Risperdal - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

RISPERDAL A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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RISPERDAL A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Risperdal: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84067-9 1. Risperdal-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Risperdal. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON RISPERDAL ................................................................................................ 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Risperdal ....................................................................................... 6 E-Journals: PubMed Central ....................................................................................................... 10 The National Library of Medicine: PubMed ................................................................................ 10 CHAPTER 2. NUTRITION AND RISPERDAL ...................................................................................... 27 Overview...................................................................................................................................... 27 Finding Nutrition Studies on Risperdal ...................................................................................... 27 Federal Resources on Nutrition ................................................................................................... 32 Additional Web Resources ........................................................................................................... 33 CHAPTER 3. CLINICAL TRIALS AND RISPERDAL ............................................................................. 35 Overview...................................................................................................................................... 35 Recent Trials on Risperdal ........................................................................................................... 35 Keeping Current on Clinical Trials ............................................................................................. 39 CHAPTER 4. PATENTS ON RISPERDAL ............................................................................................. 41 Overview...................................................................................................................................... 41 Patents on Risperdal .................................................................................................................... 41 Patent Applications on Risperdal ................................................................................................ 43 Keeping Current .......................................................................................................................... 44 CHAPTER 5. BOOKS ON RISPERDAL................................................................................................. 45 Overview...................................................................................................................................... 45 Book Summaries: Online Booksellers........................................................................................... 45 The National Library of Medicine Book Index ............................................................................. 45 Chapters on Risperdal .................................................................................................................. 46 CHAPTER 6. PERIODICALS AND NEWS ON RISPERDAL ................................................................... 47 Overview...................................................................................................................................... 47 News Services and Press Releases................................................................................................ 47 Academic Periodicals covering Risperdal..................................................................................... 49 CHAPTER 7. RESEARCHING MEDICATIONS .................................................................................... 51 Overview...................................................................................................................................... 51 U.S. Pharmacopeia....................................................................................................................... 51 Commercial Databases ................................................................................................................. 52 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 55 Overview...................................................................................................................................... 55 NIH Guidelines............................................................................................................................ 55 NIH Databases............................................................................................................................. 57 Other Commercial Databases....................................................................................................... 59 APPENDIX B. PATIENT RESOURCES ................................................................................................. 61 Overview...................................................................................................................................... 61 Patient Guideline Sources............................................................................................................ 61 Finding Associations.................................................................................................................... 63 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 65 Overview...................................................................................................................................... 65 Preparation................................................................................................................................... 65 Finding a Local Medical Library.................................................................................................. 65 Medical Libraries in the U.S. and Canada ................................................................................... 65 ONLINE GLOSSARIES.................................................................................................................. 71 Online Dictionary Directories ..................................................................................................... 71

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RISPERDAL DICTIONARY .......................................................................................................... 73 INDEX ................................................................................................................................................ 99

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Risperdal is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about Risperdal, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to Risperdal, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on Risperdal. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to Risperdal, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on Risperdal. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON RISPERDAL Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Risperdal.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and Risperdal, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “Risperdal” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Effect of Risperidone on Behavioral and Psychological Symptoms and Cognitive Function in Dementia Source: Journal of Clinical Psychiatry. 62: 894-900. November 2001. Summary: This article describes an open-label study of risperidone for the treatment of aggression, agitation, and psychotic symptoms in dementia. A total of 34 hospital inpatients and outpatients with dementia were treated with flexible doses of risperidone (0.5 to 2.0 mg/day) for 8 weeks. Assessments were conducted at baseline and after weeks 4 and 8. At the end of the study, 18 percent of the patients were receiving risperidone 0.5 mg/day, 50 percent were receiving 1 mg/day, and 32 percent were receiving more than 1 mg/day. Eighty-two percent of patients showed improvement on a measure of global functioning. The frequency and severity of delusions, hallucinations, agitation/aggression, and irritability were substantially reduced, and

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cognitive function was maintained throughout the study period. Risperidone treatment was well tolerated and no clinically significant adverse effects were observed. The results suggest that low-dose risperidone can be useful for treating the behavioral and psychological symptoms of dementia. 3 figures, 3 tables, 39 references. •

Risperidone Treatment of Behavioral Disturbances in Outpatients With Dementia Source: Journal of Neuropsychiatry and Clinical Neuroscience. 11(3): 336-342. Summer 1999. Summary: This article reports the effectiveness and side effects of risperidone used to treat behavioral disturbances in 41 older outpatients with dementia. The sample included 32 patients with probable Alzheimer's disease. The mean dose of risperidone was 1.8 mg/day, and the mean duration of treatment was 4.2 months. The indications for risperidone treatment were hallucinations in 15 patients (37%), delusions in 13 (32%), and agitation in 31 (76%). There was complete suppression of the target symptom in 15 percent of the patients, partial response in 41 percent, and no response in 44 percent. Risperidone appeared equally effective in treating agitation and psychosis. New or worsening extrapyramidal side effects occurred in 32 percent of the patients and was associated with longer duration of treatment and possibly the concomitant use of serotonergic antidepressants. 4 tables, 39 references.

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Structured Trial of Risperidone for the Treatment of Agitation in Dementia Source: American Journal of Geriatric Psychiatry. 6(2): 127-135. Spring 1998. Summary: This journal article describes a 9-week structured trial of risperidone for agitated behaviors in 15 patients with dementia on a geriatric psychiatric inpatient unit. Their mean age was 78.5 years and mean duration of dementia was 60.7 months; 8 of the patients had Alzheimer's disease. All patients exhibited agitated behaviors, four had fragmented delusional ideas, and one had a history of psychosis during the early stages of dementia. After baseline assessment, the patients began a three-week dose finding phase followed by a six-week extended treatment phase. Risperidone was started at 0.5 mg per day and adjusted as frequently as twice a week based on clinical response and side effects. Aggressive symptoms decreased substantially over three weeks, whereas global agitation declined over a longer period of five to seven weeks. Of the 13 patients who completed the trial, 4 were judged to be much improved and 9 as very much improved. The modal optimal daily dose of risperidone was 0.5 mg per day. Extrapyramidal symptoms developed in eight patients, but resolved with dose reduction in four cases. Cognitive skills declined in three patients. The authors conclude that risperidone may be effective for the treatment of agitation in dementia, although adverse extrapyramidal or cognitive effects might occur, even with low doses. 2 figures, 1 table, 57 references.

•

Randomized Trial of Risperidone, Placebo, and Haloperidol for Behavioral Symptoms of Dementia Source: Neurology. 53: 946-955. September 1999. Summary: This journal article describes a randomized trial comparing the efficacy and tolerability of risperidone with placebo, and the tolerability of haloperidol as treatment for aggression and other behavioral symptoms in patients with dementia. After a 1week washout period, 344 dementia patients were randomly assigned to receive placebo or flexible doses of risperidone or haloperidol for 12 weeks. Efficacy and tolerability assessments were conducted at selection, baseline, and weeks 1, 2, 4, 6, 8, 10, and 12. The

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primary end point was defined as the percentage of patients with a 30 percent or greater improvement on a standard behavioral measure. The mean dose at end point was 1.1 mg/d of risperidone and 1.2 mg/d of haloperidol. Risperidone resulted in a greater reduction in the severity and frequency of behavioral symptoms, particularly aggression, than did placebo. Severity of extrapyramidal symptoms with risperidone did not differ significantly from that of placebo and was less than that of haloperidol. The authors conclude that low-dose risperidone appears to be well tolerated and effective for reducing the behavioral symptoms of dementia. 4 figures, 4 tables, 39 references. •

Risperidone in the Elderly: A Pharmacoepidemiologic Study Source: Journal of Clinical Psychiatry. 58(7): 311-317. July 1997. Summary: This journal article describes a study of the efficacy and safety of risperidone in 122 hospitalized psychiatric patients, aged 65 years and older. The patients were given risperidone for agitation or psychosis associated with dementia (53 percent), a major mood disorder (29 percent), or other disorders (18 percent). Most patients also were medically ill and received other psychotropic or cardiovascular agents. Daily doses of risperidone ranged from 0.25 to 8.0 mg (average 1.6 mg). Risperidone appeared to be effective in 85 percent of cases, but it was discontinued in 11 percent due to intolerability and in 7 percent due to inefficacy. Adverse events occurred in 32 percent of the patients. Benefits were associated with younger age and male gender, but not with risperidone dosage. Adverse events were associated with cardiovascular disease and its treatment, cotreatment with a serotonin reuptake inhibitor antidepressant or valproate, and relatively rapid dose increases. The authors conclude that risperidone may be safe and effective for many older psychiatric patients when given in low doses and when dosage is increased slowly. 2 tables, 31 references. (AA-M).

•

Risperidone for Dementia-Related Disturbed Behavior in Nursing Home Residents: A Clinical Experience Source: International Psychogeriatrics. 9(1): 65-68. 1997. Summary: This journal article describes the use of risperidone in 109 patients with dementia-related behavioral disturbances who lived in 9 nursing homes in Rhode Island. Fifty-five percent of the patients had Alzheimer's disease (AD), 18 percent had multiinfarct dementia, 15 percent had a combination of AD and multiinfarct dementia, 5 percent had Parkinson's disease, and 8 percent had dementia of unknown origin. Participants ranged in age from 57 to 99 years, and all were taking multiple medications for various psychiatric and medical illnesses. Their behavior problems included physical aggression and agitation, verbal outbursts, anxiety, hallucinations, delusions, and depression. A nursing staff member at each nursing home monitored the patients' behavior over a period of up to 6 months. Most of the patients received 0.25 mg or 0.50 mg of risperidone twice daily. The medication was well tolerated in all but 17 patients. The nurses rated risperidone as very helpful in 38 of 100 patients, moderately helpful in 26, slightly helpful in 17, and not helpful in 19. The authors conclude that risperidone may be a safe and effective option for nursing home residents who are receiving multiple concurrent medications. 2 tables, 15 references.

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Comparison of Risperidone and Placebo for Psychosis and Behavioral Disturbances Associated With Dementia: A Randomized, Double-Blind Trial Source: Journal of Clincial Psychiatry. 60(2): 107-115. February 1999.

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Summary: This journal article reports the findings from the first large, double-blind, placebo-controlled study that evaluated the efficacy and safety of risperidone for treating psychotic and behavioral symptoms in institutionalized elderly patients with dementia. Researchers randomly assigned Alzheimer's disease patients to receive either risperidone or placebo for 12 weeks. Data showed that patients receiving risperidone had significant reductions on a behavioral pathology rating scale, especially on the psychosis and aggressiveness subscales; risperidone was superior to placebo in reducing aggression scores; adverse effects were dose-dependent; and the most common adverse events were extrapyramidal symptoms, somnolence, and mild peripheral edema. The frequency of extrapyramidal symptoms was not significantly greater in risperidone patients compared to placebo. The authors conclude that risperidone significantly improved symptoms of psychosis and aggressive behavior in patients with severe dementia. The appropriate dose was shown to be 1 mg/day for most elderly patients with dementia. 3 figures, 3 tables, 24 references. (AA-M).

Federally Funded Research on Risperdal The U.S. Government supports a variety of research studies relating to Risperdal. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to Risperdal. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore Risperdal. The following is typical of the type of information found when searching the CRISP database for Risperdal: •

Project Title: CANNABIS AND SCHIZOPHRENIA: CLOZAPINE VS RISPERIDONE Principal Investigator & Institution: Green, Alan I.; Psychiatry; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2002; Project Start 30-SEP-2000; Project End 30-NOV-2002 Summary: (Applicant's Abstract) Cannabis use disorder contributes to the morbidity of schizophrenia, leading to, poorer overall functioning. The typical antipsychotic drugs are of limited value in controlling cannabis use in these "dual diagnosis" patients. This study will assess whether new antipsychotic medications, introduced into clinical practice in the past decade, are of value for this purpose. Preliminary data suggest that the atypical antipsychotic drug clozapine (CLOZ), currently used primarily for treatment resistant patients, may limit cannabis use in "dual diagnosis" patients with schizophrenia much more effectively than do either typical antipsychotics or the "novel" (post-CLOZ) antipsychotic risperidone (RISP). In a recently published paper, we have

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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hypothesized (a) that CLOZ will lessen substance use in such "dual diagnosis" patients in part because of its mechanism of action that includes release of dopamine (DA) in the prefrontal cortex (PFC), and (b) that the CLOZ-induced release of DA in the PFC will decrease negative symptoms (an effect shared especially by the novel antipsychotic RISP). Moreover, we have further hypothesized, (c) that through its diverse effects on both dopaminergic and noradrenergic systems, CLOZ (but not RISP or typical antipsychotics) will help to normalize dysfunctional brain reward circuits that may underlie the comorbid substance use in patients with schizophrenia. In the proposed study, patients comorbid for both schizophrenia and a cannabis use disorder will be randomly assigned to double-blind treatment (for 12 weeks) with either CLOZ or RISP. The primary aim of this study is to launch a carefully controlled pharmacological trial of the short-term effects of CLOZ and RISP on cannabis use in this population to test the hypothesis that patients treated with CLOZ will have decreases in cannabis use as compared to patients treated with RISP. A secondary aim is to begin to investigate the process by which CLOZ produces its effects on cannabis use through study of negative symptoms. A subsidiary aim is to begin to address key auxiliary measures of the effects of CLOZ in this "dual diagnosis" population: psychiatric symptoms, quality of life, and measures of neuropsychological functions. If the results of this study confirm the preliminary data, they could suggest a new use for CLOZ, one that could have important public health implications. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DIVALPROEX SODIUM & RISPERIDONE IN PEDIATRIC BIPOLAR DIS Principal Investigator & Institution: Pavuluri, Mani N.; Psychiatry; University of Illinois at Chicago 1737 West Polk Street Chicago, Il 60612 Timing: Fiscal Year 2003; Project Start 15-AUG-2003; Project End 31-JUL-2008 Summary: (provided by applicant): Pediatric bipolar disorder (PBD) is increasingly recognized, poorly understood, and ineffectively treated. With newly available fMRI technology, the field has matured for use in children to examine underlying brain dysfunction and treatment effects in PBD. There are very few investigators in the field trained to integrate clinical trials with fMRI methods. This career (K23) award will permit the candidate to develop as an independent clinical investigator to fill this void. The project described below serves as a medium to learn new skills under the mentorship of active, senior clinical investigators and will also allow her to take part in didactic training by protecting her time for these activities. The proposal reflects the need to bring a multidisciplinary approach to clinical research, particularly in the area of pediatric psychiatric research. Thus, the plan emphasizes pharmacotherapy, clinical trial methodology, statistics, ethics, and brain imaging using fMRI. The plan includes regular supervision by her primary mentors, interactions with internal and external-consultants and attendance at relevant didactic courses. Drs. Janicak and Sweeney will be the primary mentors. The study described in this application will examine treatment effects on the disturbances of affective circuitry hypothesized to underlie PBD. Specifically, the central aim is to conduct a double-blind, randomized clinical trial to test the hypothesis that the novel antipsychotic, risperidone, will have a rapid onset of action and efficacy at least comparable to divalproex sodium in the treatment of mixed and manic episodes of PBD. A pilot study, using a subset of subjects, will investigate whether activity in the amygdala and prefrontal cortex (PFC) underlies dysfunction in the affective circuitry of PBD and whether effective treatment normalizes any aberrant activity. During five

