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Comparing Antiepileptics for Bipolar Disorder, Migraines, Fibromyalgia, and Chronic Pain

How do antiepileptics compare in treating bipolar disorder?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: October 1, 2010

Single dose dipyrone for acute renal colic pain

Renal colic pain is extremely painful and requires immediate treatment with strong analgesics. Dipyrone is a non‐opioid analgesic widely used for this purpose but not licensed in some countries (e.g., USA, UK) because of potentially fatal side effects (agranulocytosis). This review aimed to assess the effectiveness and safety of single dose dipyrone in adults with moderate/severe renal colic pain but there were too few data to obtain clear results. The data available indicated that intravenous dipyrone was more effective than intramuscular dipyrone, and combining dipyrone with antispasmolytic agents did not improve its efficacy. Commonly reported side effects included dry mouth and drowsiness, and some patients experienced pain at the injection site. Agranulocytosis was not reported.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Interventions for people with schizophrenia who have too much saliva due to clozapine treatment

Clozapine is an antipsychotic medication used in the treatment of schizophrenia, a mental health problem that can cause symptoms such as hallucinations and delusions and social withdrawal. Clozapine may be useful in those for whom other medications have not worked very well. One of the common side‐effects of clozapine is having too much saliva in the mouth (hypersalivation). This can be embarrassing in public and problematic, especially at night. This review is about ways of reducing this problem and includes 15 trials containing 964 people, most of which were done in hospitals in China. Treatments included medications that had previously been useful for this problem or were thought to work in theory. The medications used were from a group of drugs called antimuscarinics, traditional Chinese medicines or others. The trials were short (all four weeks or less). From these trials the antimuscarinics; astemizole, diphenhydramine and propantheline, were shown to be better than placebo at reducing hypersalivation. Another medication called oryzanol and a Chinese traditional medicine called Suo quo wan were found to have benefit over doxepin, an antimuscarinic. However, because of the shortness of the trials, poor reporting and the limitations of design, it is difficult to draw any firm conclusions from these results. 

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antipsychotic medication for childhood‐onset schizophrenia

Schizophrenia is a serious mental illness which can cause hallucinations, fixed false beliefs (delusions) and/or apathy, slowing and less movement or thought. For the majority of people, its onset is in the late teens or early twenties. However, although rare, the illness can appear in childhood, where it is generally more severe and the long term prospects are poorer. Childhood‐onset is defined in this case as the illness appearing before the age of 13 years.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Comparing Atypical Antipsychotics

How do atypical antipsychotics compare in schizophrenia?

PubMed Clinical Q&A [Internet] - National Center for Biotechnology Information (US).

Version: February 11, 2011

Clozapine versus other atypical antipsychotics for schizophrenia

This review compared the clinical effects of clozapine with the other atypical antipsychotics. Twenty‐seven studies fulfilled the review's criteria and provided data to compare clozapine with antipsychotics such as olanzapine, quetiapine, risperidone, ziprasidone and zotepine. Clozapine was somewhat more efficacious than zotepine. Also, inefficacy of treatment led more frequently to leaving the studies early in the risperidone group suggesting a certain higher efficacy of clozapine. The principal drawback of clozapine were its adverse effects which lead to significantly higher numbers of participants leaving the studies early compared to olanzapine and risperidone. Clozapine was associated with more sedation and hypersalivation than olanzapine, quetiapine and risperidone and with more seizures than olanzapine and risperidone. There was a higher incidence of white blood cell decrease in clozapine groups than olanzapine and more weight gain than in risperidone groups. On the other hand clozapine produced fewer movement disorder than risperidone and less prolactin increase than olanzapine, quetiapine and zotepine.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Clozapine versus typical neuroleptic medication for schizophrenia

Schizophrenia is a serious, chronic and relapsing mental illness with a worldwide lifetime prevalence of about one per cent. Schizophrenia is characterised by 'positive' symptoms such as hallucinations and delusions and 'negative' symptoms such as emotional numbness and withdrawal. One quarter of those who have experienced an episode of schizophrenia recover and the illness does not recur. Another 25% experience an unremitting illness. Half do have a recurrent illness but with long episodes of considerable recovery from the positive symptoms. The overall cost of the illness to the individual, their carers and the community is considerable.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Systematic Reviews in PubMed

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