September 2008

ECGs for Kids with ADHD?
An electrocardiogram may be advisable for some children before they begin pharmacologic treatment for attention-deficit/hyperactivity disorder.

Valproate for Agitation in Dementia
In two studies, valproate (Depakote and others) did not seem to decrease agitation and aggression in patients with dementia.

Topiramate in the Treatment of Borderline Personality Disorder
Preliminary research suggests topiramate may be useful in the treatment of borderline personality disorder.

In Brief
Generic Risperidone Now Available; Ginkgo biloba Not Effective for Dementia; Autism Linked to Defects in “Learning” Genes

Quetiapine Augmentation in GAD: A Negative Trial
In a recent study, augmenting paroxetine (Paxil and others) treatment of generalized anxiety disorder with quetiapine (Seroquel) was ineffective.

BTP Announces ASCP Partnership
BTP proudly announces our partnership with the American Society of Clinical Psychopharmacology (ASCP) and extends a warm welcome to all ASCP members.

In Brief

September 2008

On June 30, 2008, the U.S. Food and Drug Administration approved the first generic versions of risperidone (Risperdal and others). The labeling for generic risperidone may be different from that of Risperdal, because some uses of the trade-name medication are protected by patents and exclusivity rights.

McCarney and colleagues studied the effectiveness and safety profile of Ginkgo biloba for treating early stage dementia in a community setting (Int J Geriatr Psychiatry, in press). In a double-blind, parallel-group trial, 176 subjects, aged 55 years and older, with a clinical diagnosis of dementia were given a standardized extract of G. biloba, 120 mg/day, or placebo for 6 months. Patients who started treatment with cholinesterase inhibitors within 2 months of baseline or during follow-up were excluded. At study endpoint, ginkgo did not have a significant effect on cognitive functioning (ADAS-Cog) nor on participant- and caregiver-rated quality of life (QOL-AD).

The growing number of genetic defects associated with autism spectrum disorders are beginning to fit into a pattern (C. Wallis: New Clues to Autism's Cause, TIME, July 10, 2008. Available online at,8599,1821595,00.html. Accessed July 27, 2008). So far, there are more than a dozen genes believed to be involved in the development of autism, and they are found in various regions of the human chromosome. However, they all seem to be related to the physical and biochemical changes that occur during learning. At least 300 genes switch on and off to regulate experience-dependent learning, and defects in any number of them could lead to autism, possibly explaining the hundreds of varieties of autism spectrum disorder. Dr Eric M. Morrow and coworkers recently studied large families in the Middle East and Turkey, in which cousins sometimes married cousins, which provided subjects whose parents had common ancestors, thus increasing the role of inherited factors (Science 2008;321:218-223). They identified five new autism-related gene defects. Most of the defects were not in the part of the gene that encodes critical brain proteins, but in the part that controls whether the genes are fully or partially turned on or off. This might mean that certain therapies or drugs could help normalize the activity of these genes. It also suggests that early intervention involving intensive instruction in speech and social behavior may work by altering the expression of affected genes.

Heather S. Hopkins