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years, 40 outpatient subjects with PBD manic or mixed episodes, ages 8-17 years, referred to the UI Pediatric Mood Disorder Clinic will be recruited. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DOUBLE BLIND PLACEBO CONTROLLED TRIAL OF RISPERIDONE IN TS Principal Investigator & Institution: Peterson, Bradley S.; House Jamison Assistant Professor; Yale University 47 College Street, Suite 203 New Haven, Ct 065208047 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

•

Project Title: HALOPERIDOL, OLANZAPINE & RISPERIDONE IN CHILDREN W/ PSYCHOTIC DISORD Principal Investigator & Institution: Lieberman, Jeffrey J.; University of North Carolina Chapel Hill Office of Sponsored Research Chapel Hill, Nc 27599 Timing: Fiscal Year 2001 Summary: This abstract is not available. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: RISPERIDONE PHARMACOKINETICS IN CHILDREN WITH PDD Principal Investigator & Institution: Vinks, Alexander A.; Children's Hospital Med Ctr (Cincinnati) 3333 Burnet Ave Cincinnati, Oh 45229 Timing: Fiscal Year 2001; Project Start 30-SEP-2001; Project End 31-AUG-2004 Summary: (provided by applicant): Pervasive Developmental Disorder (PDD) is a category of extremely debilitating behavioral disorder of childhood which includes autism, and for whom efficacious therapy is lacking. Neuroleptic use in PDD is high even in children as young as 2 years. The PDD population appears to be particularly vulnerable and at increased risk of serious sequelae including extrapyramidal side effects (EPS) and tardive dyskinesia. An atypical neuroleptic risperidone (RIS) is now used in 87 percent of pediatric cases, but pharmacokinetic (PK) and safety data are lacking in this vulnerable population. Our laboratory has recently explored the relationship between the inter-individual metabolism of RIS and EPS. Recent evidence suggests that the major active metabolite of RIS, 9-hydroxyrisperidone (9-OH-RIS) is present in enantiomeric forms with potentially differing toxic profiles. This metabolic finding, coupled with the lack of basic PK information in children with PDD, suggests further study is needed to promote better dose titration and safety in the clinical use of RIS. Our research plan is to: (1) adapt and establish assay methodology sufficient for pediatric sampling; (2) prove feasibility of RIS and 9-OH-RIS enantiomers determination in samples from pediatric PDD patients; (3) gather preliminary population PK data sufficient to provide parameter estimates to allow future full population PK characterization in children suffering from PDD, and explore the relationship between EPS adverse event data and RIS metabolism/ elimination. We propose a collaborative multi-center approach utilizing the complementary strengths of two NIH supported Pediatric Pharmacology Networks; i.e. the Pediatric Pharmacology Research Unit (PPRU) (lead site Cincinnati Children's) and the Research Units of Pediatric Psychopharmacology (RUPP) networks (lead site Ohio State). This strategy will rely on the unique strengths and expertise of each network to collaboratively produce

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innovative technology and apply it to a vulnerable population to achieve maximum public health benefit. The RUPP network is able to access PDD patients and optimize clinical sampling while the PPRU network has expertise in micro-assay development and access to a GLP certified lab (Louisiana State University) as well as population PK expertise (Cincinnati and San Diego). Specifically, we plan a population PK study in which we will determine drug concentration-time profiles of RIS by integrating information from relatively dense data, absorption phase levels through the early and late hours of drug elimination, with a sparse sampling strategy. The population approach will allow the analysis of data from ongoing clinical trials as well as from a study specifically designed for PK evaluation. RIS and 9-OH-RIS enantiomeric concentrations will be determined with a new low volume high sensitivity assay. Simultaneously we will survey therapeutic plasma concentrations of RIS and 9-OH-RIS enantiomers, characterize pharmacodynamic RIS and 9-OH-RIS enantiomers (e.g. EPS), and obtain safety/adverse event data. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: RISPERIDONE SCHIZOPHRENIA

TREATMENT

OF

ADOLESCENTS

WITH

Principal Investigator & Institution: Armenteros, Jorge L.; Psychiatry and Behavioral Scis; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2001; Project Start 01-MAR-1998; Project End 28-FEB-2003 Summary: (Adapted from applicant's abstract): Schizophrenia in adolescents is an understudied area and data on its psychopharmacological treatment are scarce. The goal of this First Independent Research Support and Transition (FIRST) Award proposal is to contribute to the development of a rational foundation for the pharmacological treatment of schizophrenia in adolescents. A program for the evaluation of risperidone will be used as a model. Over a 42 month period a minimum of 70 adolescents who meet DSM IV criteria and who need inpatient hospitalization are expected to complete the study. The primary aims of the study in this population are (1) to assess the short efficacy of risperidone (2) to assess critically the short-term safety of risperidone. Secondary aims are to examine the relationship of risperidone plasma levels to clinical response and side effects, the relationship of serotonin-2 (5-HT2) binding in blood platelets to risperidone treatment response and the effect of risperidone on cognitive functioning. The importance of this research arises from the pressing need for data about the safety and efficacy of neuroleptics in adolescents with schizophrenia; current treatment of this disorder in adolescents is based largely on extrapolation from research on adults even though research with other medications suggests that the response of adolescents to psychotropics may differ from adults. A double blind, placebo controlled parallel groups design will be used. An initial one week washout will be followed by a one week placebo baseline during which placebo will be administered under singleblind conditions. Patients who meet clinical criteria will be randomly assigned to two independent treatment groups, risperidone or placebo, for a period of four weeks. Treatment response will be measured with the Positive and Negative Syndrome Scale for Schizophrenia as well as other widely used measures sensitive to medication effects. Side effects will be carefully monitored with standard instruments. Plasma levels of risperidone plus 9-OH-risperidone will be monitored throughout the treatment period and related to treatment response and side effects. Pre- and post-treatment serotonin platelet will be assessed and related to treatment response. The study will advance knowledge about the pharmacological treatment of schizophrenia in adolescents (1) it will replace clinical anecdote and case reports about this now widely used medication

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with systematic data regarding efficacy and safety relative to placebo (2) it will provide needed information about the relationship between plasma levels, treatment response and side-effects and serve as guide for minimal effective therapeutic dose in the future (3) it will explore 5-HT2 platelet binding as a predictor of treatment response to risperidone, which may permit the selection of patients most likely to respond (4) it will examine the effects of risperidone on cognitive function. The study will also provide the basis for other innovative grant proposals by the Principal Investigator to study questions relevant to the treatment of schizophrenia in adolescents. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “Risperdal” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for Risperdal in the PubMed Central database: •

Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials. by Wooltorton E.; 2002 Nov 26; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=134141

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with Risperdal, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Risperdal” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Risperdal (hyperlinks lead to article summaries): 3 4

Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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1-year follow-up of patients treated with risperidone and topiramate for a manic episode. Author(s): Vieta E, Goikolea JM, Olivares JM, Gonzalez-Pinto A, Rodriguez A, Colom F, Comes M, Torrent C, Sanchez-Moreno J. Source: The Journal of Clinical Psychiatry. 2003 July; 64(7): 834-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12934986&dopt=Abstract

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A case of neuroleptic malignant syndrome with clozapine and risperidone. Author(s): Beauchemin MA, Millaud F, Nguyen KA. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 November; 47(9): 886. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500761&dopt=Abstract

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A case of risperidone-induced priapism. Author(s): Relan P, Gupta N, Mattoo SK. Source: The Journal of Clinical Psychiatry. 2003 April; 64(4): 482-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716256&dopt=Abstract

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A case series of eight aggressive young children treated with risperidone. Author(s): Cesena M, Gonzalez-Heydrich J, Szigethy E, Kohlenberg TM, DeMaso DR. Source: Journal of Child and Adolescent Psychopharmacology. 2002 Winter; 12(4): 33745. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12625994&dopt=Abstract

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A clinical evaluation of risperidone in the treatment of schizophrenia: a 10-week, open-label, multicenter trial. ARCS Study Group. Assessment of Risperdal in a Clinical Setting. Author(s): Jeste DV, Klausner M, Brecher M, Clyde C, Jones R. Source: Psychopharmacology. 1997 June; 131(3): 239-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9203234&dopt=Abstract

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A double-blind comparison of olanzapine versus risperidone in the acute treatment of dementia-related behavioral disturbances in extended care facilities. Author(s): Fontaine CS, Hynan LS, Koch K, Martin-Cook K, Svetlik D, Weiner MF. Source: The Journal of Clinical Psychiatry. 2003 June; 64(6): 726-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823090&dopt=Abstract

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A naturalistic study of risperidone treatment in seven affiliated university hospitals in Korea. Author(s): Bahk WM, Pae CU, Chae JH, Kim KS, Jun TY, Tsoh J, Kim DJ, Lee CT, Lee C, Han SI, Choi BM, Han JH, Go HJ. Source: Psychiatry and Clinical Neurosciences. 2003 February; 57(1): 83-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12519459&dopt=Abstract

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A placebo-controlled trial of risperidone in Tourette syndrome. Author(s): Scahill L, Leckman JF, Schultz RT, Katsovich L, Peterson BS. Source: Neurology. 2003 April 8; 60(7): 1130-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12682319&dopt=Abstract

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A randomized placebo-controlled trial of risperidone for the treatment of aggression, agitation, and psychosis of dementia. Author(s): Brodaty H, Ames D, Snowdon J, Woodward M, Kirwan J, Clarnette R, Lee E, Lyons B, Grossman F. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 134-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633121&dopt=Abstract

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A structured, open trial of risperidone therapy for delusions of theft in Alzheimer disease. Author(s): Shigenobu K, Ikeda M, Fukuhara R, Komori K, Tanabe H. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 March-April; 11(2): 256-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12611757&dopt=Abstract

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Acute massive pulmonary thromboembolism associated with risperidone and conventional phenothiazines. Author(s): Kamijo Y, Soma K, Nagai T, Kurihara K, Ohwada T. Source: Circulation Journal : Official Journal of the Japanese Circulation Society. 2003 January; 67(1): 46-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12520151&dopt=Abstract

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Acute risperidone overdose. Author(s): Catalano G, Catalano MC, Taylor W. Source: Clinical Neuropharmacology. 1997 February; 20(1): 82-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9037577&dopt=Abstract

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Adjunctive risperidone treatment in post-traumatic stress disorder: a preliminary controlled trial of effects on comorbid psychotic symptoms. Author(s): Hamner MB, Faldowski RA, Ulmer HG, Frueh BC, Huber MG, Arana GW. Source: International Clinical Psychopharmacology. 2003 January; 18(1): 1-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490768&dopt=Abstract

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Alcohol and cannabis use in schizophrenia: effects of clozapine vs. risperidone. Author(s): Green AI, Burgess ES, Dawson R, Zimmet SV, Strous RD. Source: Schizophrenia Research. 2003 March 1; 60(1): 81-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505141&dopt=Abstract

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Amisulpride versus risperidone in the treatment of schizophrenic patients: a doubleblind pilot study in Taiwan. Author(s): Hwang TJ, Lee SM, Sun HJ, Lin HN, Tsai SJ, Lee YC, Chen YS. Source: J Formos Med Assoc. 2003 January; 102(1): 30-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12684609&dopt=Abstract

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Amisulpride vs. risperidone in chronic schizophrenia: results of a 6-month doubleblind study. Author(s): Sechter D, Peuskens J, Fleurot O, Rein W, Lecrubier Y; Amisulpride Study Group. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2002 December; 27(6): 1071-81. Erratum In: Neuropsychopharmacology. 2003 March; 28(3): 611. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464464&dopt=Abstract

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An integrated analysis of acute treatment-emergent extrapyramidal syndrome in patients with schizophrenia during olanzapine clinical trials: comparisons with placebo, haloperidol, risperidone, or clozapine. Author(s): Carlson CD, Cavazzoni PA, Berg PH, Wei H, Beasley CM, Kane JM. Source: The Journal of Clinical Psychiatry. 2003 August; 64(8): 898-906. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12927004&dopt=Abstract

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Antiaggressive action of combined risperidone and quetiapine in a patient with schizophrenia. Author(s): Bozikas VP, Deseri C, Pitsavas S, Karavatos A. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 July; 48(6): 426-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894620&dopt=Abstract

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Aripiprazole, an Antipsychotic With a Novel Mechanism of Action, and Risperidone vs Placebo in Patients With Schizophrenia and Schizoaffective Disorder. Author(s): Potkin SG, Saha AR, Kujawa MJ, Carson WH, Ali M, Stock E, Stringfellow J, Ingenito G, Marder SR. Source: Archives of General Psychiatry. 2003 July; 60(7): 681-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860772&dopt=Abstract

