F.D.A. Approves Wyeth Antidepressant

Antidepressant drugs

Faced with the looming loss of patent protection for its top-selling drug, the antidepressant Effexor XR, Wyeth received federal approval on Friday for a successor drug, Pristiq, which the company hopes will also become a blockbuster.

With the Food and Drug Administration’s approval of Pristiq, Wyeth said the company planned a big sales effort to introduce the product to psychiatrists and primary care doctors.

Wyeth needs a product that will replace some of the revenue expected to be lost to generic competitors of Effexor XR, whose patent protection expires in 2010. Sales of Effexor XR last year were $3.8 billion.

Dr. Philip Ninan, a Wyeth vice president for neuroscience, said he thought that Pristiq, which is chemically similar to Effexor, would have similar benefits in treating major depression. But the company said the drug had distinct advantages over its existing product.

Among them are that patients can start taking Pristiq at the therapeutic dose of 50 milligrams. Frequently, antidepressants must be started at a low dose, then ramped up to the therapeutic dose, to test whether patients can tolerate the drug and to determine the correct dose for the individual. Another advantage is that Pristiq does not have to be broken down by the liver, Dr. Ninan said, so it is not likely to interact with other medications metabolized by the liver.

“I think what’s important to understand in the depression category is that many patients fail to respond to anything that’s available,” said Geno Germano, Wyeth’s president of pharmaceuticals for the United States. “What’s important is that physicians and patients need multiple options available.”

But several analysts are skeptical of Pristiq, saying it has little advantage over other products on the market. And they raised questions about whether insurance companies would cover its cost in light of the availability of other drugs, including a less expensive generic version of Wyeth’s original version of Effexor that is already on the market.

Wyeth applied for F.D.A. approval of Pristiq in 2005. But in January 2007, the agency asked for additional information, a process that delayed approval until now.

During regular stock market trading on Friday, when most of the market was plunging, Wyeth’s shares were up more than 2.5 percent, closing at $43.62, in apparent anticipation of the F.D.A. approval.

Wyeth, based in Madison, N.J., has not yet announced how much Pristiq will cost. Effexor XR sells for about $120 for a 30-day supply, while the generic version of the original Effexor has been priced at less than half that recently on the Web site of one domestic chain pharmacy.

Dr. Timothy Anderson, a pharmaceutical analyst for Sanford C. Bernstein & Company, said that data Wyeth presented at a recent meeting of the American College of Neuropsychopharmacology failed to distinguish Pristiq from other marketed antidepressants.

“Payers are not likely to widely cover Pristiq in our view, and we forecast only low levels of sales,” Dr. Anderson wrote in a note to clients. He predicted the drug’s sales at $500 million by 2012, a relatively small figure in the antidepressant category.

And Dr. Daniel Carlat, a psychiatrist in Newburyport, Mass., who publishes the Carlat Psychiatry Report, said the release of Pristiq appeared mainly to be an effort by the company to, in effect, extend its patent for Effexor XR.

That is because Pristiq is a metabolite of Effexor — meaning it is the chemical compound that results after Effexor is swallowed and processed in the body.

“Is there a compelling public health reason for Wyeth to be releasing another antidepressant into the market, with no clear advantages over others?” Dr. Carlat said. “Not that I can see.”

Wyeth is also seeking F.D.A. approval for Pristiq as a drug to reduce hot flashes in menopause. The agency has asked for more data for that use.

Symptoms of High Blood Pressure

High Blood Pressure

High Blood Pressure Symptoms

Screening and prevention are the best ways to protect your health, since there are many symptoms of high blood pressure. At every check up, your doctor should measure your blood pressure. The average blood pressure is what your normal blood pressure measurement is. Taking it one time does not reflect your true average.

Lots of people don't notice or experience the symptoms of high blood pressure, even though they suffer from this condition. In many cases, someone could experience the high blood pressure symptoms but mistake them for the symptoms of some other disorder. But at some time or other, most people with high blood pressure will experience some of the following symptoms:

* Headache - This can be one of the biggest hints when it comes to high blood pressure symptoms. * Dizziness * Irritableness * Queasiness * Feeling Hot * Faintness

When high blood pressure is left untreated, it can cause many issues, like organ damage. Just a few of the examples of what high blood pressure can induce include eye damage and vision problems, stroke, aneurysms, and heart attack. It's important that if you have experienced any symptoms of high blood pressure that you contact your doctor immediately. This could be a life or death situation, and you need to get it under control. Even if you haven't experienced symptoms, if you have a history of high blood pressure in your family, you should get your blood pressure taken regularly to monitor arising problems.

You may also be able to help prevent high blood pressure problems and symptoms by eating a healthy diet, exercising, and avoiding alcohol and cigarettes. Prevention: That's the key to healthy and happy living. Take control of your life and your health.

