-12 months to consolidate recovery. For patients with recurrent depressive episodes, long-term maintenance therapy can reduce the risk of recurrence.
Med Lett Drugs Ther. 2016 Jul 4;58(1498):85-90 | Show Full IntroductionHide Full Introduction

Drugs for Tobacco Dependence

   
The Medical Letter on Drugs and Therapeutics • February 29, 2016;  (Issue 1489)
Tobacco dependence remains the primary preventable cause of death in the United States. It is a chronic disorder that often requires pharmacologic therapy, but counseling may be equally effective and can add...
Tobacco dependence remains the primary preventable cause of death in the United States. It is a chronic disorder that often requires pharmacologic therapy, but counseling may be equally effective and can add to the effectiveness of any treatment for this indication. Abrupt cessation of smoking appears to be as effective as gradual reduction.
Med Lett Drugs Ther. 2016 Feb 29;58(1489):27-31 | Show Full IntroductionHide Full Introduction

Brexpiprazole (Rexulti) for Schizophrenia and Depression

   
The Medical Letter on Drugs and Therapeutics • August 17, 2015;  (Issue 1475)
The FDA has approved the oral, once-daily, second-generation antipsychotic brexpiprazole (Rexulti – Otsuka/Lundbeck) for treatment of schizophrenia and as an adjunct to antidepressants for treatment of...
The FDA has approved the oral, once-daily, second-generation antipsychotic brexpiprazole (Rexulti – Otsuka/Lundbeck) for treatment of schizophrenia and as an adjunct to antidepressants for treatment of major depressive disorder (MDD). Aripiprazole (Abilify), a structurally similar second-generation antipsychotic also comarketed by Otsuka (with BMS), recently became available generically.
Med Lett Drugs Ther. 2015 Aug 17;57(1475):116-8 | Show Full IntroductionHide Full Introduction

Liraglutide (Saxenda) for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • June 22, 2015;  (Issue 1471)
The injectable glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide, previously approved by the FDA for treatment of type 2 diabetes as Victoza, has now also been approved at a higher dose as...
The injectable glucagon-like peptide-1 (GLP-1) receptor agonist liraglutide, previously approved by the FDA for treatment of type 2 diabetes as Victoza, has now also been approved at a higher dose as Saxenda (Novo Nordisk) for chronic weight management in adults with a BMI ≥30, or a BMI ≥27 with a weight-related comorbidity such as hypertension, dyslipidemia, or diabetes.
Med Lett Drugs Ther. 2015 Jun 22;57(1471):89-90 | Show Full IntroductionHide Full Introduction

Diet, Drugs, and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • February 16, 2015;  (Issue 1462)
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. Losing even a small amount of weight and increasing physical activity...
Adults with a body mass index (BMI) between 25 and 29.9 kg/m2 are considered overweight. Those with a BMI ≥30 are considered obese. Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing weight, but long-term failure rates are high. Several drugs have been approved by the FDA for weight reduction, but adherence is poor, adverse effects are common, and patients usually regain the lost weight when the drug is stopped. Bariatric surgery can produce substantial weight loss and significantly reduce obesity-related comorbidities; long-term data on its safety are encouraging, but still limited. Guidelines for the management of overweight or obese adults have recently been published.
Med Lett Drugs Ther. 2015 Feb 16;57(1462):21-8 | Show Full IntroductionHide Full Introduction

Contrave - A Combination of Bupropion and Naltrexone for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • November 10, 2014;  (Issue 1455)
The FDA has approved a fixed-dose combination of the opioid receptor antagonist naltrexone (ReVia, and others) and the antidepressant and smoking cessation agent bupropion (Wellbutrin SR, Zyban, and...
The FDA has approved a fixed-dose combination of the opioid receptor antagonist naltrexone (ReVia, and others) and the antidepressant and smoking cessation agent bupropion (Wellbutrin SR, Zyban, and others), as Contrave (Orexigen/Takeda) for weight loss. The combination was approved for use as an adjunct to diet and increased physical activity in patients with a body mass index (BMI) ≥30 kg/m2 or a BMI ≥27 kg/m2 and one or more weight-related comorbidities such as hypertension, diabetes, or dyslipidemia. Naltrexone/bupropion is not a controlled substance.
Med Lett Drugs Ther. 2014 Nov 10;56(1455):112-4 | Show Full IntroductionHide Full Introduction