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Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal by risperidone and melatonin. Author(s): Ayalon L, Hermesh H, Dagan Y. Source: Chronobiology International. 2002 September; 19(5): 947-59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12405556&dopt=Abstract

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Cerebral metabolism and risperidone treatment in schizophrenia. Author(s): Molina V, Gispert JD, Reig S, Sanz J, Pascau J, Santos A, Palomo T, Desco M. Source: Schizophrenia Research. 2003 March 1; 60(1): 1-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12505132&dopt=Abstract

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Clinical experience with the long-acting injectable formulation of the atypical antipsychotic, risperidone. Author(s): Martin SD, Libretto SE, Pratt DJ, Brewin JS, Huq ZU, Saleh BT. Source: Current Medical Research and Opinion. 2003; 19(4): 298-305. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12841922&dopt=Abstract

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Clinical trial response and dropout rates with olanzapine versus risperidone. Author(s): Santarlasci B, Messori A. Source: The Annals of Pharmacotherapy. 2003 April; 37(4): 556-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12659615&dopt=Abstract

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Combination risperidone and SSRI-induced serotonin syndrome. Author(s): Karki SD, Masood GR. Source: The Annals of Pharmacotherapy. 2003 March; 37(3): 388-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12639169&dopt=Abstract

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Comparative effects of risperidone and olanzapine on cognition in elderly patients with schizophrenia or schizoaffective disorder. Author(s): Harvey PD, Napolitano JA, Mao L, Gharabawi G. Source: International Journal of Geriatric Psychiatry. 2003 September; 18(9): 820-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12949850&dopt=Abstract

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Cost-effectiveness of risperidone, olanzapine, and conventional antipsychotic medications. Author(s): Jerrell JM. Source: Schizophrenia Bulletin. 2002; 28(4): 589-605. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12795493&dopt=Abstract

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Does risperidone act better in schizophrenic patients who have a family or obstetric history? Author(s): Borkowska A, Rybakowski JK. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 December; 26(7-8): 1349-53. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502024&dopt=Abstract

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DRD4 exon III polymorphism and response to risperidone in Israeli adolescents with schizophrenia: a pilot pharmacogenetic study. Author(s): Zalsman G, Frisch A, Lev-Ran S, Martin A, Michaelovsky E, Bensason D, Gothelf D, Nahshoni E, Tyano S, Weizman A. Source: European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology. 2003 May; 13(3): 183-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12729944&dopt=Abstract

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Dysphagia associated with risperidone therapy. Author(s): Stewart JT. Source: Dysphagia. 2003 Fall; 18(4): 274-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=14571332&dopt=Abstract

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Effect of divalproex combined with olanzapine or risperidone in patients with an acute exacerbation of schizophrenia. Author(s): Casey DE, Daniel DG, Wassef AA, Tracy KA, Wozniak P, Sommerville KW. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 January; 28(1): 182-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12496955&dopt=Abstract

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Effects of CYP2D6 genotypes on plasma concentrations of risperidone and enantiomers of 9-hydroxyrisperidone in Japanese patients with schizophrenia. Author(s): Yasui-Furukori N, Mihara K, Kondo T, Kubota T, Iga T, Takarada Y, De Vries R, Kaneko S, Tateishi T. Source: Journal of Clinical Pharmacology. 2003 February; 43(2): 122-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616663&dopt=Abstract

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Effects of patient demographics, risperidone dosage, and clinical outcome on body weight in acutely exacerbated schizophrenia. Author(s): Lane HY, Chang YC, Cheng YC, Liu GC, Lin XR, Chang WH. Source: The Journal of Clinical Psychiatry. 2003 March; 64(3): 316-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716274&dopt=Abstract

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Efficacy of quetiapine and risperidone against depressive symptoms in outpatients with psychosis. Author(s): Sajatovic M, Mullen JA, Sweitzer DE. Source: The Journal of Clinical Psychiatry. 2002 December; 63(12): 1156-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523876&dopt=Abstract

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Flupenthixol versus risperidone: subjective quality of life as an important factor for compliance in chronic schizophrenic patients. Author(s): Hertling I, Philipp M, Dvorak A, Glaser T, Mast O, Beneke M, Ramskogler K, Saletu-Zyhlarz G, Walter H, Lesch OM. Source: Neuropsychobiology. 2003; 47(1): 37-46. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12606844&dopt=Abstract

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Fluvoxamine augmentation in risperidone-resistant schizophrenia: an open trial. Author(s): Takashi H, Sugita T, Higuchi H, Shimizu T. Source: Human Psychopharmacology. 2002 March; 17(2): 95-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12404698&dopt=Abstract

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Frequency of sexual dysfunction and other reproductive side-effects in patients with schizophrenia treated with risperidone, olanzapine, quetiapine, or haloperidol: the results of the EIRE study. Author(s): Bobes J, Garc A-Portilla MP, Rejas J, Hern Ndez G, Garcia-Garcia M, RicoVillademoros F, Porras A. Source: Journal of Sex & Marital Therapy. 2003 March-April; 29(2): 125-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623765&dopt=Abstract

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Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Author(s): Kane JM, Eerdekens M, Lindenmayer JP, Keith SJ, Lesem M, Karcher K. Source: The American Journal of Psychiatry. 2003 June; 160(6): 1125-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12777271&dopt=Abstract

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Long-term effectiveness of risperidone and olanzapine in resistant or intolerant schizophrenic patients. A mirror study. Author(s): Soholm B, Lublin H. Source: Acta Psychiatrica Scandinavica. 2003 May; 107(5): 344-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12752030&dopt=Abstract

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Low-dose risperidone as adjunctive therapy for irritable aggression in posttraumatic stress disorder. Author(s): Monnelly EP, Ciraulo DA, Knapp C, Keane T. Source: Journal of Clinical Psychopharmacology. 2003 April; 23(2): 193-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640221&dopt=Abstract

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Low-dose risperidone augmentation of antidepressants in nonpsychotic depressive disorders with suicidal ideation. Author(s): Viner MW, Chen Y, Bakshi I, Kamper P. Source: Journal of Clinical Psychopharmacology. 2003 February; 23(1): 104-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12544386&dopt=Abstract

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Maintenance treatment of schizophrenia with risperidone or haloperidol: 2-year outcomes. Author(s): Marder SR, Glynn SM, Wirshing WC, Wirshing DA, Ross D, Widmark C, Mintz J, Liberman RP, Blair KE. Source: The American Journal of Psychiatry. 2003 August; 160(8): 1405-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12900301&dopt=Abstract

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Mood stabilisers plus risperidone or placebo in the treatment of acute mania. International, double-blind, randomised controlled trial. Author(s): Yatham LN, Grossman F, Augustyns I, Vieta E, Ravindran A. Source: The British Journal of Psychiatry; the Journal of Mental Science. 2003 February; 182: 141-7. Erratum In: Br J Psychiatry. 2003 April; 182: 369. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12562742&dopt=Abstract

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Neuroleptic malignant syndrome following administration of risperidone and lithium. Author(s): Bourgeois JA, Kahn DR. Source: Journal of Clinical Psychopharmacology. 2003 June; 23(3): 315-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12826996&dopt=Abstract

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Olanzapine and risperidone. Author(s): Love RC, Kelly DL. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 March 1; 60(5): 487-8; Author Reply 488-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12635459&dopt=Abstract

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Olanzapine versus risperidone in the treatment of schizophrenia : a comparison of costs among Texas Medicaid recipients. Author(s): Rascati KL, Johnsrud MT, Crismon ML, Lage MJ, Barber BL. Source: Pharmacoeconomics. 2003; 21(10): 683-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12828491&dopt=Abstract

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Olanzapine, risperidone and haloperidol in the treatment of adolescent patients with schizophrenia. Author(s): Gothelf D, Apter A, Reidman J, Brand-Gothelf A, Bloch Y, Gal G, Kikinzon L, Tyano S, Weizman R, Ratzoni G. Source: Journal of Neural Transmission (Vienna, Austria : 1996). 2003 May; 110(5): 54560. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12721815&dopt=Abstract

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Olanzapine/risperidone and diabetes risk. Author(s): Lee DW, Fowler RB. Source: The Journal of Clinical Psychiatry. 2003 July; 64(7): 847-8; Author Reply 848. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12934988&dopt=Abstract

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Optimal dose of risperidone and olanzapine for patients with schizophrenia in Taiwan. Author(s): Liu CY, Chiu NY, Wu CK, Yuan LM, Hsiao MC, Liao O. Source: International Clinical Psychopharmacology. 2003 January; 18(1): 49-51. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12490775&dopt=Abstract

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Outcomes and costs of treatment with risperidone in adult and elderly patients: the Delta patient using risperidone study. Author(s): Loonen AJ, Loos JC, Van Zonneveld TH. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002 December; 26(7-8): 1313-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12502019&dopt=Abstract

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Pharmacokinetic and safety assessments of concurrent administration of risperidone and donepezil. Author(s): Zhao Q, Xie C, Pesco-Koplowitz L, Jia X, Parier JL. Source: Journal of Clinical Pharmacology. 2003 February; 43(2): 180-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12616671&dopt=Abstract

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Pharmacokinetic comparison of fast-disintegrating and conventional tablet formulations of risperidone in healthy volunteers. Author(s): van Schaick EA, Lechat P, Remmerie BM, Ko G, Lasseter KC, Mannaert E. Source: Clinical Therapeutics. 2003 June; 25(6): 1687-99. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12860492&dopt=Abstract

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Pharmacology and clinical experience with risperidone. Author(s): Love RC, Nelson MW. Source: Expert Opinion on Pharmacotherapy. 2000 December; 1(7): 1441-53. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11249477&dopt=Abstract

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Plasma levels of homovanillic acid and the response to risperidone in first episode untreated acute schizophrenia. Author(s): Yoshimura R, Ueda N, Shinkai K, Nakamura J. Source: International Clinical Psychopharmacology. 2003 March; 18(2): 107-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12598823&dopt=Abstract

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Prevalence of hyperprolactinemia in schizophrenic patients treated with conventional antipsychotic medications or risperidone. Author(s): Kinon BJ, Gilmore JA, Liu H, Halbreich UM. Source: Psychoneuroendocrinology. 2003 April; 28 Suppl 2: 55-68. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12650681&dopt=Abstract

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Priapism associated with risperidone: a case report. Author(s): Bourgeois JA, Mundh H. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 218-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633135&dopt=Abstract

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Probable dementia with Lewy bodies and risperidone-induced delirium. Author(s): Morikawa M, Kishimoto T. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2002 December; 47(10): 976. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553140&dopt=Abstract

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Psychosis of Alzheimer disease: validity of the construct and response to risperidone. Author(s): Schneider LS, Katz IR, Park S, Napolitano J, Martinez RA, Azen SP. Source: The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry. 2003 July-August; 11(4): 414-25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12837670&dopt=Abstract

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Rate-decreasing effects of the atypical neuroleptic risperidone attenuated by conditions of reinforcement in a woman with mental retardation. Author(s): Yoo JH, Williams DC, Napolitano DA, Peyton RT, Baer DM, Schroeder SR. Source: J Appl Behav Anal. 2003 Summer; 36(2): 245-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12858988&dopt=Abstract

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Reader response to, “Effects of risperidone on aberrant behavior in persons with developmental disabilities: I. A double-blind crossover study using multiple measures”. Author(s): Levitas A. Source: Am J Ment Retard. 2003 May; 108(3): 212-4; Author Reply 214-6. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12691600&dopt=Abstract

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Relationship between risperidone and 9-hydroxy-risperidone plasma concentrations and CYP2D6 enzyme activity in psychiatric patients. Author(s): Berecz R, LLerena A, de la Rubia A, Gomez J, Kellermann M, Dorado P, Degrell I. Source: Pharmacopsychiatry. 2002 November; 35(6): 231-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12518271&dopt=Abstract

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Resolution of risperidone-induced hyperprolactinemia with substitution of quetiapine. Author(s): Kunwar AR, Megna JL. Source: The Annals of Pharmacotherapy. 2003 February; 37(2): 206-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12549948&dopt=Abstract

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Risperdal advertising in JAGS. Journal of the American Geriatrics Society. Author(s): Beers MH. Source: Journal of the American Geriatrics Society. 1999 March; 47(3): 377. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10078907&dopt=Abstract

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Risperdal and parkinsonian tremor. Author(s): Roberts MD. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 1999 March; 38(3): 230. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10087680&dopt=Abstract

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Risperidone (Risperdal): increased rate of cerebrovascular events in dementia trials. Author(s): Wooltorton E. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2002 November 26; 167(11): 1269-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12451085&dopt=Abstract

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Risperidone and megacolon. Author(s): Lim DK, Mahendran R. Source: Singapore Med J. 2002 October; 43(10): 530-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12587709&dopt=Abstract

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Risperidone as an alternative treatment for paroxysmal kinesigenic dyskinesia. Author(s): Karakurum B, Karatas M, Yildirim T. Source: Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2003 June; 24(2): 92-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12846222&dopt=Abstract

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Risperidone attenuates the discriminative-stimulus effects of d-amphetamine in humans. Author(s): Rush CR, Stoops WW, Hays LR, Glaser PE, Hays LS. Source: The Journal of Pharmacology and Experimental Therapeutics. 2003 July; 306(1): 195-204. Epub 2003 April 03. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12676890&dopt=Abstract

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Risperidone augmentation decreases rapid eye movement sleep and decreases wake in treatment-resistant depressed patients. Author(s): Sharpley AL, Bhagwagar Z, Hafizi S, Whale WR, Gijsman HJ, Cowen PJ. Source: The Journal of Clinical Psychiatry. 2003 February; 64(2): 192-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12633128&dopt=Abstract

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Risperidone compared with olanzapine in a naturalistic clinical study: a cost analysis. Author(s): Taylor DM, Wright T, Libretto SE; Risperidone Olanzapine Drug Outcomes Studies in Schizophrenia (RODOS) U.K. Investigator Group. Source: The Journal of Clinical Psychiatry. 2003 May; 64(5): 589-97. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12755664&dopt=Abstract

