Most Read Articles
02 Jul 2019
New drug applications approved by US FDA as of 16 - 30 June 2019 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approval. Supplemental approvals may have occurred since the original approval date.
05 Aug 2019
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure-lowering drugs, as reported in a recent study.
Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.
14 May 2019
At the recent GLYCEMIC GUARDIANS™ dinner symposium, three eminent speakers spoke on theindispensable role of medical nutrition therapy (MNT) in improving outcomes for patients with type2 diabetes (T2D).

Carbamazepine, valproic acid may pose increased stroke risk in bipolar patients

22 Jul 2019

Mood stabilizers for bipolar disorder are implicated in the risk of stroke, which appears to vary among the different types of drugs, as suggested in a recent study. Carbamazepine carries the highest risk of stroke, followed by valproic acid, whereas lithium and lamotrigine have a null effect.

The study used data from the Taiwan National Health Insurance Research Database and identified 19,433 patients with bipolar disorder. Of these, 609 developed stroke. Researchers applied 14-day windows to evaluate the acute exposure effect of individual mood stabilizers on the risk of ischaemic, haemorrhagic and other types of stroke in the study population.

Mood stabilizers overall were associated with about a 20-percent increase in stroke risk (adjusted risk ratio, 1.26; p=0.041).

On separate analysis, acute exposure to carbamazepine posed the highest risk of stroke (adjusted risk ratio [RR], 1.68; p=0.018), especially the ischaemic type (adjusted RR, 1.81; p=0.037). Acute exposure to valproic acid, on the other hand, was associated with a heightened risk of haemorrhagic stroke (adjusted RR, 1.76; p=0.022).

Acute exposure to neither lithium nor lamotrigine significantly increased the risk of any type of stroke.

The current data may be used as a guide for choosing which mood stabilizers to use in the management of patients with bipolar disorder who require acute therapy for affective symptoms and who already have the risk factors for stroke, according to the researchers.

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Most Read Articles
02 Jul 2019
New drug applications approved by US FDA as of 16 - 30 June 2019 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approval. Supplemental approvals may have occurred since the original approval date.
05 Aug 2019
Use of alpha blockers in the treatment of hypertension in women is associated with an increased risk of hypotension and related events as compared with other blood pressure-lowering drugs, as reported in a recent study.
Dr. Bryan Li, Dr. Gerry Kwok, Dr. Thomas Yau, 07 Aug 2019

Case 1: A 59-year-old gentleman with advanced HCC was referred to our centre for management. He had a history of diabetes, hypertension and ischaemic heart disease. He was a nondrinker and not a carrier of hepatitis B or C.

Case 2: A 65-year-old man with a history of alcoholic cirrhosis and oesophageal varices was found to have rising AFP levels on routine follow-up. He also had a 3-year history of diabetes and was on diet control, with an HbA1c of 6.2 percent and fasting glucose of 6.8 mmol/L. He did not need any diabetic medications.
14 May 2019
At the recent GLYCEMIC GUARDIANS™ dinner symposium, three eminent speakers spoke on theindispensable role of medical nutrition therapy (MNT) in improving outcomes for patients with type2 diabetes (T2D).