Drugs for Asthma and COPD

   
The Medical Letter on Drugs and Therapeutics • August 1, 2013;  (Issue 132)
INHALATION DEVICES — Metered-dose inhalers (MDIs) require coordination of inhalation with hand-actuation of the device. Valved holding chambers (VHCs) or spacers help some patients, especially young...
INHALATION DEVICES — Metered-dose inhalers (MDIs) require coordination of inhalation with hand-actuation of the device. Valved holding chambers (VHCs) or spacers help some patients, especially young children and the elderly, use MDIs effectively. VHCs have one-way valves that prevent the patient from exhaling into the device, minimizing the need for coordinated actuation and inhalation. Spacers are tubes or chambers placed between the canister and a face mask or mouthpiece, which also avoids the need to coordinate actuation and inhalation. Both VHCs and spacers retain the larger particles emitted from the MDI, decreasing their deposition in the oropharynx and leading to a higher proportion of small respirable particles being inhaled.
Treat Guidel Med Lett. 2013 Aug;11(132):75-86 | Show Full IntroductionHide Full Introduction

Citalopram, Escitalopram and the QT Interval

   
The Medical Letter on Drugs and Therapeutics • July 22, 2013;  (Issue 1421)
In 2011, the FDA asked the manufacturers of the selective serotonin reuptake inhibitor (SSRI) citalopram (Celexa, and generics) to lower the maximum daily dosage of the drug because of a dose-related...
In 2011, the FDA asked the manufacturers of the selective serotonin reuptake inhibitor (SSRI) citalopram (Celexa, and generics) to lower the maximum daily dosage of the drug because of a dose-related increase in the QT interval. Since then, some of our readers have asked whether escitalopram (Lexapro, and generics), the active enantiomer of citalopram, could have the same effect.
Med Lett Drugs Ther. 2013 Jul 22;55(1421):59 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2013;  (Issue 130)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) can be used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2013 Jun;11(130):53-64 | Show Full IntroductionHide Full Introduction

In Brief: Budeprion XL 300 Has Been Withdrawn

   
The Medical Letter on Drugs and Therapeutics • October 29, 2012;  (Issue 1402)
The FDA has asked Impax Laboratories/Teva Pharmaceuticals to stop production and distribution of Budeprion XL 300 mg, a generic extended-release formulation of the antidepressant bupropion (Wellbutrin XL),...
The FDA has asked Impax Laboratories/Teva Pharmaceuticals to stop production and distribution of Budeprion XL 300 mg, a generic extended-release formulation of the antidepressant bupropion (Wellbutrin XL), because it has found that Budeprion XL 300 mg releases bupropion more rapidly than Wellbutrin XL 300 mg, the original brand name product. Patients switched from the brand name to the generic formulation have complained for years that the generic was less effective and caused more side effects than the original formulation. In 2007, ConsumerLab.com, an independent laboratory, conducted dissolution testing of Budeprion XL, which uses a matrix for slow release, and Wellbutrin XL, which uses a membrane. According to the test results, the Budeprion XL matrix released more bupropion in the first 4 hours than the Wellbutrin XL membrane did.1 The FDA decided to conduct its own studies of Budeprion XL 300 mg and arrived at a similar conclusion. The original approval of the generic formulation was based on pharmacokinetic tests conducted on 150-mg tablets of the Impax/Teva formulation, with results extrapolated to the 300-mg tablet.

Bupropion is often used as an alternative to a selective serotonin reuptake inhibitor (SSRI) or another antidepressant because it does not cause sexual dysfunction, sedation, or weight gain.2 It is also used as an aid in smoking cessation.3 It is contraindicated in patients at increased risk of seizures (including patients with a history of an eating disorder). Other 300-mg formulations of generic extended-release bupropion have not been associated with post-marketing complaints and continue to be available.

