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Too Little Safety Data To Approve Gardasil For Young Girls: CDC Warned Heart-Wrenching Return Home for Travoltas
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Medical Journal Issues Correction On Vioxx Paper Preventing weight gain associated with lithium
Goodwin and Goldstein (2003) advocate the following measures to prevent weight gain in patients on lithium carbonate:
Dietary/lifestyle measures
Encourage daily physical exercise
Restrict fluid intake to non-sugary liquids (e.g., water, diet soft drinks)
Avoid intake of simple carbohydrates, particularly early in the day (lithium may induce mild hypoglycemia, causing patients to increase caloric intake as they ?chase? their blood sugar through the day)
Medical/pharmacological measures
Measure free T4 and supplement thyroid hormone if necessary (T4 at or below the lower quartile of normal may indicate hypothyroidism, another cause of weight gain
If possible, avoid concurrent medications with additive weight gain effect
Consult with primary care physician about other options if weight gain exceeds 5 lbs despite preventive measures
Ref: - Goodwin, F.K. & Goldstein, M.A. (2003) Optimizing lithium treatment in bipolar disorder: a review of the literature and clinical recommendations. Journal of Psychiatric Practice, 9, 5, 333-343. Managing adverse effects of clozapine
Constipation: encourage high-fiber diet, adequate fluid intake, use of aperients if persistent
Fever: Symptomatic relief, check full blood count and look for sources of infection
Hypersalivation: Consider use of hyoscine hydrobromide (upto 300 mcg tds), pirenzepine (upto 50 mg tds)
Hypertension: Monitor closely, slow rate or halt dose increase, if persistent consider use of hypotensive agent (e.g., atenolol)
Hypotension: advise caution when getting up quickly, monitor closely, slow or halt dose increase.
Nausea: Consider use of antiemetic (avoid metoclopramide and prochlorperazine if previous problems with extrapyramidal side effects).
Neutropenia/agranulocytosis: Stop Clozapine, if outpatient admit to hospital
Nocturnal enuresis: avoid fluids in the evening, alter dose scheduling, if severe consider use of desmopressin
Sedation: reschedule dosing to give smaller morning or total dose
Seizures: Withhold clozapine for 24 hours, recommence at lower dose, consider prophylactic anticonvulsant
Weight gain: Dietary and exercise counseling
Ref: - Semple, D., Smyth, R., Burns, J., Darjee, R. & McIntosh, A. (2005) Oxford Handbook of Psychiatry, New York: Oxford University Press. Apple CEO Blames 'Hormone Imbalance'
Steve Jobs announced today that a hormone imbalance caused his weight loss.
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