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Risperidone improves behavior in children with autism. Author(s): Caicedo C, Williams SH. Source: The Journal of Family Practice. 2002 November; 51(11): 915. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12485538&dopt=Abstract

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Risperidone in acute and continuation treatment of mania. Author(s): Yatham LN, Binder C, Riccardelli R, Leblanc J, Connolly M, Kusumakar V; RIS-CAN 25 Study Group. Source: International Clinical Psychopharmacology. 2003 July; 18(4): 227-35. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12817157&dopt=Abstract

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Risperidone in children with autism and serious behavioral problems. Author(s): Munarriz R, Bennett L, Goldstein I. Source: The New England Journal of Medicine. 2002 December 5; 347(23): 1890-1; Author Reply 1890-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472072&dopt=Abstract

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Risperidone in children with autism and serious behavioral problems. Author(s): Valiquette G. Source: The New England Journal of Medicine. 2002 December 5; 347(23): 1890-1; Author Reply 1890-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12472071&dopt=Abstract

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Risperidone in children with autism and serious behavioral problems. Author(s): Sandler L. Source: The New England Journal of Medicine. 2002 December 5; 347(23): 1890-1; Author Reply 1890-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12466518&dopt=Abstract

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Risperidone in chronic schizophrenia: a detailed audit, open switch study and twoyear follow-up of patients on depot medication. Author(s): Conlon L, Fahy TJ, OToole R, Gilligan J, Prescott P. Source: European Psychiatry : the Journal of the Association of European Psychiatrists. 2002 December; 17(8): 459-65. Erratum In: Eur Psychiatry. 2003 February; 18(1): 45. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12504262&dopt=Abstract

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Risperidone in the treatment of Hispanic inpatients with schizophrenia: a pilot study. Author(s): Frackiewicz EJ, Herrera JM, Sramek JJ, Collazo Y, Lawson WB. Source: Psychiatry. 2002 Winter; 65(4): 371-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12530340&dopt=Abstract

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Risperidone in the treatment of schizotypal personality disorder. Author(s): Koenigsberg HW, Reynolds D, Goodman M, New AS, Mitropoulou V, Trestman RL, Silverman J, Siever LJ. Source: The Journal of Clinical Psychiatry. 2003 June; 64(6): 628-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12823075&dopt=Abstract

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Risperidone induced galactorrhea: a case analysis. Author(s): Hariharan J, Mohsin J. Source: Wmj. 2002; 101(8): 41-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12557612&dopt=Abstract

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Risperidone liquid treatment of acute mania. Author(s): Abraham TM. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 July; 48(6): 425. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894618&dopt=Abstract

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Risperidone treatment of motor restlessness following anoxic brain injury. Author(s): Silver BV, Collins L, Zidek KA. Source: Brain Injury : [bi]. 2003 March; 17(3): 237-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12623500&dopt=Abstract

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Risperidone versus typical antipsychotic medication for schizophrenia. Author(s): Hunter RH, Joy CB, Kennedy E, Gilbody SM, Song F. Source: Cochrane Database Syst Rev. 2003; (2): Cd000440. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804396&dopt=Abstract

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Risperidone, but not olanzapine, decreases bone mineral density in female premenopausal schizophrenia patients. Author(s): Becker D, Liver O, Mester R, Rapoport M, Weizman A, Weiss M. Source: The Journal of Clinical Psychiatry. 2003 July; 64(7): 761-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12934975&dopt=Abstract

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Risperidone-associated diabetes mellitus: a pharmacovigilance study. Author(s): Koller EA, Cross JT, Doraiswamy PM, Schneider BS. Source: Pharmacotherapy. 2003 June; 23(6): 735-44. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12820816&dopt=Abstract

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Risperidone-associated ejaculatory and urinary dysfunction in male adolescents. Author(s): Holtmann M, Gerstner S, Schmidt MH. Source: Journal of Child and Adolescent Psychopharmacology. 2003 Spring; 13(1): 107-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12804132&dopt=Abstract

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Risperidone-induced galactorrhoea: a case series. Author(s): Gupta SC, Jagadheesan K, Basu S, Paul SE. Source: Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 2003 March; 48(2): 130-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12655919&dopt=Abstract

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Risperidone-induced obsessive-compulsive symptoms in two children. Author(s): Diler RS, Yolga A, Avci A, Scahill L. Source: Journal of Child and Adolescent Psychopharmacology. 2003; 13 Suppl 1: S89-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12880504&dopt=Abstract

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Safety profile assessment of risperidone and olanzapine in long-term care patients with dementia. Author(s): Martin H, Slyk MP, Deymann S, Cornacchione MJ. Source: Journal of the American Medical Directors Association. 2003 July-August; 4(4): 183-8. Erratum In: J Am Med Dir Assoc. 2003 September-October; 4(5): 290. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12837138&dopt=Abstract

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Schizophrenia treatment: the use of atypical drugs--risperdal, zyperexa, and clozaril. Author(s): Kalinyak CM. Source: Int J Psychiatr Nurs Res. 1998 September; 4(2): 445-51. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10451301&dopt=Abstract

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Sexual disinhibition induced by risperidone in a child. Author(s): Sharkey L, O'Donovan A. Source: Journal of Child and Adolescent Psychopharmacology. 2002 Winter; 12(4): 367. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12626000&dopt=Abstract

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The effect of risperidone treatment on superoxide dismutase in schizophrenia. Author(s): Zhang XY, Zhou DF, Cao LY, Zhang PY, Wu GY, Shen YC. Source: Journal of Clinical Psychopharmacology. 2003 April; 23(2): 128-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12640213&dopt=Abstract

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The impact upon extra-pyramidal side effects, clinical symptoms and quality of life of a switch from conventional to atypical antipsychotics (risperidone or olanzapine) in elderly patients with schizophrenia. Author(s): Ritchie CW, Chiu E, Harrigan S, Hall K, Hassett A, Macfarlane S, Mastwyk M, O'Connor DW, Opie J, Ames D. Source: International Journal of Geriatric Psychiatry. 2003 May; 18(5): 432-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12766921&dopt=Abstract

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The influence of risperidone on cognitive functions in schizophrenia. Author(s): Barkic J, Filakovic P, Radanovic-Grguric L, Koic O, Laufer D, Pozgain I, Koic E, Hotujac L. Source: Coll Antropol. 2003; 27 Suppl 1: 111-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12955900&dopt=Abstract

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The risk of diabetes during olanzapine use compared with risperidone use: a retrospective database analysis. Author(s): Caro JJ, Ward A, Levinton C, Robinson K. Source: The Journal of Clinical Psychiatry. 2002 December; 63(12): 1135-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12523873&dopt=Abstract

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Therapeutic drug monitoring data: risperidone does not increase serum clozapine concentration. Author(s): Raaska K, Raitasuo V, Neuvonen PJ. Source: European Journal of Clinical Pharmacology. 2002 December; 58(9): 587-91. Epub 2002 November 13. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12483451&dopt=Abstract

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Therapeutic drug monitoring of risperidone and 9-hydroxyrisperidone in serum with solid-phase extraction and high-performance liquid chromatography. Author(s): Price MC, Hoffman DW. Source: Therapeutic Drug Monitoring. 1997 June; 19(3): 333-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9200776&dopt=Abstract

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Treatment for delirium with risperidone: results of a prospective open trial with 10 patients. Author(s): Horikawa N, Yamazaki T, Miyamoto K, Kurosawa A, Oiso H, Matsumoto F, Nishimura K, Karasawa K, Takamatsu K. Source: General Hospital Psychiatry. 2003 July-August; 25(4): 289-92. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12850662&dopt=Abstract

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Validated method for the determination of risperidone and 9-hydroxyrisperidone in human plasma by liquid chromatography-tandem mass spectrometry. Author(s): Remmerie BM, Sips LL, de Vries R, de Jong J, Schothuis AM, Hooijschuur EW, van de Merbel NC. Source: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences. 2003 January 15; 783(2): 461-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12482489&dopt=Abstract

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Valproic Acid and risperidone. Author(s): Good CR, Petersen CA, Krecko VF. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 January; 42(1): 2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500068&dopt=Abstract

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Valproic acid and risperidone: a drug interaction? Author(s): Sund JK, Aamo T, Spigset O. Source: Journal of the American Academy of Child and Adolescent Psychiatry. 2003 January; 42(1): 1-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12500067&dopt=Abstract

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Visual compatibility of risperidone solution and lithium citrate syrup. Author(s): Park SH, Gill MA, Dopheide JA. Source: American Journal of Health-System Pharmacy : Ajhp : Official Journal of the American Society of Health-System Pharmacists. 2003 March 15; 60(6): 612-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12659069&dopt=Abstract

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CHAPTER 2. NUTRITION AND RISPERDAL Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Risperdal.

Finding Nutrition Studies on Risperdal The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Risperdal” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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Risperdal

The following information is typical of that found when using the “Full IBIDS Database” to search for “Risperdal” (or a synonym): •

A naturalistic comparison of clozapine, risperidone, and olanzapine in the treatment of bipolar disorder. Author(s): Department of Psychiatry, Massachusetts General Hospital, Boston, USA. Source: Guille, C Sachs, G S Ghaemi, S N J-Clin-Psychiatry. 2000 September; 61(9): 63842 0160-6689

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A retrospective comparison of weight, lipid, and glucose changes between risperidone- and olanzapine-treated inpatients: metabolic outcomes after 1 year. Author(s): Department of Psychiatry, University of California, San Diego, USA. [email protected] Source: Meyer, Jonathan M J-Clin-Psychiatry. 2002 May; 63(5): 425-33 0160-6689

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Biochemical profile of risperidone, a new antipsychotic. Author(s): Department of Biochemical Pharmacology and Biochemistry, Janssen Research Foundation, Beerse, Belgium. Source: Leysen, J E Gommeren, W Eens, A de Chaffoy de Courcelles, D Stoof, J C Janssen, P A J-Pharmacol-Exp-Ther. 1988 November; 247(2): 661-70 0022-3565

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Catatonia-like events after valproic acid with risperidone and sertraline. Author(s): Department of Psychiatry and Behavioral Sciences, Mercer University School of Medicine, Macon, Georgia, USA. Source: Lauterbach, E C Neuropsychiatry-Neuropsychol-Behav-Neurol. 1998 July; 11(3): 157-63 0894-878X

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Combination of a mood stabilizer with risperidone or haloperidol for treatment of acute mania: a double-blind, placebo-controlled comparison of efficacy and safety. Author(s): Bipolar Research Program, Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, USA. [email protected] Source: Sachs, Gary S Grossman, Fred Ghaemi, S Nassir Okamoto, Akiko Bowden, Charles L Am-J-Psychiatry. 2002 July; 159(7): 1146-54 0002-953X

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Comparative effects of the antipsychotics sulpiride or risperidone in rats. I: bodyweight, food intake, body composition, hormones and glucose tolerance. Author(s): Department of Physiology, Los Andes University Medical School, 5101-A, Merida, Venezuela. [email protected] Source: Baptista, T Araujo de Baptista, E Ying Kin, N M Beaulieu, S Walker, D Joober, R Lalonde, J Richard, D Brain-Res. 2002 December 6; 957(1): 144-51 0006-8993

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D-Cycloserine added to risperidone in patients with primary negative symptoms of schizophrenia. Author(s): Harvard Medical School and the Schizophrenia Research Program of the Massachusetts General Hospital, Freedom Trail Clinic, 25 Staniford Street, Boston, MA 02114, USA. [email protected] Source: Evins, A Eden Amico, Ed Posever, Thomas A Toker, Rob Goff, Donald C Schizophr-Res. 2002 July 1; 56(1-2): 19-23 0920-9964

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Desmopressin for risperidone-induced enuresis. Author(s): University of Cincinnati College of Pharmacy, University of Cincinnati Medical Center, Ohio 45267-0004. Source: Bennett, J A Keck, P E Wallhausser, L J Ann-Clin-Psychiatry. 1994 June; 6(2): 139-40 1040-1237

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Disruption of prepulse inhibition of startle reflex in a neurodevelopmental model of schizophrenia: reversal by clozapine, olanzapine and risperidone but not by haloperidol. Author(s): Pharma Division, Preclinical CNS Research, F-Hoffmann-La Roche Ltd, CH4070 Basel, Switzerland. Source: Le Pen, Gwenaelle Moreau, Jean Luc Neuropsychopharmacology. 2002 July; 27(1): 1-11 0893-133X

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Effect of divalproex combined with olanzapine or risperidone in patients with an acute exacerbation of schizophrenia. Author(s): Mental Illness Research, Education, and Clinical Center, Portland VA Medical Center, OR 97201, USA. [email protected] Source: Casey, D E Daniel, D G Wassef, A A Tracy, K A Wozniak, P Sommerville, K W Neuropsychopharmacology. 2003 January; 28(1): 182-92 0893-133X

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Effects of acute or chronic administration of risperidone on motor and sexual behavior of male rats. Author(s): Institute of Pharmacology, University of Catania Medical School, Italy. Source: Drago, F Contarino, A Marino, R Anzallo, C Valerio, C Rampello, L Raffaele, R Scapagnini, U Pharmacol-Res. 1997 January; 35(1): 17-25 1043-6618

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Efficacy and safety of risperidone in the treatment of schizoaffective disorder: initial results from a large, multicenter surveillance study. Group for the Study of Risperidone in Affective Disorders (GSRAD). Author(s): Hospital Clinic, University of Barcelona, Spain. [email protected] Source: Vieta, E Herraiz, M Fernandez, A Gasto, C Benabarre, A Colom, F Martinez Aran, A Reinares, M J-Clin-Psychiatry. 2001 August; 62(8): 623-30 0160-6689

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Extrapyramidal symptoms with ritonavir/indinavir plus risperidone. Author(s): School of Pharmacy, Memorial University of Newfoundland, 300 Prince Phillip Drive, St. John's, Newfoundland A1B 3V6, Canada. [email protected] Source: Kelly, D V Beique, L C Bowmer, M I Ann-Pharmacother. 2002 May; 36(5): 827-30 1060-0280

