Magazine article Drug Topics

May Old Acquaintance Be Forgotten

Magazine article Drug Topics

May Old Acquaintance Be Forgotten

Article excerpt

A review of some recent studies on the long-term effects of antidepressants provides support for an attitude of "out with the old and in with the new" In a study conducted at the Albert Einstein College of Medicine, researchers found an association between the use of the older tricyclic antidepressants and an increased risk of myocardial infarction (MI.)

The trial followed approximately 2,000 patients for 4.5 years and found that the risk of MI was two times greater in users of tricyclic agents, compared with nonusers. By contrast, there was no increased risk of MI found among individuals who received selective serotonin reuptake inhibitors (SSRIs). It has already been documented that tricyclic agents affect cardiac conduction and rhythm and, therefore, should be monitored closely in patients with cardiovascular conditions. With the release of these new study results, clinicians may be swayed more toward using SSRIs in depressed patients who, especially, are predisposed to cardiovascular complications.

Antibiotic in disguise

In a nifty discovery, researchers from the Netherlands have found that a common food preservative, known as nisin Z, contains antibiotic properties. The report on raisin, published in the December 1999 issue of the journal Science, suggests that the agent is thought to combat bacteria in a way that is similar to that of vancomycin-through inhibition of cell wall syntheses. So far, no bacterial strains are known to be resistant to nisin, even though it has been used as a preservative for nearly 50 years. The authors are hopeful that the information uncovered about the agent can be used as a blueprint for developing a new antibiotic class.

Advances in diabetes

In an attempt to control mealtime glucose spikes in patients with Type 2 diabetes, Novartis is developing an oral drug that's modeled after the amino acid phenylalanine. Starlix (nateglinide), which has a rapid onset and short duration of action, acts on beta cells to improve early-- phase insulin secretion in response to food. The agent is thought to break the cycle of mealtime hyperglycemia before it begins and allow a return to baseline glucose levels without prolonged postmeal hyperinsulinemia. Mild hypoglycemia was the most common treatmentrelated side effect reported. The manufacturer recently filed an NDA for approval of nateglinide as monotherapy and in combination with metformin. …

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