California rocket fuel: And what about being a first line treatment?

IntroductionThe association venlafaxine-mirtazapine is currently known as California Rocket Fuel (CRF). Studies show advantage in terms of efficacy and rapid control of depressive symptoms compared to other associations. Venlafaxine is a selective serotonin-noradrenalin reuptake inhibitor and mirtazapine is a noradrenergic-specific serotonergic antidepressant: the result is a potent noradrenergic and serotonergic effect. Studies say that CRF should be performed only for drug-resistant depression; however, there are case reports of its use as a first line treatment, in selected patients.ObjectivesTo summarize the latest literature about this field and to present a case report.AimTo explore and critically review the controversies of venlafaxine-mirtazapine association as a first line antidepressants strategy.MethodsA brief review of the latest literature was performed, using PubMed and the keywords “venlafaxine-mirtazapine association”. A case report about a depressed woman is presented.ResultsDespite most studies are referent to its utility in drug-resistant depression, there are recent pilot studies that recommend CRF as a first line option.M., a 64-year-old woman, had her first psychiatric consultation. She had been depressed for 2 years, she lost 10 kg, had total insomnia and suicidal thoughts. CRF was started up to 150/15 mg, daily. An improvement was noticed after two weeks of treatment and the stabilization of depressive symptoms were achieved by the fourth month.ConclusionsCRF seems to be effective and useful. Patients with insomnia and weight loss may benefit from CRF as a first line option. However, more studies are needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The role of methylphenidate in depression

Mental Health Clinician ◽

10.9740/mhc.2015.11.271 ◽

2015 ◽

Vol 5 (6) ◽

pp. 271-276

Author(s):

Meghan Ellinger May ◽

Amy VandenBerg

Keyword(s):

Depressive Symptoms ◽

Terminal Illness ◽

Case Series ◽

Line Treatment ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

First Line ◽

Specific Patient ◽

Resistant Depression ◽

First Line Treatment

Abstract Introduction Depression is a burdening disease state where up to 30% of individuals do not respond to first-line treatment. Adjunctive use of psychostimulants has been investigated for the treatment of depression in patient populations, including those with treatment-resistant depression or terminal illness. The purpose of this paper is to present a review of the literature on the efficacy of using methylphenidate to manage depression. Methods A search was conducted in PubMed, Ovid/MEDLINE, and PsychINFO using the following key words: psychostimulants, stimulants, methylphenidate, alternative therapy, depression, and major depressive disorder. All reports included were published before June 30, 2015. Results For this review 10 reports, including randomized controlled, case series, and retrospective chart review studies, were identified and assessed. Patient populations studied included patients with treatment-resistant depression, patients with terminal illness, geriatric patients, and patients with miscellaneous indications, such as history of stroke and human immunodeficiency virus (HIV), or acquired immune deficiency syndrome (AIDS). For treatment-resistant depression, treatment differences for fatigue and apathy in favor of methylphenidate were found, but no difference was found for response rates in depression. Additionally, in palliative care and hospice patients, methylphenidate was found to improve fatigue and depressive symptoms. Patients with other conditions (poststroke and HIV patients) achieved some relief of depressive symptoms. Conclusion The efficacy data for methylphenidate in depression are limited, with inconsistent results in specific patient populations that limit external validity. At this time, it should not be recommended as first-line treatment in depression. Future research should be developed focusing on long-term safety and efficacy in nonspecialized patient populations.

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Refractory eosinophilic fasciitis successfully treated with infliximab: A case report

Journal of Scleroderma and Related Disorders ◽

10.1177/23971983211004399 ◽

2021 ◽

pp. 239719832110043

Author(s):

Paulina Śmigielska ◽

Justyna Czarny ◽

Jacek Kowalski ◽

Aleksandra Wilkowska ◽

Roman J. Nowicki

Keyword(s):

Case Report ◽

Connective Tissue ◽

Treatment Failure ◽

Immunosuppressive Drugs ◽

Unknown Etiology ◽

High Dose ◽

Eosinophilic Fasciitis ◽

Line Treatment ◽

First Line ◽

First Line Treatment

Eosinophilic fasciitis is a rare connective tissue disease of unknown etiology. Therapeutic options include high-dose corticosteroids and other immunosuppressive drugs. We present a typical eosinophilic fasciitis case, which did not respond to first-line treatment, but improved remarkably after infliximab administration. This report demonstrates that in case of initial treatment failure, infliximab might be a relatively safe and effective way of eosinophilic fasciitis management.

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Obstructive sleep apnea: A case report on uvulopalatopharyngoplasty and tongue reduction as a first line treatment modality in an underprivileged economic status

Dental Oral and Craniofacial Research ◽

10.15761/docr.1000252 ◽

2017 ◽

Vol 4 (3) ◽

Author(s):

Dayaratna J ◽

Nisahan B ◽

Wijesinghe S ◽

Peranantharajah T ◽

Samarasinghe B

Keyword(s):

Obstructive Sleep Apnea ◽

Case Report ◽

Sleep Apnea ◽

Treatment Modality ◽

Economic Status ◽

Line Treatment ◽

First Line ◽

Obstructive Sleep ◽

Tongue Reduction ◽

First Line Treatment

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Major response to temozolomide as first-line treatment for newly-diagnosed DDR2-mutated glioblastoma: A case report

Revue Neurologique ◽

10.1016/j.neurol.2019.09.007 ◽

2020 ◽

Vol 176 (5) ◽

pp. 402-404

Author(s):

K. El Husseini ◽

F. Marguet ◽

A. Lamy ◽

N. Magne ◽

M. Fontanilles

Keyword(s):

Case Report ◽

Line Treatment ◽

Newly Diagnosed ◽

First Line ◽

Major Response ◽

First Line Treatment

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Somatic Treatment of Catatonia