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High-dose vitamin E plus vitamin B6 treatment of risperidone-related neuroleptic malignant syndrome. Author(s): Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada. [email protected] Source: Dursun, S M Oluboka, O J DevaraJanuary, S Kutcher, S P J-Psychopharmacol. 1998; 12(2): 220-1 0269-8811

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Improvement of both psychotic symptoms and Parkinsonism in a case of dementia with Lewy bodies by the combination therapy of risperidone and L-DOPA. Author(s): Department of Neuropsychiatry, Yamagata University School of Medicine, Japan. Source: Kato, Kimiyasu Wada, Tadashi Kawakatsu, Shinobu Otani, Koichi ProgNeuropsychopharmacol-Biol-Psychiatry. 2002 January; 26(1): 201-3 0278-5846

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Lack of specific effects of selective D(1) and D(2) dopamine antagonists vs. risperidone on morphine-induced hyperactivity. Author(s): Area de Psicobiologia, Facultad de Psicologia, Universitat de Valencia, Aptdo. 22.109, 46071, Valencia, Spain. Source: Rodriguez Arias, M Broseta, I Aguilar, M A Minarro, J Pharmacol-BiochemBehavolume 2000 May; 66(1): 189-97 0091-3057

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LSD-like panic from risperidone in post-LSD visual disorder. Author(s): Department of Psychiatry, Tufts University School of Medicine, Boston, Massachusetts, USA. Source: Abraham, H D Mamen, A J-Clin-Psychopharmacol. 1996 June; 16(3): 238-41 0271-0749

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Mood stabilisers plus risperidone or placebo in the treatment of acute mania. International, double-blind, randomised controlled trial. Author(s): University of British Columbia, Vancouver, Canada. [email protected] Source: Yatham, L N Grossman, F Augustyns, I Vieta, E Ravindran, A Br-J-Psychiatry. 2003 February; 182: 141-7 0007-1250

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Nicotine interactions with haloperidol, clozapine and risperidone and working memory function in rats. Author(s): Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. Source: Addy, N Levin, E D Neuropsychopharmacology. 2002 October; 27(4): 534-41 0893-133X

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Olanzapine, quetiapine, and risperidone: long-term effects on monoamine transporters in rat forebrain. Author(s): Mailman Research Center, McLean Division of Massachusetts General Hospital, Belmont, MA 02478, USA. [email protected] Source: Tarazi, F I Zhang, K Baldessarini, R J Neurosci-Lett. 2000 June 23; 287(2): 81-4 0304-3940

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Pharmacokinetic drug interaction potential of risperidone with cytochrome p450 isozymes as assessed by the dextromethorphan, the caffeine, and the mephenytoin test. Author(s): Unit of Biochemistry and Clinical Psychopharmacology, University Department of Adult Psychiatry, Cery Hospital, CH-Prilly-Lausanne, Switzerland. [email protected] Source: Eap, C B Bondolfi, G Zullino, D Bryois, C Fuciec, M Savary, L Jonzier Perey, M Baumann, P Ther-Drug-Monit. 2001 June; 23(3): 228-31 0163-4356

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Pharmacology of risperidone (R 64 766), a new antipsychotic with serotonin-S2 and dopamine-D2 antagonistic properties. Author(s): Department of Pharmacology, Janssen Research Foundation, Beerse, Belgium. Source: Janssen, P A Niemegeers, C J Awouters, F Schellekens, K H Megens, A A Meert, T F J-Pharmacol-Exp-Ther. 1988 February; 244(2): 685-93 0022-3565

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Placebo-controlled trial of D-cycloserine added to conventional neuroleptics, olanzapine, or risperidone in schizophrenia. Author(s): Ezrath Nashim-Herzog Memorial Hospital, Jerusalem, Israel. [email protected] Source: Heresco Levy, Uriel Ermilov, Marina Shimoni, Jonathan Shapira, Baruch Silipo, Gail Javitt, Daniel C Am-J-Psychiatry. 2002 Mar; 159(3): 480-2 0002-953X

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Plasma concentrations of risperidone and 9-hydroxyrisperidone: effect of comedication with carbamazepine or valproate. Author(s): Institute of Pharmacology, University of Messina, Italy. Source: Spina, E Avenoso, A Facciola, G Salemi, M Scordo, M G Giacobello, T Madia, A G Perucca, E Ther-Drug-Monit. 2000 August; 22(4): 481-5 0163-4356

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Restless legs syndrome probably induced by risperidone treatment. Author(s): Max Planck Institute of Psychiatry, Munich, Germany. [email protected] Source: Wetter, T C Brunner, J Bronisch, T Pharmacopsychiatry. 2002 May; 35(3): 109-11 0176-3679

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Risperidone compared with both lithium and haloperidol in mania: a double-blind randomized controlled trial. Author(s): Department of Psychiatry, University of the Witwatersrand Medical School, Johannesburg, South Africa. Source: Segal, J Berk, M Brook, S Clin-Neuropharmacol. 1998 May-June; 21(3): 176-80 0362-5664

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Risperidone counteracts lethality in an animal model of the serotonin syndrome. Author(s): Department of Psychiatry, Jichi Medical School, Tochigi-Ken, Japan. Source: Nisijima, K Yoshino, T Ishiguro, T Psychopharmacology-(Berl). 2000 May; 150(1): 9-14 0033-3158

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Risperidone for the treatment of cocaine dependence: randomized, double-blind trial. Author(s): Substance Abuse-Medications Development Research Center, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas-Houston, 77005, USA. [email protected] Source: Grabowski, J Rhoades, H Silverman, P Schmitz, J M Stotts, A Creson, D Bailey, R J-Clin-Psychopharmacol. 2000 June; 20(3): 305-10 0271-0749

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Risperidone in the elderly: a pharmacoepidemiologic study. Author(s): Pharmacoepidemiology Center, McLean Hospital, Belmons, MA 02178, USA. Source: Zarate, C A Baldessarini, R J Siegel, A J Nakamura, A McDonald, J Muir Hutchinson, L A Cherkerzian, T Tohen, M J-Clin-Psychiatry. 1997 July; 58(7): 311-7 01606689

•

Risperidone in the treatment of mania. Author(s): New and Experimental Psychopharmacology Clinic, McLean Hospital, Belmont, MA, USA. Source: Tohen, M Zarate, C A Centorrino, F Hegarty, J I Froeschl, M Zarate, S B J-ClinPsychiatry. 1996 June; 57(6): 249-53 0160-6689

•

Risperidone pre-treatment reduces the euphoric effects of experimentally administered cocaine. Author(s): Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, CA 90024, USA. [email protected] Source: Newton, T F Ling, W Kalechstein, A D Uslaner, J Tervo, K Psychiatry-Res. 2001 July 24; 102(3): 227-33 0165-1781

•

Risperidone-associated, benign transient visual disturbances in schizophrenic patients with a past history of LSD abuse. Author(s): Lev Hasharon Mental Health Medical Center, Pardessya, 90000, Netanya 42100, Israel. [email protected] Source: Lerner, Arturo G Shufman, Emi Kodesh, Arad Rudinski, Dmitri Kretzmer, Gavin Sigal, Mircea Isr-J-Psychiatry-Relat-Sci. 2002; 39(1): 57-60 0333-7308

•

Risperidone-induced neuroleptic malignant syndrome. Author(s): Arnold and Marie Schwartz College of Pharmacy, Long Island University, NY, USA. Source: Sharma, R Trappler, B Ng, Y K Leeman, C P Ann-Pharmacother. 1996 JulAugust; 30(7-8): 775-8 1060-0280

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•

The effect of risperidone and ritanserin on human IgG and IgM synthesis in vitro. Author(s): Department of Clinical Immunology, Institute of Preventive and Clinical Medicine, Bratislava, Slovak Republic. Source: Jahnova, E Physiol-Res. 1994; 43(1): 27-31 0862-8408

•

The effects of excitotoxic hippocampal lesions in rats on risperidone- and olanzapineinduced locomotor suppression. Author(s): Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA. [email protected] Source: Bardgett, M E Humphrey, W M Csernansky, J G Neuropsychopharmacology. 2002 December; 27(6): 930-8 0893-133X

•

The effects of the atypical antipsychotics clozapine, remoxipride and risperidone on the contractile characteristics of rat skeletal muscle in vitro. Author(s): Department of Surgery, Clinical Sciences Building, University of New South Wales, Prince Henry Hospital, Little Bay, NSW 2036, Australia. Source: Mendes, L S Collins, S P Pharmacol-Res. 1997 December; 36(6): 457-61 1043-6618

•

Treatment of risperidone-induced hyperprolactinemia with a dopamine agonist in children. Author(s): Pediatric Psychopharmacology Unit, Massachusetts General Hospital, Boston 02114, USA. [email protected] Source: Cohen, L G Biederman, J J-Child-Adolesc-Psychopharmacol. 2001 Winter; 11(4): 435-40 1044-5463

•

Use of the dopamine agonists bromocriptine and cabergoline in the management of risperidone-induced hyperprolactinemia in patients with psychotic disorders. Author(s): Department of Medicine, Winthrop University Hospital and the State University of New York at Stony Brook School of Medicine, Mineola, USA. [email protected] Source: Tollin, S R J-Endocrinol-Invest. 2000 December; 23(11): 765-70 0391-4097

•

Weight gain in a controlled study of risperidone in children, adolescents and adults with mental retardation and autism. Author(s): Department of Psychiatry and Behavioral Sciences, University of Kansas Medical Center, Kansas City 66160, USA. [email protected] Source: Hellings, J A Zarcone, J R Crandall, K Wallace, D Schroeder, S R J-ChildAdolesc-Psychopharmacol. 2001 Fall; 11(3): 229-38 1044-5463

•

Weight gain with risperidone among patients with mental retardation: effect of calorie restriction. Author(s): Northwest Clinical Research Center, Bellevue, Wash, USA. [email protected] Source: Cohen, S Glazewski, R Khan, S Khan, A J-Clin-Psychiatry. 2001 February; 62(2): 114-6 0160-6689

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

Nutrition

33

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

The following is a specific Web list relating to Risperdal; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Vitamins Vitamin B6 Source: Healthnotes, Inc.; www.healthnotes.com Vitamin E Source: Healthnotes, Inc.; www.healthnotes.com

35

CHAPTER 3. CLINICAL TRIALS AND RISPERDAL Overview In this chapter, we will show you how to keep informed of the latest clinical trials concerning Risperdal.

Recent Trials on Risperdal The following is a list of recent trials dedicated to Risperdal.8 Further information on a trial is available at the Web site indicated. •

Clozapine and Risperidone for Treatment of First Episode Schizophrenia and Cannabis Use Disorder Condition(s): Schizophrenia; Marijuana Abuse Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to compare the safety, effectiveness, and tolerability of clozapine and risperidone in patients with first episode schizophrenia and cannabis use disorder. Phase(s): Phase II; Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00063349

•

Comparison of Risperidone and Aripiprazole for Childhood-Onset Psychotic Disorders Condition(s): Schizophrenia; Schizophrenia Disorder with Psychotic Features Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH)

8

These are listed at www.ClinicalTrials.gov.

36

Risperdal

Purpose - Excerpt: The purpose of this study is to evaluate the effectiveness, safety, and tolerability of risperidone and aripiprazole in children and adolescents with schizophrenia and psychosis. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00011869 •

Glucose regulation during risperidone and olanzapine treatment Condition(s): Schizophrenia Study Status: This study is currently recruiting patients. Sponsor(s): National Center for Research Resources (NCRR); Janssen Pharmaceutica Purpose - Excerpt: The overall purpose of this research is to look at how two of the most commonly prescribed newer antipsychotic medications, risperidone and olanzapine, affect substances in the body such as glucose and insulin. Undesirable changes in blood sugar control, or glucose regulation, and type 2 diabetes can occur more commonly in individuals with schizophrenia compared to healthy subjects and subjects with other psychiatric conditions. While abnormalities in glucose regulation were first reported in schizophrenia before the introduction of antipsychotic medications, antipsychotic treatment may contribute significantly to abnormalities in glucose regulation. Attention to the way that antipsychotic medications may affect glucose regulation has increased as doctors have become more concerned in general about disease- and drug-related medical complications, including weight gain during antipsychotic treatment. Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00006195

•

Risperidone Treatment in Schizophrenia Patients Who Are Currently Taking Clozapine Condition(s): Schizophrenia Study Status: This study is currently recruiting patients. Sponsor(s): National Institute of Mental Health (NIMH) Purpose - Excerpt: The purpose of this study is to determine whether adding the drug risperidone is more effective than placebo in treating schizophrenic patients who are taking the drug clozapine. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00056498

•

The Efficacy and Safety of Risperidone in the Treatment of Adolescents with Schizophrenia Condition(s): Schizophrenia

Clinical Trials 37

Study Status: This study is currently recruiting patients. Sponsor(s): Johnson & Johnson Pharmaceutical Research and Development, L.L.C. Purpose - Excerpt: This is a clinical study of an investigational drug called risperidone which may be effective in the treatment of schizophrenia. The study will include approximately 260 patients in the United States and will be conducted in 15-20 sites. The purpose of this study is to compare the safety and effectiveness of daily doses of liquid risperidone in two different doses in the treatment of adolescents between the ages of 13 and 17 with a diagnosis of schizophrenia. The lower dose within this range may represent an ineffective therapeutic treatment. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034749 •

Infusion Laboratory: Protocol 3 (Risperidone) - 4 Condition(s): Cocaine-Related Disorders Study Status: This study is no longer recruiting patients. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: 1) To evaluate clinical safety issues pertaining to risperidone to cocaine and to its interaction. 2) To determine how pretreatment with risperidone modifies the subjective as well as physiological effects of cocaine. Phase(s): Phase I Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000339

•

A comparison of Seroquel vs. Risperidone in Schizophrenia Condition(s): Schizophrenia Study Status: This study is completed. Sponsor(s): AstraZeneca Purpose - Excerpt: The purpose of this study is to show equal efficacy of both quetiapine and risperidone in subjects treated with study medication for up to 8 weeks. Phase(s): Phase IV Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034905

•

Efficacy and Safety of Risperidone versus Placebo in patients with Psychosis of Alzheimer's Disease Condition(s): Dementia, Alzheimer Type Study Status: This study is completed. Sponsor(s): Johnson & Johnson Pharmaceutical Research and Development, L.L.C.