1. Wellbutrin versus generic bupropion. Med Lett Drugs Ther 2008; 50:54.

2. Drugs for depression and bipolar disorder. Treat Guidel Med Lett 2010; 8:35.

3. Drugs for tobacco dependence. Treat Guidel Med Lett 2008; 6:61.

Download complete U.S. English article

Med Lett Drugs Ther. 2012 Oct 29;54(1402):88 | Show Full IntroductionHide Full Introduction

Adjunctive Antipsychotics for Major Depression

   
The Medical Letter on Drugs and Therapeutics • September 19, 2011;  (Issue 1373)
Augmentation with a second-generation (atypical) antipsychotic is a treatment option for patients with major depressive disorder (MDD) whose symptoms persist following antidepressant monotherapy. Aripiprazole...
Augmentation with a second-generation (atypical) antipsychotic is a treatment option for patients with major depressive disorder (MDD) whose symptoms persist following antidepressant monotherapy. Aripiprazole (Abilify), olanzapine in a fixed-dose combination with fluoxetine (Symbyax), and extended-release quetiapine (Seroquel XR) have been approved by the FDA for such use.
Med Lett Drugs Ther. 2011 Sep 19;53(1373):74-5 | Show Full IntroductionHide Full Introduction

Diet, Drugs and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • April 1, 2011;  (Issue 104)
...
Adults with a body mass index (BMI=kg/m2) of 25-<30 are considered overweight; those with a BMI of ≥30 are considered obese.
Treat Guidel Med Lett. 2011 Apr;9(104):17-22 | Show Full IntroductionHide Full Introduction

Drugs for Female Sexual Dysfunction

   
The Medical Letter on Drugs and Therapeutics • December 13, 2010;  (Issue 1353)
Sexual complaints related to desire, arousal, orgasm and painful intercourse are common in women. Since the last Medical Letter article on this subject, some new information has become...
Sexual complaints related to desire, arousal, orgasm and painful intercourse are common in women. Since the last Medical Letter article on this subject, some new information has become available.
Med Lett Drugs Ther. 2010 Dec 13;52(1353):100-2 | Show Full IntroductionHide Full Introduction

Drugs for Chronic Obstructive Pulmonary Disease

   
The Medical Letter on Drugs and Therapeutics • November 1, 2010;  (Issue 99)
The goals of drug therapy for chronic obstructive pulmonary disease (COPD) are to reduce symptoms such as dyspnea, improve exercise tolerance and quality of life, and decrease complications of the disease...
The goals of drug therapy for chronic obstructive pulmonary disease (COPD) are to reduce symptoms such as dyspnea, improve exercise tolerance and quality of life, and decrease complications of the disease such as acute exacerbations. Other guidelines for treatment of this condition have been published or updated in recent years.
Treat Guidel Med Lett. 2010 Nov;8(99):83-8 | Show Full IntroductionHide Full Introduction

Drugs for Depression and Bipolar Disorder

   
The Medical Letter on Drugs and Therapeutics • May 1, 2010;  (Issue 93)
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and...
Drugs are not the only treatment for mood disorders. Psychotherapy remains an important component in the management of these disorders, and electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective, poorly tolerated or cannot be used. Some drugs are recommended here for indications that have not been approved by the FDA.
Treat Guidel Med Lett. 2010 May;8(93):35-42 | Show Full IntroductionHide Full Introduction

Safety of Smoking Cessation Drugs

   
The Medical Letter on Drugs and Therapeutics • August 24, 2009;  (Issue 1319)
The most effective drugs available for treatment of tobacco dependence are bupropion (Zyban, and others and varenicline (Chantix). The FDA recently ordered the manufacturers of both to add boxed warnings about...
The most effective drugs available for treatment of tobacco dependence are bupropion (Zyban, and others and varenicline (Chantix). The FDA recently ordered the manufacturers of both to add boxed warnings about the risk of psychiatric symptoms and suicide to their prescribing information (FDA Alert, 7/1/2009).
Med Lett Drugs Ther. 2009 Aug 24;51(1319):65 | Show Full IntroductionHide Full Introduction

