MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'central nervous system'. Sat, 03 Sep 2011 01:58:33 +0100 http://www.medworm.com/index.php?rid=5086540&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2011%2F08%2F01%2Flaquinimod_fails_for_multiple_sclerosis.php If you haven't been reading carefully, you might have had trouble figuring out Teva's oral therapy for multiple sclerosis, laquinimod. After all, earlier this year, the company was blowing the horn for the compound at neurology meetings, touting how safe and effective it was, its advantages over existing therapies, and its potential in the market. You'd hardly know that the compound actually didn't perform as well as many people were hoping. And of course, that very article does mention, near the end, that the company was going to have some more results later in the year. . . . . .and that day has arrived. Unfortunately. Laquinimod missed its primary endpoint of reducing relapses in MS patients, and unless Teva and its Israeli partner company (Active Biotech) have some real surprises to u... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=5086540 Mon, 01 Aug 2011 16:57:35 +0100 5086540 http://www.medworm.com/index.php?rid=5069825&cid=t_90557_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FRqwvmj9MSCs%2F As drugmakers scramble to replenish their pipelines, they are encountering all sorts of difficulties, including rising costs for clinical trials. And this is happening across all phases. Why? There is increasing competition for trial sites and clinical research organizations that can yield reliable, high quality data, according to a recent survey. And so, 32 percent of those surveyed pointed to higher costs for enrolling patients and 25 percent cited vendor fees. Expenses for recruiting trial sites was named by 14 percent, followed by 12 percent who fingered technology costs, according to Cutting Edge Information, which surveyed 21 drugmakers, 12 biotechs, nine device makers and 23 contract research organizations. Meanwhile, staffing for drug development is rising. For instance, Phase IV ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=5069825 Tue, 26 Jul 2011 14:39:41 +0100 5069825 http://www.medworm.com/index.php?rid=4968889&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2011%2F06%2F23%2Fcladribine_is_gone.php Multiple sclerosis therapy has been changing a lot in recent years, and one of the biggest events was the introduction of Gilenya (fingolimod). That's the first non-injectable for MS, and it's quite a story (as well as being quite a weird compound from a chemistry perspective). Novartis has been racing ahead in selling that one, because they knew the Merck KgGa (Merck-Darmstadt) had another oral compound in the works, cladribine. That's a nucleoside analog with a different mechanism (targeting some lymphoctye subtypes and thus changing immune response), and it was already used in treatment of some forms of leukemia. It did show promising results in the clinic for relapsing MS, and there were high hopes. Not now. Word has come that the company that they're withdrawing their application in... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=4968889 Thu, 23 Jun 2011 12:35:59 +0100 4968889 http://www.medworm.com/index.php?rid=4664458&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2011%2F03%2F31%2Fyour_comments_on_the_nihs_cns_drug_program.php After my post the other day on the NIH neurological disease effort, I heard from Rebecca Farkas there, who's leading the medicinal chemistry effort on the program. She's glad to get feedback from people in the industry, and in fact is inviting questions and comments on the whole program. Contact her at farkasr-at-ninds-dot-nih-dotgov (perhaps putting the address in that form will give the spam filters at NIH a bit less to do than otherwise). She also sends word that they'll be advertising soon for a Project Manager position for this effort, and is looking for suggestions on how to reach the right audience for a good selection of candidates. This post might help a bit, but she's interesting in suggestions on where to advertise and who to contact for good leads. (Source: In the Pipeline) In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=4664458 Thu, 31 Mar 2011 15:00:25 +0100 4664458 http://www.medworm.com/index.php?rid=4253469&cid=t_90557_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F12%2F13%2Fthe-pain-system-is-so-complicated%2F There are a couple of ways to approach the problem of pain – the one I grew up with is the medical one: diagnose the problem, fix the problem, life returns to normal.  The person’s role in this is to be open about what is wrong, let the treatment provider know the information (and only the information) relevant to the problem, follow the medical instructions, and all will be well. Of course the majority of readers of this blog can see some short-comings in this model.  