View the Comparison Table: Some Drugs for Plaque Psoriasis

Bupropion (Wellbutrin - Burroughs Wellcome) was recently marketed in the USA for treatment of depression. First approved by the Food and Drug Administration in late 1985, the drug was withdrawn from the market in early 1986 because of a high incidence of seizures in one study.

Self-injection of papaverine, a smooth muscle relaxant, and phentolamine (Regitine), an alpha-adrenergic blocker, directly into the corpus cavernosum has been effective for treatment of impotence in some patients, even after complete quadriplegia, radical surgery for bladder or prostate cancer, or castration (Medical Letter, 29:95, 1987). Recently, injections of prostaglandin E1, now called alprostadil (Prostin VR - Upjohn), have also been tried for this purpose. No drug is approved for this use by the US Food and Drug Administration.

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.

Ciclopirox nail lacquer (Penlac - Dermik) has been approved by the FDA for treatment of mild-to-moderate onychomycosis due to Trichophyton rubrum, without involvement of the lunula. The drug has been available for many years as a lotion and cream (Loprox) for treatment of cutaneous fungal infection

The nicotine receptor partial agonist varenicline (Chantix - Pfizer) appears to be the most effective drug available to treat tobacco dependence, but the FDA has added a warning to the package insert about neuropsychiatric symptoms and exacerbations of preexisting psychiatric illness associated with its use. Agitation, hostility, depressed mood, suicidal ideation and suicidal behavior have been reported as postmarketing adverse events in patients who took varenicline and stopped smoking and in those who took the drug and continued to smoke.

The FDA has approved an extended-release formulation of clonidine hydrochloride (Kapvay– Shionogi) for treatment of attention-deficit/hyperactivity disorder (ADHD) in children 6-17 years old. It is the second alpha₂-adrenergic agonist approved for this indication; guanfacine hydrochloride (Intuniv) was the first, but only clonidine is approved for use with stimulants.

The nasal spray formulation of the corticosteroid fluticasone furoate is now available over the counter (OTC) as Flonase Sensimist Allergy Relief (GSK) in the same strength as the prescription product (Veramyst) for treatment of seasonal or perennial allergic rhinitis. It is the fourth intranasal corticosteroid to become available OTC.

Pediculosis capitis (head lice infestations) occur in all age groups, but especially in elementary school children. In most cases, transmission occurs by head-to-head contact. Pharmacologic treatment is recommended for persons with live lice or eggs (nits) within 1 cm of the scalp. Topical pediculicides should be tried first. Oral therapy is occasionally required for refractory infestations.

Mild to moderate plaque psoriasis can be treated with topical drugs and phototherapy. Patients with moderate to severe disease generally require systemic therapy. Guidelines for the treatment of psoriasis with topical therapy, phototherapy, and systemic drugs have recently been published.