In Brief: Tamoxifen and SSRI Interactions

   
The Medical Letter on Drugs and Therapeutics • June 15, 2009;  (Issue 1314)
Use of a selective serotonin reuptake inhibitor (SSRI) is common in women taking tamoxifen (Nolvadex, and others) for breast cancer, both to treat depression and to decrease hot flashes. However, tamoxifen must...
Use of a selective serotonin reuptake inhibitor (SSRI) is common in women taking tamoxifen (Nolvadex, and others) for breast cancer, both to treat depression and to decrease hot flashes. However, tamoxifen must be metabolized by CYP2D6 to become pharmacologically fully active (MJ Higgins et al. J Natl Compr Canc Netw 2009; 7:203), and the SSRIs fluoxetine (Prozac, and others) and paroxetine (Paxil, and others) are strong inhibitors of CYP2D6. Sertraline (Zoloft, and others) inhibits CYP2D6 to a lesser extent. Citalopram (Celexa, and others) and escitalopram (Lexapro), the 2 other SSRIs approved for treatment of depression, are only weak inhibitors of CYP2D6.

Two observational studies presented at a recent meeting of the American Society of Clinical Oncology (45th annual meeting, May 29-June 2, 2009, Orlando, FL abstracts CRA508, CRA509) examined the effect of strong inhibitors of CYP2D6 on the success rate of tamoxifen in preventing recurrence of breast cancer. One found that women who took fluoxetine, paroxetine or sertraline (or bupropion, duloxetine, terbinafine, quinidine or long-term diphenhydramine) with tamoxifen had a higher 2-year recurrence rate (13.9% vs. 7.5%). The other study found no association between cancer recurrence and use of a CYP2D6 inhibitor.

There is no good evidence that any one SSRI is more effective than any other for treatment of depression. For women who are taking tamoxifen and need to begin treatment with an SSRI to treat depression, citalopram or escitalopram might be the safest choice (Treat Guidel Med Lett 2006; 4:35). Use of an SSRI to treat hot flashes in women taking tamoxifen should probably be reconsidered.

Download: U.S. English
Med Lett Drugs Ther. 2009 Jun 15;51(1314):45-6 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • December 15, 2008;  (Issue 1301)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment could also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.

Click here to view the free full article.
Med Lett Drugs Ther. 2008 Dec 15;50(1301):100-3 | Show Full IntroductionHide Full Introduction

Drugs for Tobacco Dependence

   
The Medical Letter on Drugs and Therapeutics • September 1, 2008;  (Issue 73)
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking...
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. The greater the number of office visits and the longer the counseling time, the higher the smoking cessation rates have been.
Treat Guidel Med Lett. 2008 Sep;6(73):61-5 | Show Full IntroductionHide Full Introduction

Wellbutrin Versus Generic Bupropion

   
The Medical Letter on Drugs and Therapeutics • July 14, 2008;  (Issue 1290)
Bupropion (Wellbutrin - GlaxoSmithKline, and others) is a norepinephrine and dopamine reuptake inhibitor that has been a useful antidepressant because, unlike some other antidepressants, it does not cause...
Bupropion (Wellbutrin - GlaxoSmithKline, and others) is a norepinephrine and dopamine reuptake inhibitor that has been a useful antidepressant because, unlike some other antidepressants, it does not cause sexual dysfunction, weight gain or sedation. Some patients who were switched from Wellbutrin to a generic alternative have reported worsening side effects and relapse of previously controlled depressive symptoms.1 Most of the complaints have come from patients switched from Wellbutrin XL 300 mg to the generic 300-mg formulation of extended-release bupropion marketed by Teva (Budeprion XL).2 In 2007, about 1 million prescriptions per month were dispensed for extended-release formulations of bupropion; about 40% of these were written for Budeprion XL 300 mg.
Med Lett Drugs Ther. 2008 Jul 14;50(1290):54-5 | Show Full IntroductionHide Full Introduction

Diet, Drugs and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • April 1, 2008;  (Issue 68)
Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing...
Losing even a small amount of weight and increasing physical activity can prevent some of the complications of obesity, particularly type 2 diabetes. Diet and exercise are the preferred methods for losing weight but are associated with high long-term failure rates. Drugs may help some patients, but all currently available drugs for weight reduction have drawbacks. Gastric surgery can produce marked weight loss in the severely obese, but long-term data on safety are limited.
Treat Guidel Med Lett. 2008 Apr;6(68):23-7 | Show Full IntroductionHide Full Introduction

