Alprazolam for panic disorder

Article Abstract:

The medication alprazolam (Xanax) has been widely used to treat anxiety, and was recently approved by the United States Food and Drug Administration (FDA) for use in treating panic disorder as well. Panic disorder involves attacks of intense fear or dread, often accompanied by physical symptoms such as shortness of breath, dizziness, chest pain, sweating, and trembling. As these attacks recur, sufferers may begin to avoid certain situations that have triggered the attacks. Drugs that have been used previously to treat panic disorder include the tricyclic antidepressants and monoamine oxidase inhibitors, but these drugs have significant side effects and have not been approved by the FDA for use in panic disorder. Despite its approval for treating panic disorder, alprazolam has not performed well in clinical trials so far. One study of approximately 500 patients found that 82 percent of the alprazolam group and 43 percent of the placebo group experienced moderate or better improvement after four weeks; for patients who continued until eight weeks, only 59 percent of those on alprazolam and 50 percent of those on placebo were free of panic attacks. While the drug dose was being reduced, 27 percent of responders to alprazolam had more panic attacks than they had before the study; none of the responders to placebo showed this pattern. Another study, which compared alprazolam with imipramine and placebo, found that neither drug was significantly more effective than placebo by the end of the study (alprazolam had appeared to be effective in the first two weeks of the study). It is concluded that alprazolam can stop panic attacks for a few weeks, but its effectiveness over the long term has not been demonstrated. Also, over time its use can cause strong physical dependence. Alprazolam is not recommended for treating known drug or alcohol abusers. At this time, a tricyclic antidepressant or monoamine oxidase inhibitor may be preferable for treating panic disorder patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Drug therapy, Panic disorders, Panic disorder, Alprazolam, Xanax (Medication)

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BCG for bladder cancer

Article Abstract:

A new treatment for a type of bladder cancer has been approved by the United States Food and Drug Administration. The treatment consists of the BCG (Bacillus Calmette-Guerin) vaccine administered into the bladder. BCG, which has been used since 1921 as a vaccine against tuberculosis, stimulates various immune system cells and can also inhibit the growth of some tumors. It has recently been approved for use in patients with carcinoma in situ of the bladder (either initial tumors or relapses), with or without papillary tumors. However, patients with only the papillary tumors should not be treated with BCG. Preliminary data from clinical trials of intravesical BCG showed that 70 percent of 64 patients with carcinoma in situ experienced a complete response, as compared with only 34 percent of 67 patients given intravesical doxorubicin (Adriamycin) instead. When the entire BCG group was compared with the entire doxorubicin group (including responders and nonresponders), the average time until either cancer recurrence, cancer progression, or death was 39 months for BCG patients versus five months for doxorubicin patients. The results of five-year follow-up are not yet available, but researchers predict that in five years the proportion of patients free of disease will be 45 percent for the BCG group and 18 percent for the doxorubicin group. Side effects of BCG include irritation of the bladder in most patients, and fever, nausea, vomiting, and loss of appetite in many. Hypersensitivity reactions can develop and cause shock, and serious infections (BCG sepsis) leading to organ failure and death can also occur. It is concluded that BCG therapy can provide long periods of remission and even a cure in some patients with carcinoma in situ of the bladder. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Chemotherapy, Bladder cancer, BCG vaccines, BCG

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Phenylpropanolamine and other OTC alpha-adrenergic agonists

Article Abstract:

The FDA has ordered all manufacturers of cold remedies and weight loss aids to remove phenylpropanolamine from their products. The agency took this action based on a study that found an increased risk of brain hemorrhage in women who had taken products containing phenylpropanolamine.

Risk factors, Stroke (Disease), Stroke, Brain, Brain hemorrhage, Product discontinuation, Phenylpropanolamine, Adrenergic alpha-agonists

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