38

Risperdal

Purpose - Excerpt: The purpose of this study is to compare the effectiveness and safety of risperidone versus placebo in patients that have been diagnosed with psychosis of Alzheimer's Disease Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034762 •

Open label trial exploring a switch from oral medications, to risperidone depot microspheres Condition(s): Schizophrenia Study Status: This study is completed. Sponsor(s): Johnson & Johnson Pharmaceutical Research and Development, L.L.C. Purpose - Excerpt: The purpose of this trial is to look at the effectiveness of patients being switched from haldol, seroquel or zyprexa to biweekly risperidone injections. Phase(s): Phase III Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00034775

•

Phase II Double Blind Placebo Controlled Trial of Risperidone in Tourette Syndrome Condition(s): Tourette Syndrome Study Status: This study is completed. Sponsor(s): National Center for Research Resources (NCRR); Yale University Purpose - Excerpt: Objectives: I. Conduct a randomized, double blind, placebo controlled, parallel study of the atypical neuroleptic risperidone (RIS) in the treatment of children and adults with moderate to severe Tourette Syndrome. II. Evaluate further the safety of RIS in this population. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00004393

•

Risperidone for the Treatment of Cocaine Dependence - 7 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: 1. To evaluate clinical safety and pharmacological efficacy in the treatment of cocaine dependence. 2. Evaluate impact of treatment on craving. 3. Correlate evidence of baseline neurotoxic damage of cocaine with treatment outcome and clinical side-effects. Phase(s): Phase II

Clinical Trials 39

Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000342 •

Risperidone for Treatment of Cocaine Dependence in Outpatients - 12 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA) Purpose - Excerpt: To evaluate pharmacological efficacy and clinical safety in the treatment of cocaine and amphetamine dependence. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000347

•

Risperidone Treatment in Dually-Diagnosed Individuals - 2 Condition(s): Cocaine-Related Disorders Study Status: This study is completed. Sponsor(s): National Institute on Drug Abuse (NIDA); New York State Psychiatric Institute Purpose - Excerpt: To evaluate the safety and efficacy of risperidone for cocaine dependence in individuals with schizophrenia/schizoaffective illness. Phase(s): Phase II Study Type: Interventional Contact(s): see Web site below Web Site: http://clinicaltrials.gov/ct/show/NCT00000267

Keeping Current on Clinical Trials The U.S. National Institutes of Health, through the National Library of Medicine, has developed ClinicalTrials.gov to provide current information about clinical research across the broadest number of diseases and conditions. The site was launched in February 2000 and currently contains approximately 5,700 clinical studies in over 59,000 locations worldwide, with most studies being conducted in the United States. ClinicalTrials.gov receives about 2 million hits per month and hosts approximately 5,400 visitors daily. To access this database, simply go to the Web site at http://www.clinicaltrials.gov/ and search by “Risperdal” (or synonyms). While ClinicalTrials.gov is the most comprehensive listing of NIH-supported clinical trials available, not all trials are in the database. The database is updated regularly, so clinical trials are continually being added. The following is a list of specialty databases affiliated with the National Institutes of Health that offer additional information on trials:

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•

For clinical studies at the Warren Grant Magnuson Clinical Center located in Bethesda, Maryland, visit their Web site: http://clinicalstudies.info.nih.gov/

•

For clinical studies conducted at the Bayview Campus in Baltimore, Maryland, visit their Web site: http://www.jhbmc.jhu.edu/studies/index.html

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For cancer trials, visit the National Cancer Institute: http://cancertrials.nci.nih.gov/

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For eye-related trials, visit and search the Web page of the National Eye Institute: http://www.nei.nih.gov/neitrials/index.htm

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For heart, lung and blood trials, visit the Web page of the National Heart, Lung and Blood Institute: http://www.nhlbi.nih.gov/studies/index.htm

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For trials on aging, visit and search the Web site of the National Institute on Aging: http://www.grc.nia.nih.gov/studies/index.htm

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For rare diseases, visit and search the Web site sponsored by the Office of Rare Diseases: http://ord.aspensys.com/asp/resources/rsch_trials.asp

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For alcoholism, visit the National Institute on Alcohol Abuse and Alcoholism: http://www.niaaa.nih.gov/intramural/Web_dicbr_hp/particip.htm

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For trials on infectious, immune, and allergic diseases, visit the site of the National Institute of Allergy and Infectious Diseases: http://www.niaid.nih.gov/clintrials/

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For trials on arthritis, musculoskeletal and skin diseases, visit newly revised site of the National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health: http://www.niams.nih.gov/hi/studies/index.htm

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For hearing-related trials, visit the National Institute on Deafness and Other Communication Disorders: http://www.nidcd.nih.gov/health/clinical/index.htm

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For trials on diseases of the digestive system and kidneys, and diabetes, visit the National Institute of Diabetes and Digestive and Kidney Diseases: http://www.niddk.nih.gov/patient/patient.htm

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For drug abuse trials, visit and search the Web site sponsored by the National Institute on Drug Abuse: http://www.nida.nih.gov/CTN/Index.htm

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For trials on mental disorders, visit and search the Web site of the National Institute of Mental Health: http://www.nimh.nih.gov/studies/index.cfm

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For trials on neurological disorders and stroke, visit and search the Web site sponsored by the National Institute of Neurological Disorders and Stroke of the NIH: http://www.ninds.nih.gov/funding/funding_opportunities.htm#Clinical_Trials

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CHAPTER 4. PATENTS ON RISPERDAL Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.9 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “Risperdal” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Risperdal, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Risperdal By performing a patent search focusing on Risperdal, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

9Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

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Risperdal

will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on Risperdal: •

Risperidone oral formulation Inventor(s): Dries; Willy M. A. C. (Merksplas, BE), Francois; Marc K. J. (Brussel, BE) Assignee(s): Janssen Pharmaceutica N.V. (Beerse, BE) Patent Number: 5,453,425 Date filed: July 11, 1994 Excerpt(s): The present invention is concerned with physicochemically stable aqueous solutions of risperidone for oral administration which do not contain sorbitol. The present invention concerns an aqueous solution for oral administration comprising water, risperidone or a pharmaceutically acceptable acid addition salt thereof, a buffer to maintain the pH in the range of 2 to 6, and a preservative, characterized in that said solution is essentially free of sorbitol. The subject compositions are characterized by their improved physicochemical stability when compared to the art composition. The term "physicochemically stable" as herein defined refers to a solution wherein, after storage for a period up to 4 weeks at a temperature of 80.degree. C. or below, the residual amount of risperidone is 80% or more of the initial risperidone concentration. Several compositions of the subject invention are characterized by an unchanged concentration of fispefidone under even more stringent conditions, in particular an extended storage time at an elevated temperature. Web site: http://www.delphion.com/details?pn=US05453425__

•

Risperidone pamoate Inventor(s): Mesens; Jean L. (Wechelderzande, BE), Peeters; Jozef (Beerse, BE) Assignee(s): Janssen Pharmaceutica N.V. (Beerse, BE) Patent Number: 5,612,346 Date filed: September 22, 1995 Abstract: A compound which is a pamoate acid addition salt of risperidone, compositions comprising the same and processes for preparing said compound and compositions. Excerpt(s): This application is based upon PCT application Ser. No. PCT/EP 94/01296, filed Apr. 22, 1994, which claims priority from European Patent Application Ser. No. 93.201.216.4, filed on Apr. 28, 1993. Currently available long-acting neuroleptics include solutions in oils, e.g. sesame oil, of poorly water-soluble ester derivatives of the neuroleptic compounds. Trials to prolong the activity of some particular phenothiazine neuroleptics by the use of poorly water-soluble salts such as the pamoates proved to be little successful (e.g. Florence et al., 1976, J. Pharm. Sci., 65(11), 1665-1668). Unexpectedly, the use of the pamoate salt of risperidone in dogs significantly prolonged the release of risperidone, yielding plasma levels of risperidone and its active metabolite that were effective against apomorphine induced emesis during several weeks. Risperidone, its preparation and the pharmacological activity thereof are described in EP-0,196,132. The pamoate salt of risperidone can be prepared by the treatment of risperidone with parnoic acid or a salt derivative thereof, e.g. the disodium pamoate, in a reaction-inert solvent. In particular, risperidone pamoate can be prepared

Patents 43

by adding a solution of risperidone in an appropriate solvent, e.g. ethanol, to a solution of pamoic acid in an appropriate solvent, e.g. N,N-dimethylformamide, and stirring the mixture until precipitation of the risperidone pamoate salt. The reaction product may be isolated from the medium and, if necessary, further purified according to methodologies generally known in the art such as, for example, extraction, crystallization and chromatography. Micronized forms of the subject compounds can be prepared by micronization techniques known in the art, e.g. by milling in appropriate mills and sieving through appropriate sieves. Web site: http://www.delphion.com/details?pn=US05612346__

Patent Applications on Risperdal As of December 2000, U.S. patent applications are open to public viewing.10 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to Risperdal: •

Preparation of risperidone Inventor(s): Aronhime, Judith; (Rehovot, IL), Diller, Dov; (Jerusalem, IL), Dolitzky, BenZion; (Petach Tiqva, IL), Krochmal, Barnaba; (Jerusalem, IL) Correspondence: Kenyon & Kenyon; One Broadway; New York; NY; 10004; US Patent Application Number: 20020115672 Date filed: August 8, 2001 Abstract: The present invention is directed to the novel forms of risperidone, designated Form A, Form B and Form E. Methods for their preparation are also disclosed. The present invention also relates to processes for making risperidone. Pharmaceutical compositions containing the new forms of risperidone and methods of using them are also disclosed. Excerpt(s): This application claims the benefit of provisional application serial No. 60/223,779, filed Aug. 8, 2000; provisional application serial No. 60/225,361, filed Aug. 14, 2000; and provisional application serial No. 60/243,263, filed Oct. 25, 2000. All three of these applications are incorporated herein by reference. The present invention relates to novel polymorphic forms of risperidone. The present invention also relates to methods of making polymorphic forms of risperidone. RISPERDALS.RTM. (risperidone) is an antipsychotic agent belonging to a new chemical class, the benzisoxazole derivatives. The chemical designation is 3-[2-[4-(6-fluoro-1,2benzisoxazol-3-yl)-1-piperidinyl]ethyl]-6,7,8,9-tetrahydro-2-methyl-4H-pyrido[1,2a]pyrimidin-4-one. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

10

This has been a common practice outside the United States prior to December 2000.

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Risperdal

Keeping Current In order to stay informed about patents and patent applications dealing with Risperdal, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “Risperdal” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on Risperdal. You can also use this procedure to view pending patent applications concerning Risperdal. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON RISPERDAL Overview This chapter provides bibliographic book references relating to Risperdal. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Risperdal include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “Risperdal” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “Risperdal” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “Risperdal” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Risperdal : risperidone, clinical monograph; ISBN: 0444019057; http://www.amazon.com/exec/obidos/ASIN/0444019057/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “Risperdal” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:11 11

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed

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•

Pharmacoeconomic evaluation in schizophrenia: clozapine in treatment-resistant schizophrenia and risperidone in chronic schizophrenia Author: Oh, Paul.; Year: 1995; Ottawa, Ont.: CCOHTA Publications, [1997]; ISBN: 1895561523

•

Risperidone: major progress in antipsychotic treatment: Kyoto, Japan, Monday, September 10, 1990: satellite symposium at the 17th Congress of Collegium Internationale Neuro-psychopharmacologicum. Author: Collegium Internationale Neuro-psychopharmacologicum. Congress; Year: 1997; [Beerse, Belgium]: Janssen Research Foundation, [1990?]

•

Risperidone for the treatment of refractory schizophrenia Author: Robert, G.; Year: 2001; Bristol, England: U.K. National Health Service, South and West Regional Health Authority, 1995

Chapters on Risperdal In order to find chapters that specifically relate to Risperdal, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Risperdal using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Risperdal” (or synonyms) into the “For these words:” box.

in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

47

CHAPTER 6. PERIODICALS AND NEWS ON RISPERDAL Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Risperdal.

News Services and Press Releases One of the simplest ways of tracking press releases on Risperdal is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “Risperdal” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to Risperdal. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “Risperdal” (or synonyms). The following was recently listed in this archive for Risperdal: •

FDA approves Risperdal for bipolar disorder Source: Reuters Medical News Date: December 05, 2003

•

Risperidone may increase stroke risk in elderly Source: Reuters Medical News Date: April 11, 2003

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Risperdal

•

Company to warn of possible Risperdal stroke risk Source: Reuters Health eLine Date: April 11, 2003

•

JJ cleared to sell orally disintegrating Risperdal tablets Source: Reuters Medical News Date: April 03, 2003

•

FDA approves Risperdal for relapsing schizophrenia Source: Reuters Medical News Date: March 14, 2002

•

Janssen's extended-release Risperdal effective for schizophrenia in phase III Source: Reuters Industry Breifing Date: May 02, 2001

•

Janssen's pending Risperdal injectable uses Alkermes delivery technology Source: Reuters Industry Breifing Date: February 20, 2001

•

Risperidone reduces aggression in dementia patients Source: Reuters Health eLine Date: September 21, 1999

•

Risperidone more cost effective and efficacious than olanzapine for treatment of schizophrenia Source: Reuters Medical News Date: May 20, 1999

•

Janssen Pharmaceutica Applies For Once-Daily Risperdal Approval Source: Reuters Medical News Date: December 10, 1996 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at

Periodicals and News

49

http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “Risperdal” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “Risperdal” (or synonyms). If you know the name of a company that is relevant to Risperdal, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “Risperdal” (or synonyms).