In Brief: Varenicline (Chantix) Revisited

   
The Medical Letter on Drugs and Therapeutics • November 19, 2007;  (Issue 1274)
When the nicotine receptor partial agonist varenicline (Chantix – Pfizer) was first marketed, The Medical Letter concluded that it was moderately effective in increasing smoking cessation rates.1 More recent...
When the nicotine receptor partial agonist varenicline (Chantix – Pfizer) was first marketed, The Medical Letter concluded that it was moderately effective in increasing smoking cessation rates.1 More recent publications and the clinical experience of Medical Letter consultants now suggest that varenicline is the most effective drug available for this indication, more effective than nicotine replacement therapy or bupropion SR (Zyban).2,3 A word of caution: exacerbations of psychiatric illness have been reported in patients who took higher-than-recommended starting doses of varenicline.4,5

1. Varenicline (Chantix) for tobacco dependence. Med Lett Drugs Ther 2006; 48:66.
2. P Wu et al. Effectiveness of smoking cessation therapies: a systemic review and meta-analysis. BMC Public Health 2006; 6:300.
3. K Cahill et al. Nicotine receptor partial agonists for smoking cessation. Cochrane Database Syst Rev 2007; (1):CD006103.
4. R Freedman. Exacerbation of schizophrenia by varenicline. Am J Psychiatry 2007; 164:1269.
5. I Kohen and N Kremen. Varenicline-induced manic episode in a patient with bipolar disorder. Am J Psychiatry 2007; 164:1269.

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Med Lett Drugs Ther. 2007 Nov 19;49(1274):93-6 | Show Full IntroductionHide Full Introduction

Drugs for Chronic Obstructive Pulmonary Disease

   
The Medical Letter on Drugs and Therapeutics • November 1, 2007;  (Issue 63)
The goals of drug therapy for chronic obstructive pulmonary disease (COPD) are to reduce symptoms such as dyspnea, improve exercise tolerance and quality of life, and minimize complications of the disease such...
The goals of drug therapy for chronic obstructive pulmonary disease (COPD) are to reduce symptoms such as dyspnea, improve exercise tolerance and quality of life, and minimize complications of the disease such as acute exacerbations and cor pulmonale. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines developed by the World Health Organization and the National Heart, Lung and Blood Institute were updated in 2006. The American Thoracic Society and the European Respiratory Society jointly developed guidelines for COPD in 2004.
Treat Guidel Med Lett. 2007 Nov;5(63):95-100 | Show Full IntroductionHide Full Introduction

Drugs for Female Sexual Dysfunction

   
The Medical Letter on Drugs and Therapeutics • April 23, 2007;  (Issue 1259)
Sexual complaints related to desire, arousal, orgasm and pain are common in women. No drugs are approved by the FDA for any of these indications, but many are used...
Sexual complaints related to desire, arousal, orgasm and pain are common in women. No drugs are approved by the FDA for any of these indications, but many are used off-label.
Med Lett Drugs Ther. 2007 Apr 23;49(1259):33-5 | Show Full IntroductionHide Full Introduction

Varenicline (Chantix) for Tobacco Dependence

   
The Medical Letter on Drugs and Therapeutics • August 14, 2006;  (Issue 1241)
Varenicline tartrate (Chantix - Pfizer) is now available for oral treatment of tobacco dependence. Some other drugs for this indication are listed in this...
Varenicline tartrate (Chantix - Pfizer) is now available for oral treatment of tobacco dependence. Some other drugs for this indication are listed in this article.
Med Lett Drugs Ther. 2006 Aug 14;48(1241):66-8 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • June 1, 2006;  (Issue 46)
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as...
Drugs are not the only treatment for psychiatric illness. Psychotherapy remains an important component in the management of these disorders, and cognitive behavioral therapy (CBT) is used for many of them as well. Electroconvulsive therapy (ECT) has a long history of efficacy and safety when drugs are ineffective or cannot be used.
Treat Guidel Med Lett. 2006 Jun;4(46):35-46 | Show Full IntroductionHide Full Introduction