Psychological drug tolerance, Sensitization

drug sensitization

The reward system is partly responsible for the psychological part of drug tolerance;

The CREB protein, a transcription factor activated by cyclic adenosine monophosphate (cAMP) immediately after a high, triggers genes that produce proteins such as dynorphin, which cuts off dopamine release and temporarily inhibits the reward circuit. In chronic drug users, a sustained activation of CREB thus forces a larger dose to be taken to reach the same effect. In addition it leaves the user feeling generally depressed and dissatisfied, and unable to find pleasure in previously enjoyable activities, often leading to a return to the drug for an additional "fix".

Sensitization is the increase in sensitivity to a drug after prolonged use. The proteins delta FosB and regulator of G-protein Signaling 9-2 (RGS 9-2) are thought to be involved:

A transcription factor, known as delta FosB, is thought to activate genes that, counter to the effects of CREB, actually increase the user's sensitivity to the effects of the substance. Delta FosB slowly builds up with each exposure to the drug and remains activated for weeks after the last exposure—long after the effects of CREB have faded. The hypersensitivity that it causes is thought to be responsible for the intense cravings associated with drug addiction, and is often extended to even the peripheral cues of drug use, such as related behaviors or the sight of drug paraphernalia. There is some evidence that delta FosB even causes structural changes within the nucleus accumbens, which presumably helps to perpetuate the cravings, and may be responsible for the high incidence of relapse that occur in treated drug addicts.

Regulator of G-protein Signaling 9-2 (RGS 9-2) has recently been the subject of several animal knockout studies. Animals lacking RGS 9-2 appear to have increased sensitivity to dopamine receptor agonists such as cocaine and amphetamines; over-expression of RGS 9-2 causes a lack of responsiveness to these same agonists. RGS 9-2 is believed to catalyze inactivation of the G-protein coupled D2 receptor by enhancing the rate of GTP hydrolysis of the G alpha subunit which transmits signals into the interior of the cell.

Drugs causing addiction

Drugs causing addiction

Drugs known to cause addiction include illegal drugs as well as prescription or over-the-counter drugs.

* Stimulants:
o Amphetamine and Methamphetamine;
o Caffeine;
o Cocaine;
o Nicotine.

* Sedatives and Hypnotics:
o Alcohol;
o Barbiturates;
o Benzodiazepines, particularly alprazolam, clonazepam, temazepam, and nimetazepam;
o Methaqualone and the related quinazolinone sedative-hypnotics;
o GHB and analogues (specifically GBL).

* Opiate and Opioid analgesics;
o Morphine and Codeine, the two naturally-occurring opiate analgesics;
o Semi-synthetic opiates, such as Heroin (Diacetylmorphine), Oxycodone, and Hydromorphone;
o Fully synthetic opiods, such as Fentanyl and its analogs, Meperidine/Pethidine, and Methadone;
* Anabolic steroids.

Addictive drugs also includes a large number of substrates that are currently considered to have no medical value and are not available over the counter or by prescription.

The legality of psychoactive drugs

legality of psychoactive drugs

The legality of psychoactive drugs has been controversial through most of history; the Opium Wars and Prohibition are two historical examples of legal controversy surrounding psychoactive drugs. However, in recent years, the most influential document regarding the legality of psychoactive drugs is the Single Convention on Narcotic Drugs, an international treaty signed in 1961 as an Act of the United Nations. Signed by 73 nations including the United States, the USSR, India, and the United Kingdom, the Single Convention on Narcotic Drugs established Schedules for the legality of each drug and laid out an international agreement to fight addiction to recreational drugs by combatting the sale, trafficking, and use of scheduled drugs. All countries that signed the treaty passed laws to implement these rules within their borders. However, some countries that signed the Single Convention on Narcotic Drugs, such as the Netherlands, are more lenient with their enforcement of these laws.

In the United States, the Food and Drug Administration (FDA) has authority over all drugs, including psychoactive drugs. The FDA regulates which psychoactive drugs are over the counter and which are only available with a prescription. However, certain psychoactive drugs, like alcohol, tobacco, and drugs listed in the Single Convention on Narcotic Drugs are subject to criminal laws. The Controlled Substances Act of 1970 regulates the recreational drugs outlined in the Single Convention on Narcotic Drugs. Alcohol is regulated by state governments, but the federal National Minimum Drinking Age Act penalizes states for not following a national drinking age. Tobacco is also regulated by all fifty state governments. Most people accept such restrictions and prohibitions of certain drugs, especially the "hard" drugs, which are illegal in most countries.

In the medical context, psychoactive drugs as a treatment for illness is widespread and generally accepted. Little controversy exists concerning over the counter psychoactive medications in antiemetics and antitussives. Psychoactive drugs are commonly prescribed to patients with psychiatric disorders. However, certain critics believe that certain prescription psychoactives, such as antidepressants and stimulants, are overprescribed and threaten patients' judgement and autonomy.