Academic Periodicals covering Risperdal Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Risperdal. In addition to these sources, you can search for articles covering Risperdal that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

51

CHAPTER 7. RESEARCHING MEDICATIONS Overview While a number of hard copy or CD-ROM resources are available for researching medications, a more flexible method is to use Internet-based databases. Broadly speaking, there are two sources of information on approved medications: public sources and private sources. We will emphasize free-to-use public sources.

U.S. Pharmacopeia Because of historical investments by various organizations and the emergence of the Internet, it has become rather simple to learn about the medications recommended for Risperdal. One such source is the United States Pharmacopeia. In 1820, eleven physicians met in Washington, D.C. to establish the first compendium of standard drugs for the United States. They called this compendium the U.S. Pharmacopeia (USP). Today, the USP is a nonprofit organization consisting of 800 volunteer scientists, eleven elected officials, and 400 representatives of state associations and colleges of medicine and pharmacy. The USP is located in Rockville, Maryland, and its home page is located at http://www.usp.org/. The USP currently provides standards for over 3,700 medications. The resulting USP DI Advice for the Patient can be accessed through the National Library of Medicine of the National Institutes of Health. The database is partially derived from lists of federally approved medications in the Food and Drug Administration’s (FDA) Drug Approvals database, located at http://www.fda.gov/cder/da/da.htm. While the FDA database is rather large and difficult to navigate, the Phamacopeia is both user-friendly and free to use. It covers more than 9,000 prescription and over-the-counter medications. To access this database, simply type the following hyperlink into your Web browser: http://www.nlm.nih.gov/medlineplus/druginformation.html. To view examples of a given medication (brand names, category, description, preparation, proper use, precautions, side effects, etc.), simply follow the hyperlinks indicated within the United States Pharmacopeia (USP). Below, we have compiled a list of medications associated with Risperdal. If you would like more information on a particular medication, the provided hyperlinks will direct you to ample documentation (e.g. typical dosage, side effects, drug-interaction risks, etc.). The

52

Risperdal

following drugs have been mentioned in the Pharmacopeia and other sources as being potentially applicable to Risperdal: Risperidone •

Systemic - U.S. Brands: Risperdal http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202769.html

Commercial Databases In addition to the medications listed in the USP above, a number of commercial sites are available by subscription to physicians and their institutions. Or, you may be able to access these sources from your local medical library.

Mosby’s Drug Consult Mosby’s Drug Consult database (also available on CD-ROM and book format) covers 45,000 drug products including generics and international brands. It provides prescribing information, drug interactions, and patient information. Subscription information is available at the following hyperlink: http://www.mosbysdrugconsult.com/. PDRhealth The PDRhealth database is a free-to-use, drug information search engine that has been written for the public in layman’s terms. It contains FDA-approved drug information adapted from the Physicians’ Desk Reference (PDR) database. PDRhealth can be searched by brand name, generic name, or indication. It features multiple drug interactions reports. Search PDRhealth at http://www.pdrhealth.com/drug_info/index.html. Other Web Sites Drugs.com (www.drugs.com) reproduces the information in the Pharmacopeia as well as commercial information. You may also want to consider the Web site of the Medical Letter, Inc. (http://www.medletter.com/) which allows users to download articles on various drugs and therapeutics for a nominal fee. If you have any questions about a medical treatment, the FDA may have an office near you. Look for their number in the blue pages of the phone book. You can also contact the FDA through its toll-free number, 1-888-INFO-FDA (1-888-463-6332), or on the World Wide Web at www.fda.gov.

53

APPENDICES

55

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute12: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

12

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

Physician Resources

57

NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.13 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:14 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

13

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 14 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway15 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.16 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Risperdal” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 15 1 526 3 0 545

HSTAT17 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.18 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.19 Simply search by “Risperdal” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

15

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

16

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 17 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 18 19

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

Physician Resources

59

Coffee Break: Tutorials for Biologists20 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.21 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.22 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

20 Adapted 21

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 22 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on Risperdal can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Risperdal. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to Risperdal. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “Risperdal”:

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Risperdal

•

Other guides Alcoholism http://www.nlm.nih.gov/medlineplus/alcoholism.html Autism http://www.nlm.nih.gov/medlineplus/autism.html Bipolar Disorder http://www.nlm.nih.gov/medlineplus/bipolardisorder.html Child Mental Health http://www.nlm.nih.gov/medlineplus/childmentalhealth.html Schizophrenia http://www.nlm.nih.gov/medlineplus/schizophrenia.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on Risperdal. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Taking the Next Step With Risperdal: A Guide for Better Understanding of Mental Illness and Its Treatment Source: Titusville, NJ: Janssen Pharmaceutica Products. 1999. 14 p. Contact: Available from Janssen Pharmaceutica Products. (800) 526-7736. Internet: http://www.mentalwellness.com. Summary: This booklet is a guide to taking Risperdal (risperidone) for psychotic symptoms such as delusions or hallucinations which may occur in a patient with Alzheimer's disease. This booklet describes some of these symptoms and explains how Risperdal can help, how the medicine works, how long it takes to start working, what side effects may occur, and how to help ensure successful treatment. It includes tips for remembering to take Risperdal, a list of topics to discuss with a doctor, and suggestions about how to keep feeling better. The brochure also includes a pull-out reference card for recording personal and medical information, and the manufacturer's product information sheet.

Patient Resources

63

The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Risperdal. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Risperdal. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Risperdal. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about Risperdal. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at

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Risperdal

http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “Risperdal” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “Risperdal”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “Risperdal” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Risperdal” (or a synonym) into the search box, and click “Submit Query.”

65

APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.23

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

23

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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Risperdal

libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)24: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

24

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

Finding Medical Libraries

67

•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

71

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

73

RISPERDAL DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Aberrant: Wandering or deviating from the usual or normal course. [EU] Adenosine: A nucleoside that is composed of adenine and d-ribose. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter. [NIH] Adjunctive Therapy: Another treatment used together with the primary treatment. Its purpose is to assist the primary treatment. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age of Onset: The age or period of life at which a disease or the initial symptoms or manifestations of a disease appear in an individual. [NIH] Aggressiveness: The quality of being aggressive (= characterized by aggression; militant; enterprising; spreading with vigour; chemically active; variable and adaptable). [EU] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Akathisia: 1. A condition of motor restlessness in which there is a feeling of muscular quivering, an urge to move about constantly, and an inability to sit still, a common extrapyramidal side effect of neuroleptic drugs. 2. An inability to sit down because of intense anxiety at the thought of doing so. [EU] Alertness: A state of readiness to detect and respond to certain specified small changes occurring at random intervals in the environment. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH]

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Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amenorrhea: Absence of menstruation. [NIH] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]

Analgesic: An agent that alleviates pain without causing loss of consciousness. [EU] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anticonvulsant: An agent that prevents or relieves convulsions. [EU] Antidepressant: A drug used to treat depression. [NIH] Antiemetic: An agent that prevents or alleviates nausea and vomiting. Also antinauseant. [EU]

Antipsychotic: Effective in the treatment of psychosis. Antipsychotic drugs (called also neuroleptic drugs and major tranquilizers) are a chemically diverse (including phenothiazines, thioxanthenes, butyrophenones, dibenzoxazepines, dibenzodiazepines, and diphenylbutylpiperidines) but pharmacologically similar class of drugs used to treat schizophrenic, paranoid, schizoaffective, and other psychotic disorders; acute delirium and dementia, and manic episodes (during induction of lithium therapy); to control the movement disorders associated with Huntington's chorea, Gilles de la Tourette's syndrome, and ballismus; and to treat intractable hiccups and severe nausea and vomiting. Antipsychotic agents bind to dopamine, histamine, muscarinic cholinergic, a-adrenergic, and serotonin receptors. Blockade of dopaminergic transmission in various areas is thought to be responsible for their major effects : antipsychotic action by blockade in the mesolimbic and mesocortical areas; extrapyramidal side effects (dystonia, akathisia, parkinsonism, and tardive dyskinesia) by blockade in the basal ganglia; and antiemetic effects by blockade in the chemoreceptor trigger zone of the medulla. Sedation and autonomic side effects (orthostatic hypotension, blurred vision, dry mouth, nasal congestion and constipation) are

Dictionary 75

caused by blockade of histamine, cholinergic, and adrenergic receptors. [EU] Antipsychotic Agents: Agents that control agitated psychotic behavior, alleviate acute psychotic states, reduce psychotic symptoms, and exert a quieting effect. They are used in schizophrenia, senile dementia, transient psychosis following surgery or myocardial infarction, etc. These drugs are often referred to as neuroleptics alluding to the tendency to produce neurological side effects, but not all antipsychotics are likely to produce such effects. Many of these drugs may also be effective against nausea, emesis, and pruritus. [NIH] Antitussive: An agent that relieves or prevents cough. [EU] Anxiety: Persistent feeling of dread, apprehension, and impending disaster. [NIH] Apathy: Lack of feeling or emotion; indifference. [EU] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspartate: A synthetic amino acid. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Attenuated: Strain with weakened or reduced virulence. [NIH] Atypical: Irregular; not conformable to the type; in microbiology, applied specifically to strains of unusual type. [EU] Auditory: Pertaining to the sense of hearing. [EU] Autonomic: Self-controlling; functionally independent. [EU] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Behavioral Symptoms: Observable manifestions of impaired psychological functioning. [NIH]

Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Bioavailability: The degree to which a drug or other substance becomes available to the target tissue after administration. [EU]

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Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence. [NIH] Bladder: The organ that stores urine. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood Volume: Volume of circulating blood. It is the sum of the plasma volume and erythrocyte volume. [NIH] Body Composition: The relative amounts of various components in the body, such as percent body fat. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Bromocriptine: A semisynthetic ergot alkaloid that is a dopamine D2 agonist. It suppresses prolactin secretion and is used to treat amenorrhea, galactorrhea, and female infertility, and has been proposed for Parkinson disease. [NIH] Caffeine: A methylxanthine naturally occurring in some beverages and also used as a pharmacological agent. Caffeine's most notable pharmacological effect is as a central nervous system stimulant, increasing alertness and producing agitation. It also relaxes smooth muscle, stimulates cardiac muscle, stimulates diuresis, and appears to be useful in the treatment of some types of headache. Several cellular actions of caffeine have been observed, but it is not entirely clear how each contributes to its pharmacological profile. Among the most important are inhibition of cyclic nucleotide phosphodiesterases, antagonism of adenosine receptors, and modulation of intracellular calcium handling. [NIH] Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in

Dictionary 77

many enzymatic processes. [NIH] Cannabis: The hemp plant Cannabis sativa. Products prepared from the dried flowering tops of the plant include marijuana, hashish, bhang, and ganja. [NIH] Carbamazepine: An anticonvulsant used to control grand mal and psychomotor or focal seizures. Its mode of action is not fully understood, but some of its actions resemble those of phenytoin; although there is little chemical resemblance between the two compounds, their three-dimensional structure is similar. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Cardiac: Having to do with the heart. [NIH] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume. [NIH] Cardiovascular disease: Any abnormal condition characterized by dysfunction of the heart and blood vessels. CVD includes atherosclerosis (especially coronary heart disease, which can lead to heart attacks), cerebrovascular disease (e.g., stroke), and hypertension (high blood pressure). [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebellar: Pertaining to the cerebellum. [EU] Cerebellar Diseases: Diseases that affect the structure or function of the cerebellum. Cardinal manifestations of cerebellar dysfunction include dysmetria, gait ataxia, and muscle hypotonia. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Chemoreceptor: A receptor adapted for excitation by chemical substances, e.g., olfactory and gustatory receptors, or a sense organ, as the carotid body or the aortic (supracardial) bodies, which is sensitive to chemical changes in the blood stream, especially reduced

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oxygen content, and reflexly increases both respiration and blood pressure. [EU] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Cholinesterase Inhibitors: Drugs that inhibit cholinesterases. The neurotransmitter acetylcholine is rapidly hydrolyzed, and thereby inactivated, by cholinesterases. When cholinesterases are inhibited, the action of endogenously released acetylcholine at cholinergic synapses is potentiated. Cholinesterase inhibitors are widely used clinically for their potentiation of cholinergic inputs to the gastrointestinal tract and urinary bladder, the eye, and skeletal muscles; they are also used for their effects on the heart and the central nervous system. [NIH] Chorea: Involuntary, forcible, rapid, jerky movements that may be subtle or become confluent, markedly altering normal patterns of movement. Hypotonia and pendular reflexes are often associated. Conditions which feature recurrent or persistent episodes of chorea as a primary manifestation of disease are referred to as choreatic disorders. Chorea is also a frequent manifestation of basal ganglia diseases. [NIH] Chromosomal: Pertaining to chromosomes. [EU] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Circadian: Repeated more or less daily, i. e. on a 23- to 25-hour cycle. [NIH] Circadian Rhythm: The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs and stimuli, hormone secretion, sleeping, feeding, etc. This rhythm seems to be set by a 'biological clock' which seems to be set by recurring daylight and darkness. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Clonic: Pertaining to or of the nature of clonus. [EU] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Clozapine: A tricylic dibenzodiazepine, classified as an atypical antipsychotic agent. It binds several types of central nervous system receptors, and displays a unique pharmacological profile. Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors, but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Agranulocytosis is a major adverse effect associated with administration of this agent. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple

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mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Codeine: An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Cognition: Intellectual or mental process whereby an organism becomes aware of or obtains knowledge. [NIH] Combination Therapy: Association of 3 drugs to treat AIDS (AZT + DDC or DDI + protease inhibitor). [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Concomitant: Accompanying; accessory; joined with another. [EU] Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Conjugated: Acting or operating as if joined; simultaneous. [EU] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Constriction: The act of constricting. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary heart disease: A type of heart disease caused by narrowing of the coronary arteries that feed the heart, which needs a constant supply of oxygen and nutrients carried by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by fat and cholesterol deposits and cannot supply enough blood to the heart, CHD results. [NIH] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Crystallization: The formation of crystals; conversion to a crystalline form. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Cyclic: Pertaining to or occurring in a cycle or cycles; the term is applied to chemical compounds that contain a ring of atoms in the nucleus. [EU] Cycloserine: Antibiotic substance produced by Streptomyces garyphalus. It may be used in the treatment of resistant tuberculosis as part of a multi-drug regimen. It has also been used in urinary tract infections. [NIH]