Drugs for Insomnia

   
The Medical Letter on Drugs and Therapeutics • February 1, 2006;  (Issue 42)
Many drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be more effective and durable than...
Many drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be more effective and durable than treatment with drugs. Hypnotic drugs are generally FDA-approved only for short-term use, but in practice they often are taken much longer.
Treat Guidel Med Lett. 2006 Feb;4(42):5-10 | Show Full IntroductionHide Full Introduction

Drugs for Intermittent Claudication

   
The Medical Letter on Drugs and Therapeutics • February 16, 2004;  (Issue 1176)
Management of intermittent claudication, the most common symptom of peripheral arterial disease (PAD), involves both risk factor modification and symptomatic treatment (WR Hiatt, N Engl J Med 2001; 344:1608; RM...
Management of intermittent claudication, the most common symptom of peripheral arterial disease (PAD), involves both risk factor modification and symptomatic treatment (WR Hiatt, N Engl J Med 2001; 344:1608; RM Schainfeld, J Am Board Fam Pract 2001; 14:443).
Med Lett Drugs Ther. 2004 Feb 16;46(1176):13-5 | Show Full IntroductionHide Full Introduction

Diet, Drugs and Surgery for Weight Loss

   
The Medical Letter on Drugs and Therapeutics • December 1, 2003;  (Issue 16)
The latest definitions of overweight and obesity are based on body mass index (BMI). The BMI is calculated by dividing the weight in kilograms by the square of the height in meters (kg/m2). More than half of...
The latest definitions of overweight and obesity are based on body mass index (BMI). The BMI is calculated by dividing the weight in kilograms by the square of the height in meters (kg/m2). More than half of American adults are considered overweight with a BMI of ≥25, and about one third are obese with a BMI of ≥30. All ages seem to be affected; the proportion of children and adolescents who are overweight has more than doubled in the past 25 years. There is no lack of effort to treat obesity: drugs, diets and programs to change lifestyle are the basis for a large and flourishing industry. The frequent failure of diet and drug treatment sometimes leads to recommendations for surgery, usually restricted to those with a BMI ≥40.
Treat Guidel Med Lett. 2003 Dec;1(16):101-6 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • July 1, 2003;  (Issue 11)
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 2003.
Treat Guidel Med Lett. 2003 Jul;1(11):69-76 | Show Full IntroductionHide Full Introduction

Drugs for Tobacco Dependence

   
The Medical Letter on Drugs and Therapeutics • June 1, 2003;  (Issue 10)
Tobacco dependence is a chronic illness that may require pharmacological treatment (MC Fiore et al, JAMA 2000; 283:3244; DPL Sachs in JE Hodgkin et al, eds, Pulmonary Rehabilitation: Guidelines to Success, 3rd...
Tobacco dependence is a chronic illness that may require pharmacological treatment (MC Fiore et al, JAMA 2000; 283:3244; DPL Sachs in JE Hodgkin et al, eds, Pulmonary Rehabilitation: Guidelines to Success, 3rd ed, Philadelphia; Lippincott Williams & Wilkins, 2000, page 261).
Treat Guidel Med Lett. 2003 Jun;1(10):65-8 | Show Full IntroductionHide Full Introduction

Drugs That May Cause Psychiatric Symptoms

   
The Medical Letter on Drugs and Therapeutics • July 8, 2002;  (Issue 1134)
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously...
Many drugs can cause psychiatric symptoms, but a causal connection is often difficult to establish. Psychiatric symptoms that emerge during drug treatment may also be due to the underlying illness, previously unrecognized psychopathology, or psychosocial factors. The withdrawal of some drugs can cause symptoms such as anxiety, psychosis, delirium, agitation or depression.
Med Lett Drugs Ther. 2002 Jul 8;44(1134):59-62 | Show Full IntroductionHide Full Introduction

Fluoxetine Sarafem For Premenstrual Dysphoric Disorder

   
The Medical Letter on Drugs and Therapeutics • January 22, 2001;  (Issue 1096)
Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) previously sold only as Prozac, is now also marketed as Sarafem for treatment of premenstrual dysphoric disorder (PMDD). Generic fluoxetine is...
Fluoxetine, a selective serotonin reuptake inhibitor (SSRI) previously sold only as Prozac, is now also marketed as Sarafem for treatment of premenstrual dysphoric disorder (PMDD). Generic fluoxetine is expected to be available sometime this year.
Med Lett Drugs Ther. 2001 Jan 22;43(1096):5-6 | Show Full IntroductionHide Full Introduction

