Interest in surgical treatment of Parkinson's disease has increased as the limitations of medical treatment have become apparent (Medical Letter, 35:31, 1993). Two approaches have been used. The first is transplantation of dopamine-producing cells into the patient's brain. The second is stereotactic surgery in areas of the brain that modify movement.

Atomoxetine (Strattera - Lilly), a nonstimulant drug that is not a controlled substance, was approved by the FDA in early 2003 for the treatment of attention deficit hyperactivity disorder (ADHD). At that time, The Medical Letter concluded that it was unclear whether atomoxetine was as effective as stimulants such as methylphenidate (Concerta, and others) (Medical Letter 2003; 45:11). Since then, the drug has been heavily advertised directly to the public for use in both children and...

Invega Hafyera (Janssen), a long-acting, extended-release (ER) formulation of the second-generation antipsychotic paliperidone palmitate, has been approved by the FDA for twice-yearly IM treatment of schizophrenia in adults who have been adequately treated with another injectable ER formulation of the drug (Invega Sustenna or Invega Trinza). It is the first drug to become available in the US for twice-yearly treatment of schizophrenia.

The oral second-generation antipsychotic drug iloperidone (Fanapt – Vanda) has been approved by the FDA for acute treatment of manic or mixed episodes associated with bipolar I disorder in adults. First approved in 2009 for treatment of schizophrenia, iloperidone is the eighth second-generation antipsychotic to be approved for acute treatment of manic or mixed episodes of bipolar I disorder (see Table 1).

Summer heat waves cause thousands of cases of heat-related illness in the USA each year and hundreds of heat-related deaths, especially among the elderly. A few principles may be helpful in preventing and treating heat injury.

Zolpidem (Ambien - Searle), an imidazopyridine hypnotic available in Europe for several years, was recently approved by the US Food and Drug Administration for short-term treatment of insomnia.

Citalopram hydrobromide (Celexa - Forest/Parke-Davis), a selective serotonin reuptake inhibitor (SSRI) available in Europe since 1989, has now been approved by the US Food and Drug Administration (FDA) for treatment of depression. It is being advertised as having a 'favorable side-effect profile.'

Modafinil (Provigil), a benzhydryl sulfinylacetamide non-amphetamine stimulant that has been used in Europe since 1995, has now been approved by the FDA for treatment of excessive daytime sleepiness associated with narcolepsy.

Galantamine hydrobromide (Reminyl), a tertiary alkaloid and phenanthrene derivative extracted from daffodil bulbs, is now being marketed for oral treatment of mild to moderate Alzheimer's disease. Galantamine is the fourth acetylcholinesterase inhibitor approved for this indication.

Dexmethylphenidate (Focalin - Novartis), a new formulation of methylphenidate (Ritalin, and others) is now available for treatment of attention deficit/hyperactivity disorder (ADHD). Dexmethylphenidate is the d-threo-enantiomer of racemic methylphenidate. "Now the right half may be all your patients need," said a recent ad. Focalin is the third new methylphenidate formulation marketed in the last two years.