It forgets that people choose when to seek treatment and that they make decisions about this based on ‘common knowledge’ (or what the community around them says they should do), family history, current stressors and activities, degree of distress, and how much the symptoms get in the way of living l... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4253469 Sun, 12 Dec 2010 19:17:10 +0100 4253469 http://www.medworm.com/index.php?rid=4152271&cid=t_90557_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FPN1cDZXQRcw%2F Long time passing? The lament is a take-off on an old Pete Seeger song, but one might get the impression the refrain is appropriate after viewing a new summary of compounds presented at the recent American Chemical Society meeting in Boston. The latest gathering yielded presentations for 58 new drug candidates but, by one reckoning, the amount of innovation on display was lacking. Specifically, not one previously unidentified drug target was reported at ACS, which was held in August, according to Citeline Drug Intelligence, a market research firm that tracked the presentations. What was on display? Central nervous system compounds ranked highest, with 23 candidates, followed by 16 for metabolic diseases and just eight for oncology. This, by the way, stands in contrast to previous years whe... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4152271 Wed, 10 Nov 2010 13:01:41 +0100 4152271 http://www.medworm.com/index.php?rid=4125256&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F11%2F01%2Fdrugs_at_home.php This article reminds me of the "designer drug" era in the 1980s. The Wall Street Journal profiles one of the many European chemical entrepreneurs making a fortune by synthesizing and selling new psychoactive drugs. And they're all labeled "Not For Human Consumption", so hey, everything's perfectly legal. Until the authorities ban the specific substance, naturally, and then he moves on to another one down the list. As someone who doesn't see a new chemical structure go into humans until years of testing have been done, you can imagine what I think of this. The small amount of amazement I feel is completely overwhelmed by contempt for anyone who would dose people with an untried CNS drug. Oh, but he's not dosing anyone, is he? All he's doing is selling them little vials of white powdery stu... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=4125256 Mon, 01 Nov 2010 11:21:25 +0100 4125256 http://www.medworm.com/index.php?rid=3982034&cid=t_90557_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F09%2F18%2Ftreating-chronic-depression-and-anxiety-with-hallucinogens-and-marijuana%2F Johns Hopkins just published an interesting summary of the research recently on treating mood disorders with hallucinogens. In the most recent Depression and Anxiety Health Alert, the author chronicles the history of hallucinogens and how they affect the central nervous system to release the right kind of neurotransmitters. As per the Johns Hopkins report: Hallucinogens (also called psychedelics) were a promising area of research in the 1960s and early 1970s, when they were being developed as possible treatments for a number of conditions, including depression, anxiety, and chronic pain. These drugs were banned in the ’70s and ’80s, however, after their recreational use became a widespread problem. In 1990, the U.S. Food and Drug Administration (FDA) again began allowing resear... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3982034 Sat, 18 Sep 2010 14:22:34 +0100 3982034 http://www.medworm.com/index.php?rid=3896079&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F08%2F23%2Fkurzweil_responds.php Ray Kurzweil has responded to the criticism of his Singularity Summit comments on reverse-engineering the brain, a chorus to which I added my voice here. He says that he was misquoted on the timeline and on the importance of genomic data for doing it. His plan, he says, is to understand what level of complexity will be needed in order for a system to organize and adapt the way the brain does to stimuli, and the modular nature of its organization gives him hope that this can be realized: For example, the cerebellum (which has been modeled, simulated and tested) — the region responsible for part of our skill formation, like catching a fly ball — contains a module of four types of neurons. That module is repeated about ten billion times. The cortex, a region that only mammals have and t... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=3896079 Mon, 23 Aug 2010 11:48:31 +0100 3896079 http://www.medworm.com/index.php?rid=3695567&cid=t_90557_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fusing-ultrasound-to-zap-the-brain-back-into-action%2F2010.06.24 Scientists at Arizona State University have developed a new method of non-surgical brain stimulation using pulsed ultrasound that enhances cognitive function in mice, and may one day be used to non-invasively treat patients with mental retardation, Alzheimer’s disease and other central nervous system (CNS) dysfunctions. In intact motor cortex in mice, ultrasound was found to stimulate action potentials and elicit motor responses comparable to those only previously achieved with implanted electrodes and related techniques. It also activates meaningful brain wave patterns and the production of brain-derived neurotrophic factor (BDNF) in the hippocampus — one of the most potent regulators of brain plasticity. (more…) *This blog post was originally published at Medgad... Better Health blogs http://www.medworm.com/rss/comments.php?id=3695567 Thu, 24 Jun 2010 22:00:01 +0100 3695567 http://www.medworm.com/index.php?rid=3671890&cid=t_90557_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fms-pill-approved%2F The first oral, disease-modifying MS drug, Fingolimod, was approved for release and marketing by the FDA’s Advisory Committee on Peripheral and Central Nervous System Drugs a few days ago! I apologize for the delay my reporting such important news, but my travel schedule has been a bit nutty of late. Data was submitted earlier this year as to the efficacy and safety of the drug and the approval process took a HUGE leap on June 10 this a unanimous, 25-0 vote to allow drug maker, Novartis, to begin the next phase in the long process of bringing new drugs to market. Contacts at Novartis wouldn’t give a firm date as to the release of the drug to the US market, but it will most assuredly be available before for doctors’ prescriptions by the end of the calendar year. A .25mg dose of the dr... Life with MS blogs http://www.medworm.com/rss/comments.php?id=3671890 Wed, 16 Jun 2010 19:26:56 +0100 3671890 http://www.medworm.com/index.php?rid=3629856&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F06%2F04%2Focd_linked_to_the_immune_system.php Now here's one that I certainly didn't expect: there's a mouse model of obsessive-compulsive disorder, where the animals have a mutation in the Hoxb8 gene. These animals spend huge amounts of time repetitively grooming themselves (and their cagemates), and eventually remove so much hair that they give themselves lesions. From what I can see, they're doing the usual moves that mice do, but spending a lot more time doing them. And it doesn't seem to be something due to insensitivity to pain; the animals have some sensory alterations, but disrupting Hoxb8 in the spinal cord only doesn't lead to the grooming phenotype. A new paper from a group at University of Utah reports that the brain signature of Hoxb8 mutation is found only in a population of microglia, one variety of the support cells t... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=3629856 Fri, 04 Jun 2010 12:23:27 +0100 3629856 http://www.medworm.com/index.php?rid=3573775&cid=t_90557_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FQ4Reaa85lRs%2F           Tourette syndrome (TS), or Tourette disorder, is more common Origins of Tourette Syndrome than doctors once thought.  It affects at least 1 in 1,000 to 2,000 people and maybe more.  It is believed that about 100,000 Americans have the disorder. Many more may have other tic disorders that are less severe.  Tourette syndrome is more common in boys than in girls.  It almost always starts before age 18 – usually between ages 5 and 7.  Even though kids with Tourette syndrome can get better as they get older, many will always have it.  The good news is that it won’t make them sick or shorten their lives.  The syndrome is a condition that affects a person’s central nervous system and causes tics.  Tics are unwanted twitches, movements or sounds that ... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3573775 Tue, 18 May 2010 09:35:04 +0100 3573775 http://www.medworm.com/index.php?rid=3560496&cid=t_90557_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fas95V6glgzI%2F Containing drug development costs and speeding compounds through the pipeline is always a big issue, but clinical trials are becoming more expensive anyway. Why? One answer is the increasing complexity of the studies - the number of procedures for each clinical trial rose 49 percent from the 2000 to 2003 period to the 2004 to 2007 timeframe, and the total effort per protocal jumped 54 percent. For instance, the average number of eligibility criteria used to screen volunteers rose 58 percent, which contributed to a 21 percent decline in volunteers enrolling in trials. But the larger number of procedures per protocol dissuades volunteers from completing trials - retention rates dropped 230 percent, according to the Tufts Centers for the Study of Drug Development, which reviewed data from 8,... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3560496 Thu, 13 May 2010 15:15:35 +0100 3560496 http://www.medworm.com/index.php?rid=3511762&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F04%2F28%2Fhomemade_morphine.php I wrote here some time ago about human cells actually making their own morphine - real morphine, the kind that everyone thought was only produced in poppy plants. Now there's a paper in PNAS where various deuterium-labeled precursors of morphine were dosed in rats, and in each case they converted it to the next step in the known biosynthesis. The yields were small, since each compound was metabolically degraded as well, but it appears that rats are capable of all steps of a morphine synthesis from at least the isoquinoline compound tetrahydropapaveroline (THP). And that's pretty interesting, because it's also been established that rats have small THP in their brains and other tissues - as do humans. And humans, it appears, almost always have trace amounts of morphine in the urine - which ... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=3511762 Wed, 28 Apr 2010 11:19:37 +0100 3511762 http://www.medworm.com/index.php?rid=3216829&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F01%2F28%2Facorda_and_ampyra.php I had not been following the progress of Acorda's recently approved drug Ampyra for MS. (Well, more specifically, it's to improve gait and walking speed in MS patients). Opinion seems to be rather divided about how successful it'll be. On the one hand, new therapies for multiple sclerosis are certainly needed, but there's also room to argue about just how efficacious Ampyra really is. I'm not going to fight that one out here, because we'll have the judgment of the market pretty soon. What I find interesting is the structure of this new drug: it's 4-aminopyridine. If there's a more simple, lower molecular weight structure approved within the next few years as an oral drug for anything, I'll be quite surprised. This brings up several interesting topics relating to drug development and in... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=3216829 Thu, 28 Jan 2010 12:35:20 +0100 3216829 http://www.medworm.com/index.php?rid=3216730&cid=t_90557_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Ffda-approves-the-walking-pill-for-multiple-sclerosis%2F As of Friday afternoon, a long awaited addition to our arsenal of MS symptomatic drugs has been approved. We had a conversation about Ampyra which is a timed-release version of the drug 4-Aminopyridine (and formerly known as Fampridine SR), last May.  At that time the drug was being resubmitted to the FDA for approval (rejected, originally, due to “formatting issues” during the application process). This drug is thought to increase signal conduction by blocking tiny pore-like potassium channels on nerves of the central nervous system (CNS). The time-released part of the drug is what is new, for those of you who have been getting 4-Aminopyridine from compound pharmacies. Phase III clinical trials suggest that some 34-43 percent of people taking Ampyra had positive results in the areas ... Life with MS blogs http://www.medworm.com/rss/comments.php?id=3216730 Wed, 27 Jan 2010 23:01:39 +0100 3216730 http://www.medworm.com/index.php?rid=3197880&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2010%2F01%2F22%2Fmaybe_you_need_some_more_testosterone_over_there.php This one's also from the Department of Placebo Effects - read on. An interesting paper out in Nature details a study where volunteers took small doses of testosterone or placebo, and then participated in a standard behavioral test, the "Ultimatum Game". That's the one where two people participate, with one of them given a sum of money (say, $10), that's to be divided between the two of them. The player with the money makes an offer to divide the pot, which the other player can only take or leave (no counteroffers). A number of interesting questions about altruism and competition have been examined through this game and its variants - basically, the first thing to ask is how much the "dictator" player will feel like offering at all. (If you like, here's the Freakonomics guys talking about t... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=3197880 Fri, 22 Jan 2010 13:32:59 +0100 3197880 http://www.medworm.com/index.php?rid=3189288&cid=t_90557_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Freally-weird-ms-symptoms%2F If multiple sclerosis symptoms are nothing else, especially to the newly diagnosed, they are weird!  Sure, symptoms can be frightening, challenging, difficult and even debilitating… but how many times have I caught myself saying, “Hmmmm, that’s weird!” Often we are told, “That’s doesn’t sound like MS,” or something of the kind, by our medical professionals only to find out (oft, via the pages of this blog) that we are not alone in our experience of something not in the medical text books.  It is one of the aspects of the Life with MS blog of which I am most proud! I have a real doozie to share, with a discussion of MS symptoms from the X-Files. The middle of last week, I developed a cold.  