Hypnotic Drugs

   
The Medical Letter on Drugs and Therapeutics • August 7, 2000;  (Issue 1084)
Superseded by Drugs of Choice HandbookMany drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be...
Superseded by Drugs of Choice Handbook
Many drugs are used to treat insomnia, but for some patients nonpharmacological treatments such as changing sleep habits, relaxation training and cognitive therapy may be more effective than drugs.
Med Lett Drugs Ther. 2000 Aug 7;42(1084):71-2 | Show Full IntroductionHide Full Introduction

Drugs for Depression and Anxiety

   
The Medical Letter on Drugs and Therapeutics • April 9, 1999;  (Issue 1050)
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of...
The number of drugs marketed for treatment of depression has increased in recent years. Antidepressants are generally also effective for treatment of anxiety.
Med Lett Drugs Ther. 1999 Apr 9;41(1050):33-8 | Show Full IntroductionHide Full Introduction

Drugs for Psychiatric Disorders

   
The Medical Letter on Drugs and Therapeutics • April 11, 1997;  (Issue 998)
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and...
The number of new drugs marketed for psychiatric indications has increased sharply in recent years. The recommendations in this article are based on the results of controlled trials and on the experience and opinions of Medical Letter consultants. Interactions with other drugs can be found in The Medical Letter Handbook of Adverse Drug Interactions, 1997.
Med Lett Drugs Ther. 1997 Apr 11;39(998):33-40 | Show Full IntroductionHide Full Introduction

Mirtazapine - A New Antidepressant

   
The Medical Letter on Drugs and Therapeutics • December 20, 1996;  (Issue 990)
Mirtazapine (mir taz a peen; Remeron - Organon) has been approved by the US Food and Drug Administration for treatment of depression. A tetracyclic piperazinoazepine, it is an analog of mianserin, an...
Mirtazapine (mir taz a peen; Remeron - Organon) has been approved by the US Food and Drug Administration for treatment of depression. A tetracyclic piperazinoazepine, it is an analog of mianserin, an antidepressant available in Europe, but is structurally unrelated to antidepressants previously available in the USA.
Med Lett Drugs Ther. 1996 Dec 20;38(990):113-4 | Show Full IntroductionHide Full Introduction

Nefazodone for Depression

   
The Medical Letter on Drugs and Therapeutics • April 14, 1995;  (Issue 946)
Nefazodone (Serzone - Bristol-Myers Squibb) was recently approved by the US Food and Drug Administration for treatment of depression. A phenylpiperazine, nefazodone is chemically related to trazodone...
Nefazodone (Serzone - Bristol-Myers Squibb) was recently approved by the US Food and Drug Administration for treatment of depression. A phenylpiperazine, nefazodone is chemically related to trazodone (Desyrel, and others).
Med Lett Drugs Ther. 1995 Apr 14;37(946):33-5 | Show Full IntroductionHide Full Introduction

Use of Nicotine to Stop Smoking

   
The Medical Letter on Drugs and Therapeutics • January 20, 1995;  (Issue 940)
Many patients ask physicians to help them stop smoking. Since nicotine gum and patches were first marketed (Medical Letter, 26:47, 1984; 34:37, 1992), more data have become available on their effective use,...
Many patients ask physicians to help them stop smoking. Since nicotine gum and patches were first marketed (Medical Letter, 26:47, 1984; 34:37, 1992), more data have become available on their effective use, and new formulations of the drug have been developed. Because of its slower rate of absorption, nicotine from gum or patches does not produce the pleasure some people associate with cigarette smoking, but it can relieve the irritability, difficulty in concentrating and other symptoms that occur after withdrawal from smoking.
Med Lett Drugs Ther. 1995 Jan 20;37(940):6-8 | Show Full IntroductionHide Full Introduction