The International Journal of Psychiatry in Medicine ◽

10.2190/x0ff-vu7g-qqp7-l5v7 ◽

1995 ◽

Vol 25 (4) ◽

pp. 345-369 ◽

Cited By ~ 83

Author(s):

John M. Hawkins ◽

Katharine J. Archer ◽

Stephen M. Strakowski ◽

Paul E. Keck

Keyword(s):

Case Reports ◽

Case Series ◽

Complete Response ◽

Positive Outcome ◽

Line Treatment ◽

First Line ◽

Frequency Of Use ◽

Specific Symptoms ◽

First Line Treatment ◽

Malignant Catatonia

Objective: The authors reviewed the recent literature regarding the treatment of catatonia as a syndrome of multiple etiologies. Given the historical and clinical association of catatonia with schizophrenia, the authors' examined the assumption that the first-line treatment of catatonia is antipsychotic medication. Methods: Articles published between January 1, 1985 and December 31, 1994 were located using the Paperchase® medical literature search system. Additionally, references from those identified articles were examined for possible inclusion in this review. To be included in this review, articles had to be written in English and report specific symptoms of catatonia to determine, retrospectively, if DSM-IV criteria for catatonia were met. Results: Seventy publications met inclusion criteria and reported on a total of 178 patients and included 270 separate treatment episodes. Most of the articles were case-reports, although a few case-series were identified. Multiple causes of catatonia were identified in these reports. The most commonly reported treatment for catatonia was with benzodiazepines which were effective in 70 percent of the cases, with lorazepam demonstrating the highest frequency of use and a 79 percent complete response rate. Electroconvulsive therapy (ECT) was also efficacious (85%) and was more likely to provide a positive outcome in cases of malignant catatonia. Antipsychotics demonstrated poor efficacy. Conclusions: Catatonia is a nonspecific syndrome with multiple etiologies. Treatment of catatonia should be based on the underlying cause when it is identifiable. Lorazepam appears to offer a safe, effective first-line treatment of catatonia. ECT should be considered when rapid resolution is necessary (e.g., malignant catatonia) or when an initial lorazepam trial fails.

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Oxcarbazepine – place in the treatment of epilepsy

Medycyna Faktów ◽

10.24292/01.mf.0121.13 ◽

2021 ◽

Vol 14 (1) ◽

pp. 98-101

Author(s):

Marcin Kopka

Keyword(s):

Depressive Symptoms ◽

Side Effects ◽

Line Treatment ◽

First Line ◽

Focal Seizures ◽

Treatment Of Epilepsy ◽

Positive Effect ◽

First Line Treatment

Oxcarbazepine is recommended for the first line treatment of focal seizures in monotherapy and add-on therapy in both children and adults. It is well tolerated and less frequently interacts with other drugs, possible side effects less often lead to the cessation of the therapy. An important feature of the drug is a positive effect on the sexual sphere of patients and a presumed positive effect on reducing depressive symptoms.

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Apatinib in gastric carcinoma: A case report of partial response for first-line treatment in advanced disease

Asia-Pacific Journal of Clinical Oncology ◽

10.1111/ajco.12648 ◽

2016 ◽

Vol 13 (5) ◽

pp. e528-e530 ◽

Cited By ~ 1

Author(s):

Yaping Wang ◽

Minghong Bi ◽

Haoran Zhang ◽

Zhenyuan Gao ◽

Hairong Zhou ◽

...

Keyword(s):

Case Report ◽

Gastric Carcinoma ◽

Partial Response ◽

Advanced Disease ◽

Line Treatment ◽

First Line ◽

First Line Treatment

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Successful alectinib desensitization in a patient with anaplastic lymphoma kinase-positive adenocarcinoma of the lung and alectinib-induced drug rash

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155220918644 ◽

2020 ◽

Vol 26 (8) ◽

pp. 2028-2030

Author(s):

Ben E Anderson ◽

Tiana S Luczak ◽

Lauren M Ries ◽

Gena E Hoefs ◽

Anne C Silva-Benedict

Keyword(s):

Case Report ◽

Treatment Option ◽

Anaplastic Lymphoma Kinase ◽

Gene Rearrangement ◽

Kinase Inhibitor ◽

Skin Toxicity ◽

Line Treatment ◽

First Line ◽

Anaplastic Lymphoma ◽

First Line Treatment

Introduction Alectinib is an oral tyrosine kinase inhibitor currently recommended by the National Comprehensive Cancer Network (NCCN) as the preferred first-line treatment option for the treatment of metastatic anaplastic lymphoma kinase (ALK) gene rearrangement-positive non-small cell lung cancer (NSCLC). Skin toxicity is a known adverse effect of this medication, yet current recommendations are unclear regarding how to best manage patients who develop severe skin toxicity while taking alectinib. Case report Here, we describe a case of successful rechallenge with alectinib by utilizing a desensitization procedure in a patient who had developed severe alectinib-induced skin toxicity about two weeks into treatment. Management and outcome: Upon resolution of the initial skin toxicity symptoms, the patient was rechallenged with alectinib using a modified version of a previously published desensitization procedure. The patient tolerated the rechallenge with no recurrence of skin toxicity or other adverse effects and was able to continue treatment with alectinib. Discussion Alectinib is currently recommended as the preferred first-line treatment option for the treatment of metastatic anaplastic lymphoma kinase gene rearrangement-positive NSCLC due to improved progression-free survival when compared to crizotinib. The development of skin toxicity can lead to early discontinuation of alectinib treatment, forcing providers and patients to select alternative, potentially less effective options. This case report provides evidence that patients who have experienced severe skin toxicity due to alectinib may be able to continue this first-line treatment option by rechallenging them using a desensitization procedure.

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