You know that feeling when you wake, somewhere between the back of your nose and t... Life with MS blogs http://www.medworm.com/rss/comments.php?id=3189288 Wed, 20 Jan 2010 17:14:22 +0100 3189288 http://www.medworm.com/index.php?rid=3015387&cid=t_90557_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fneuropathic-pain-from-multiple-sclerosis%2F Multiple sclerosis can hurt! Pain is a real part of life with MS for over half of us. Pain can come in several forms and affect several areas of the body.  The pain I’d like to proffer for our consideration in this post is called neuropathic pain or neuropathy. This is a pain which is caused by a dysfunction of the peripheral nervous system (PNS).  Owing to the fact that we have a disease of the central nervous system (CNS), many of us may not be familiar with the PNS. These are the nerves which connect the limbs and organs to the CNS. While there is not suspected demyelination of the PNS, the stripping and scaring of neurons and axons in the CNS is thought to cause misfiring of signals from the PNS, which then tell the brain that we are feeling pain in an uninjured part of the body. I... Life with MS blogs http://www.medworm.com/rss/comments.php?id=3015387 Fri, 20 Nov 2009 20:11:58 +0100 3015387 http://www.medworm.com/index.php?rid=2985021&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2009%2F11%2F12%2Fmassaging_the_data_for_neurontin.php There's a disturbing article out at the New England Journal of Medicine on studies conducted on Neurontin (gabapentin) for various unapproved indications. Parke-Davis (and later Pfizer) looked at a wide range of possible indications for the drug - migraine, neuropathic pain, bipolar disorder, and more. That in itself isn't unusual, since CNS drugs often have rather broad and poorly defined mechanisms, and it's not like we understand any of them all that well. What is unusual is the pattern found when comparing the internal reports with the published versions that showed up in the literature. The authors found that: "More than half the clinical trials that we included in our analysis (11 of 20) were not published as full-length research articles. For 7 of the 9 trials that were published... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=2985021 Thu, 12 Nov 2009 16:13:42 +0100 2985021 http://www.medworm.com/index.php?rid=2927364&cid=t_90557_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F10%2F26%2Fare-the-media-becoming-addicted-to-internet-addiction%2F As Dr. John Grohol has cogently argued, there are many reasons to be skeptical of “Internet Addiction” as a discrete and specific “disorder” or diagnosis. Yet I am impressed, and a bit dismayed, by all the attention this issue seems to garner in the popular media. I don’t intend any disrespect to the reporters and journalists who are trying to cover the topic, several of whom have graciously interviewed me. Some reporters are as skeptical as many of us in the mental health field, and a number have asked pertinent questions as to how real so-called Internet addiction is. I simply wish that devastating illnesses like schizophrenia, major depression, and bipolar disorder created such a buzz in the media and in the awareness of the general public. Over the last 30... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2927364 Mon, 26 Oct 2009 12:01:59 +0100 2927364 http://www.medworm.com/index.php?rid=2300967&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2009%2F03%2F30%2Flillys_latest_loses_this_time.php Over the years of this blog, I’ve occasionally made comments about how no one really knows much about how drugs for the major central nervous system diseases work. Well, actually, I’ve stated things more forcefully than that, but you get the idea. And although many people who work in the area have written in to say that they agree, I’ve had questions from people completely outside it (journalists and others) about whether I’m serious when I say these things. Oh, I am. For the latest piece of evidence, see what’s just happened to LY2140023, Eli Lilly’s new drug candidate for schizophrenia. The company was running a three-armed Phase II trial: placebo vs. their existing drug Zyprexa vs. the new one, which is a metabotropic glutamate ligand. And what happens? The placebo group pe... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=2300967 Mon, 30 Mar 2009 11:31:57 +0100 2300967 http://www.medworm.com/index.php?rid=2097936&cid=t_90557_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FiwQPMH6okcI%2F There is no doubt that obesity is primarily caused by poor eating habits and inactive lifestyle. But a meta-analysis of several obesity studies found that six new obesity genes are expressed in the brain. Scientists from the international GIANT (Genetic Investigation of Anthropometric Parameters) consortium analyzed data from 15 genome-wide association studies and identified six new candidate genes that were related to regulation of body weight. Several of these new genes are highly expressed or known to act in the brain, emphasizing the role of the central nervous system in predisposition to obesity. UPDATE: Endurance Geek made me rethink my title with obesity being “all in the mind”. Instead of changing the post title (or maybe I should? I DID) I thought I would add to my p... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=2097936 Mon, 12 Jan 2009 17:53:04 +0100 2097936 http://www.medworm.com/index.php?rid=2021724&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F12%2F08%2Fenhancing_the_brain_here_we_go.php Depending on what news sources you follow, you may have heard a lot about it already: taking cognition-enhancing drugs to improve normal brain function. An editorial in Nature has just come out in favor of it, so although I wrote about this back in April, it’s time to talk over the issue again. Let's define what we're talking about first. We really don’t have anything to selectively affect memory or general intelligence per se, but we do know something about how to affect attention span and wakefulness. So right now, cognition enhancement is mostly going to be found via the stimulants used for attention-deficit disorders, along with Cephalon’s Provigil (modafinil) for narcolepsy. These are the drugs of issue. Nature started off this latest debate on this a few months ago, when they... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=2021724 Mon, 08 Dec 2008 14:28:53 +0100 2021724 http://www.medworm.com/index.php?rid=1876474&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F10%2F15%2Fwhere_are_the_drugs.php A recent correspondence on the topic of “Why aren’t there more drugs for the big CNS disorders” got me thinking about the topic. My take, having worked in the field, is that there is still so much unmet need in that area because we just don’t understand what's going on. It’s hard to come up with disease-altering therapies when you don’t really understand a single disease in the whole field. Does amyloid cause Alzheimer’s, or does Alzheimer’s give you amyloid, or is amyloid just a sideshow? What sets off the chain of events that ends up killing off cells in the substantia nigra in Parkinson’s? What are the detailed molecular mechanisms of depression, or schizophrenia? Why don’t neurons remyelinate in multiple sclerosis? We don’t know. We know a lot more than we used t... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=1876474 Wed, 15 Oct 2008 12:36:36 +0100 1876474 http://www.medworm.com/index.php?rid=1779674&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F09%2F09%2Fantipsychotics_do_they_work_for_a_completely_different_reason.php As I’ve noted here, and many others have elsewhere, we have very little idea how many important central nervous system drugs actually work. Antidepressants, antipsychotics, antiseizure medications for epilepsy – the real workings of these drugs are quite obscure. The standard explanation for this state of things is that the human brain is extremely complicated and difficult to study, and that’s absolutely right. But there’s an interesting paper on antipsychotics that’s just come out from a group at Duke, suggesting that there’s an important common mechanism that has been missed up until now. One thing that everyone can agree on is that dopamine receptors are important in this area. Which ones, and how they should be affected (agonist, antagonist, inverse partial what-have-you)... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=1779674 Tue, 09 Sep 2008 12:35:04 +0100 1779674 http://www.medworm.com/index.php?rid=1664624&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F07%2F29%2Filoperidone_a_schizophrenia_drug_goes_down_for_the_last_time.php I've talked about a lot of difficult therapeutic areas, but here's another boulevard of broken dreams: schizophrenia drugs. I was working on follow-ups to a promising clincial candidate, which has since been promising a number of times without ever delivering. It certainly missed its endpoints in schizophrenia by a mile in Phase II. That was actually my introduction to the drug industry back in 1989 - I followed that up with several years working on Alzheimer's, another notorious graveyard of good ideas, which makes me wonder why I didn't just quit at some point and open that chain of all-you-can-eat catfish restaurants that the Northeast so desperately needs. Of course, once in a while a drug for dementia actually works a bit, and since there's a huge underserved market out there, it's a... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=1664624 Tue, 29 Jul 2008 12:39:09 +0100 1664624 http://www.medworm.com/index.php?rid=1261806&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F02%2F27%2Fantidepressants_depressing_news_or_not.php There’s an interesting analysis in the latest PLoS Medicine on the clinical effectiveness of four modern antidepressant drugs: Prozac (fluoxetine), Effexor (venlafaxine), the partially discontinued Serzone (nefazodone), and Paxil (paroxetine). The authors compared all the published placebo-controlled studies on these drugs, and further included all the regulatory filing data. (Update: not so! See below). The result made headlines all over the place yesterday, because one of the things they found was that these drugs hardly seem, compared to placebo, to do anything at all. Here’s the odd part: that shouldn’t have been such a big surprise. It wasn’t surprising to the authors of the paper – in fact, they started with the belief that this would be the case, because that analysis has... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=1261806 Wed, 27 Feb 2008 13:27:15 +0100 1261806 http://www.medworm.com/index.php?rid=1225729&cid=t_90557_117_f&fid=36026&url=http%3A%2F%2Fblog.healthtalk.com%2Fzimney%2Fheath-ledger-celebrity-overdoses-and-the-danger-of-combining-prescriptions%2F What do Heath Ledger, Elvis Presley, Anna Nicole Smith, Judy Garland, and Marilyn Monroe have in common? They all died of accidental prescription drug overdoses. And those are just a few of the most famous cases. There are lots more cases involving lesser known stars and of course most tragic are the thousands of “average” people who die each year due to accidental prescription drug overdoses. Exact numbers are hard to come by because of the difficulty in separating out prescription drug overdoses from those involving street drug overdoses (e.g., heroin, cocaine, etc), but one study found that deaths involving prescription opioid analgesics increased from roughly 2900 in 1999 to 7500 in 2004, a 160% increase. That study was done by Dr. Leonard Paulozzi of the Centers for Disease Contr... Dr. Z's Medical Report blogs http://www.medworm.com/rss/comments.php?id=1225729 Tue, 12 Feb 2008 21:03:19 +0100 1225729 http://www.medworm.com/index.php?rid=1137212&cid=t_90557_149_f&fid=35776&url=http%3A%2F%2Fpipeline.corante.com%2Farchives%2F2008%2F01%2F08%2Frainbows_and_fishing_expeditions.php I came across a neat article in Nature from a group working on a new technique in neuroscience imaging. They expressed an array of four differently colored fluorescent proteins in developing neurons in vivo, and placed them so that recombination events would scramble the relative expression of the multiple transgenes as the cell population expands. That leads to what they’re calling a “brainbow”: a striking array of about a hundred different shades of fluorescent neurons, tangled into what looks like a close-up of a Seurat painting. The good part is that the entire neuron fluoresces, not just a particular structure inside it. Being able to see all those axons opens up the possibility of tracking how the cells interact in the developing brain – where synapses form and when. That sh... In the Pipeline blogs http://www.medworm.com/rss/comments.php?id=1137212 Tue, 08 Jan 2008 13:37:21 +0100 1137212 http://www.medworm.com/index.php?rid=828377&cid=t_90557_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F143822115%2F All righty then. I found research out of UT Southwestern Medical Center that is a bit taboo. They have found a drug that can counteract the symptoms associated with a cocaine overdose. That handy little drug is most often seen in the operating room or ICU’s and is used as a anesthetic. And it’s name… dexmedetomidine. They found that the drug was effective in reversing the actions of cocaine on heart rate, blood pressure and vascular resistance in the skin by interfering with the ability of cocaine to increase nerve activity. “Typically, patients with cocaine overdoses in the emergency room are treated with nitroglycerin, sedatives such as Valium, and some blood-pressure medications such as calcium channel blockers and some beta blockers,” Dr. Vongpatanasin sai... A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=828377 Mon, 13 Aug 2007 19:31:14 +0100 828377 http://www.medworm.com/index.php?rid=548573&cid=t_90557_87_f&fid=34867&url=http%3A%2F%2Fwww.thediabetesblog.com%2F2007%2F04%2F17%2Fis-human-synthetic-insulin-a-cock-block%2F Filed under: Type 1, Type 2, Childhood, Adult Onset, Lifestyle, Drugs, Research, Exercise, SupportNow that the US market is suspiciously saturated with human insulin - and many of us diagnosed within the last 10 years did not have a shot at trying porcine insulin - I'd like to set the record straight. When the pharmaceutical companies cherry pick the studies they wish to use for their gain, and not so much for your enhanced quality of life - they must've lost this study. Please read the entire study (if you have access to it in a local library) but what grabbed my undivided attention was the sentence that says: it was observed that the action of porcine insulin was associated with... a striking increase of prolactinaemia, in relation to semisynthetic human insulin. Okay -- so as I look dee... The Diabetes Blog blogs http://www.medworm.com/rss/comments.php?id=548573 Tue, 17 Apr 2007 04:00:00 +0100 548573