Adderall and Other Drugs for Attention-Deficit/Hyperactivity Disorder

   
The Medical Letter on Drugs and Therapeutics • November 25, 1994;  (Issue 936)
A drug that combines the neutral sulfate salts of dextroamphetamine and racemic amphetamine with the dextro isomer of amphetamine saccharate and d,l amphetamine aspartate (Adderall - Richwood Pharmaceutical)...
A drug that combines the neutral sulfate salts of dextroamphetamine and racemic amphetamine with the dextro isomer of amphetamine saccharate and d,l amphetamine aspartate (Adderall - Richwood Pharmaceutical) has recently been promoted for treatment of children with Attention-Deficit/Hyperactivity Disorder (ADHD). This same mixture of amphetamine salts was previously marketed as Obetrol for treatment of obesity.
Med Lett Drugs Ther. 1994 Nov 25;36(936):109-10 | Show Full IntroductionHide Full Introduction

Venlafaxine - A New Antidepressant

   
The Medical Letter on Drugs and Therapeutics • June 10, 1994;  (Issue 924)
Venlafaxine hydrochloride (Effexor - Wyeth-Ayerst) was recently approved by the US Food and Drug Administration for treatment of depression. An aminomethyl-benzyl- cyclohexanol, it is chemically related to...
Venlafaxine hydrochloride (Effexor - Wyeth-Ayerst) was recently approved by the US Food and Drug Administration for treatment of depression. An aminomethyl-benzyl- cyclohexanol, it is chemically related to bupropion (Wellbutrin).
Med Lett Drugs Ther. 1994 Jun 10;36(924):49-50 | Show Full IntroductionHide Full Introduction

Drugs for Parkinson's Disease

   
The Medical Letter on Drugs and Therapeutics • April 16, 1993;  (Issue 894)
Approaches to treatment of Parkinson's disease have changed in recent years. Previously, the only goal was to treat symptoms with levodopa or other drugs. A new approach is to try to slow progression of the...
Approaches to treatment of Parkinson's disease have changed in recent years. Previously, the only goal was to treat symptoms with levodopa or other drugs. A new approach is to try to slow progression of the disease. (This issue is superseded by 1999 Drugs of Choice.)
Med Lett Drugs Ther. 1993 Apr 16;35(894):31-4 | Show Full IntroductionHide Full Introduction

Choice of an Antidepressant

   
The Medical Letter on Drugs and Therapeutics • March 19, 1993;  (Issue 892)
Since the introduction of fluoxetine (Prozac - Medical Letter, 30:45, 1988), bupropion (Wellbutrin - Medical Letter, 31:97, 1989), sertraline (Zoloft - Medical Letter, 34:47, 1992) and paroxetine (Paxil -...
Since the introduction of fluoxetine (Prozac - Medical Letter, 30:45, 1988), bupropion (Wellbutrin - Medical Letter, 31:97, 1989), sertraline (Zoloft - Medical Letter, 34:47, 1992) and paroxetine (Paxil - this issue), the choice of an antidepressant has become more difficult. Should these widely prescribed new drugs replace tricyclic antidepressants such as amitriptyline (Elavil, and others), imipramine (Tofranil, and others), or nortriptyline (Aventyl, and others) for treatment of most patients with depression?
Med Lett Drugs Ther. 1993 Mar 19;35(892):25-6 | Show Full IntroductionHide Full Introduction

Sertraline For Treatment Of Depression

   
The Medical Letter on Drugs and Therapeutics • May 15, 1992;  (Issue 870)
Sertraline (Zoloft - Roerig), a serotonin reuptake inhibitor, was recently approved for marketing by the US Food and Drug Administration for treatment of depression. Another serotonin reuptake inhibitor,...
Sertraline (Zoloft - Roerig), a serotonin reuptake inhibitor, was recently approved for marketing by the US Food and Drug Administration for treatment of depression. Another serotonin reuptake inhibitor, fluoxetine (Prozac), is prescribed more frequently in the USA than any other antidepressant (Medical Letter, 32:83, 1990).
Med Lett Drugs Ther. 1992 May 15;34(870):47-8 | Show Full IntroductionHide Full Introduction

Bupropion For Depression

   
The Medical Letter on Drugs and Therapeutics • November 3, 1989;  (Issue 804)
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the...
Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the market in early 1986 because of a high incidence of seizures in one study.
Med Lett Drugs Ther. 1989 Nov 3;31(804):97-8 | Show Full IntroductionHide Full Introduction