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Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU] Cytogenetics: A branch of genetics which deals with the cytological and molecular behavior of genes and chromosomes during cell division. [NIH] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia, hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dementia: An acquired organic mental disorder with loss of intellectual abilities of sufficient severity to interfere with social or occupational functioning. The dysfunction is multifaceted and involves memory, behavior, personality, judgment, attention, spatial relations, language, abstract thought, and other executive functions. The intellectual decline is usually progressive, and initially spares the level of consciousness. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Depersonalization: Alteration in the perception of the self so that the usual sense of one's own reality is lost, manifested in a sense of unreality or self-estrangement, in changes of body image, or in a feeling that one does not control his own actions and speech; seen in depersonalization disorder, schizophrenic disorders, and schizotypal personality disorder. Some do not draw a distinction between depersonalization and derealization, using depersonalization to include both. [EU] Depressive Disorder: An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating

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release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Dextromethorphan: The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is a NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is used widely as an antitussive agent, and is also used to study the involvement of glutamate receptors in neurotoxicity. [NIH] Diabetes Mellitus: A heterogeneous group of disorders that share glucose intolerance in common. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Diencephalon: The paired caudal parts of the prosencephalon from which the thalamus, hypothalamus, epithalamus, and subthalamus are derived. [NIH] Digestive system: The organs that take in food and turn it into products that the body can use to stay healthy. Waste products the body cannot use leave the body through bowel movements. The digestive system includes the salivary glands, mouth, esophagus, stomach, liver, pancreas, gallbladder, small and large intestines, and rectum. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disinfectant: An agent that disinfects; applied particularly to agents used on inanimate objects. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Diuresis: Increased excretion of urine. [EU] Diuretic: A drug that increases the production of urine. [NIH] Donepezil: A drug used in the treatment of Alzheimer's disease. It belongs to the family of drugs called cholinesterase inhibitors. It is being studied as a treatment for side effects caused by radiation therapy to the brain. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH] Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Dopamine Antagonists: Drugs that bind to but do not activate dopamine receptors, thereby blocking the actions of dopamine or exogenous agonists. Many drugs used in the treatment of psychotic disorders (antipsychotic agents) are dopamine antagonists, although their therapeutic effects may be due to long-term adjustments of the brain rather than to the acute effects of blocking dopamine receptors. Dopamine antagonists have been used for several other clinical purposes including as antiemetics, in the treatment of Tourette syndrome, and for hiccup. [NIH] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH]

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Drug Monitoring: The process of observing, recording, or detecting the effects of a chemical substance administered to an individual therapeutically or diagnostically. [NIH] Dyskinesia: Impairment of the power of voluntary movement, resulting in fragmentary or incomplete movements. [EU] Dysphoric: A feeling of unpleasantness and discomfort. [NIH] Dystonia: Disordered tonicity of muscle. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Emesis: Vomiting; an act of vomiting. Also used as a word termination, as in haematemesis. [EU]

Emetic: An agent that causes vomiting. [EU] Endocrine Glands: Ductless glands that secrete substances which are released directly into the circulation and which influence metabolism and other body functions. [NIH] Enuresis: Involuntary discharge of urine after the age at which urinary control should have been achieved; often used alone with specific reference to involuntary discharge of urine occurring during sleep at night (bed-wetting, nocturnal enuresis). [EU] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erection: The condition of being made rigid and elevated; as erectile tissue when filled with blood. [EU] Ergot: Cataract due to ergot poisoning caused by eating of rye cereals contaminated by a fungus. [NIH] Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ethanol: A clear, colorless liquid rapidly absorbed from the gastrointestinal tract and distributed throughout the body. It has bactericidal activity and is used often as a topical disinfectant. It is widely used as a solvent and preservative in pharmaceutical preparations as well as serving as the primary ingredient in alcoholic beverages. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Exon: The part of the DNA that encodes the information for the actual amino acid sequence of the protein. In many eucaryotic genes, the coding sequences consist of a series of exons alternating with intron sequences. [NIH]

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Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fissure: Any cleft or groove, normal or otherwise; especially a deep fold in the cerebral cortex which involves the entire thickness of the brain wall. [EU] Frontal Lobe: The anterior part of the cerebral hemisphere. [NIH] Galactorrhoea: Excessive or spontaneous flow of milk; persistent secretion of milk irrespective of nursing. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Geriatric: Pertaining to the treatment of the aged. [EU] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucose Intolerance: A pathological state in which the fasting plasma glucose level is less than 140 mg per deciliter and the 30-, 60-, or 90-minute plasma glucose concentration following a glucose tolerance test exceeds 200 mg per deciliter. This condition is seen frequently in diabetes mellitus but also occurs with other diseases. [NIH] Glucose tolerance: The power of the normal liver to absorb and store large quantities of glucose and the effectiveness of intestinal absorption of glucose. The glucose tolerance test is a metabolic test of carbohydrate tolerance that measures active insulin, a hepatic function based on the ability of the liver to absorb glucose. The test consists of ingesting 100 grams of glucose into a fasting stomach; blood sugar should return to normal in 2 to 21 hours after ingestion. [NIH] Glucose Tolerance Test: Determination of whole blood or plasma sugar in a fasting state before and at prescribed intervals (usually 1/2 hr, 1 hr, 3 hr, 4 hr) after taking a specified amount (usually 100 gm orally) of glucose. [NIH] Glutamate: Excitatory neurotransmitter of the brain. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Haematemesis: The vomiting of blood. [EU] Haloperidol: Butyrophenone derivative. [NIH]

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Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Heart attack: A seizure of weak or abnormal functioning of the heart. [NIH] Heme: The color-furnishing portion of hemoglobin. It is found free in tissues and as the prosthetic group in many hemeproteins. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Hiccup: A spasm of the diaphragm that causes a sudden inhalation followed by rapid closure of the glottis which produces a sound. [NIH] Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Hormone: A substance in the body that regulates certain organs. Hormones such as gastrin help in breaking down food. Some hormones come from cells in the stomach and small intestine. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent, bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hypertension: Persistently high arterial blood pressure. Currently accepted threshold levels are 140 mm Hg systolic and 90 mm Hg diastolic pressure. [NIH] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypotension: Abnormally low blood pressure. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Illusions: The misinterpretation of a real external, sensory experience. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH]

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In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Indinavir: A potent and specific HIV protease inhibitor that appears to have good oral bioavailability. [NIH] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Infertility: The diminished or absent ability to conceive or produce an offspring while sterility is the complete inability to conceive or produce an offspring. [NIH] Ingestion: Taking into the body by mouth [NIH] Inotropic: Affecting the force or energy of muscular contractions. [EU] Inpatients: Persons admitted to health facilities which provide board and room, for the purpose of observation, care, diagnosis or treatment. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Insulin-dependent diabetes mellitus: A disease characterized by high levels of blood glucose resulting from defects in insulin secretion, insulin action, or both. Autoimmune, genetic, and environmental factors are involved in the development of type I diabetes. [NIH] Intermittent: Occurring at separated intervals; having periods of cessation of activity. [EU] Intestinal: Having to do with the intestines. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Involuntary: Reaction occurring without intention or volition. [NIH] Isozymes: The multiple forms of a single enzyme. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH]

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Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lesion: An area of abnormal tissue change. [NIH] Levorphanol: A narcotic analgesic that may be habit-forming. It is nearly as effective orally as by injection. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Limbic: Pertaining to a limbus, or margin; forming a border around. [EU] Limbic System: A set of forebrain structures common to all mammals that is defined functionally and anatomically. It is implicated in the higher integration of visceral, olfactory, and somatic information as well as homeostatic responses including fundamental survival behaviors (feeding, mating, emotion). For most authors, it includes the amygdala, epithalamus, gyrus cinguli, hippocampal formation (see hippocampus), hypothalamus, parahippocampal gyrus, septal nuclei, anterior nuclear group of thalamus, and portions of the basal ganglia. (Parent, Carpenter's Human Neuroanatomy, 9th ed, p744; NeuroNames, http://rprcsgi.rprc.washington.edu/neuronames/index.html (September 2, 1998)). [NIH] Lipid: Fat. [NIH] Lithium: An element in the alkali metals family. It has the atomic symbol Li, atomic number 3, and atomic weight 6.94. Salts of lithium are used in treating manic-depressive disorders. [NIH]

Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Long-Term Care: Care over an extended period, usually for a chronic condition or disability, requiring periodic, intermittent, or continuous care. [NIH] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mania: Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behaviour, and elevation of mood. [EU] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Medullary: Pertaining to the marrow or to any medulla; resembling marrow. [EU] Megacolon: Pathological enlargement of the colon. [NIH]

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Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Menopause: Permanent cessation of menstruation. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mental Retardation: Refers to sub-average general intellectual functioning which originated during the developmental period and is associated with impairment in adaptive behavior. [NIH]

Mentors: Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. [NIH] Mephenytoin: An anticonvulsant effective in tonic-clonic epilepsy. It may cause blood dyscrasias. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Microspheres: Small uniformly-sized spherical particles frequently radioisotopes or various reagents acting as tags or markers. [NIH]

labeled

with

Modification: A change in an organism, or in a process in an organism, that is acquired from its own activity or environment. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Monoamine Oxidase: An enzyme that catalyzes the oxidative deamination of naturally occurring monoamines. It is a flavin-containing enzyme that is localized in mitochondrial membranes, whether in nerve terminals, the liver, or other organs. Monoamine oxidase is important in regulating the metabolic degradation of catecholamines and serotonin in neural or target tissues. Hepatic monoamine oxidase has a crucial defensive role in inactivating circulating monoamines or those, such as tyramine, that originate in the gut and are absorbed into the portal circulation. (From Goodman and Gilman's, The Pharmacological Basis of Therapeutics, 8th ed, p415) EC 1.4.3.4. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Movement Disorders: Syndromes which feature dyskinesias as a cardinal manifestation of the disease process. Included in this category are degenerative, hereditary, post-infectious, medication-induced, post-inflammatory, and post-traumatic conditions. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH]

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Narcotic: 1. Pertaining to or producing narcosis. 2. An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions. [EU] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] NCI: National Cancer Institute. NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the federal government's principal agency for cancer research. NCI conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://cancer.gov. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Networks: Pertaining to a nerve or to the nerves, a meshlike structure of interlocking fibers or strands. [NIH] Neuroleptic: A term coined to refer to the effects on cognition and behaviour of antipsychotic drugs, which produce a state of apathy, lack of initiative, and limited range of emotion and in psychotic patients cause a reduction in confusion and agitation and normalization of psychomotor activity. [EU] Neuromuscular: Pertaining to muscles and nerves. [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxicity: The tendency of some treatments to cause damage to the nervous system. [NIH]

Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nuclei: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nursing Staff: Personnel who provide nursing service to patients in an organized facility, institution, or agency. [NIH] Opacity: Degree of density (area most dense taken for reading). [NIH] Opium: The air-dried exudate from the unripe seed capsule of the opium poppy, Papaver

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somniferum, or its variant, P. album. It contains a number of alkaloids, but only a few morphine, codeine, and papaverine - have clinical significance. Opium has been used as an analgesic, antitussive, antidiarrheal, and antispasmodic. [NIH] Orthostatic: Pertaining to or caused by standing erect. [EU] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Panic: A state of extreme acute, intense anxiety and unreasoning fear accompanied by disorganization of personality function. [NIH] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Paroxysmal: Recurring in paroxysms (= spasms or seizures). [EU] Partial response: A decrease in the size of a tumor, or in the extent of cancer in the body, in response to treatment. [NIH] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Penis: The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Pharmacodynamic: Is concerned with the response of living tissues to chemical stimuli, that is, the action of drugs on the living organism in the absence of disease. [NIH] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharmacotherapy: A regimen of using appetite suppressant medications to manage obesity by decreasing appetite or increasing the feeling of satiety. These medications decrease appetite by increasing serotonin or catecholamine—two brain chemicals that affect mood and appetite. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age.

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[NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Polymorphic: Occurring in several or many forms; appearing in different forms at different stages of development. [EU] Polymorphism: The occurrence together of two or more distinct forms in the same population. [NIH] Portal Pressure: The venous pressure measured in the portal vein. [NIH] Post-traumatic: Occurring as a result of or after injury. [EU] Post-traumatic stress disorder: A psychological disorder that develops in some individuals after a major traumatic experience such as war, rape, domestic violence, or accident. [NIH] Practicability: A non-standard characteristic of an analytical procedure. It is dependent on the scope of the method and is determined by requirements such as sample throughout and costs. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precipitation: The act or process of precipitating. [EU] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prefrontal Cortex: The rostral part of the frontal lobe, bounded by the inferior precentral fissure in humans, which receives projection fibers from the mediodorsal nucleus of the thalamus. The prefrontal cortex receives afferent fibers from numerous structures of the diencephalon, mesencephalon, and limbic system as well as cortical afferents of visual, auditory, and somatic origin. [NIH] Premenopausal: Refers to the time before menopause. Menopause is the time of life when a women's menstrual periods stop permanently; also called "change of life." [NIH] Priapism: Persistent abnormal erection of the penis, usually without sexual desire, and accompanied by pain and tenderness. It is seen in diseases and injuries of the spinal cord, and may be caused by vesical calculus and certain injuries to the penis. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Projection: A defense mechanism, operating unconsciously, whereby that which is

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emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prolactin: Pituitary lactogenic hormone. A polypeptide hormone with a molecular weight of about 23,000. It is essential in the induction of lactation in mammals at parturition and is synergistic with estrogen. The hormone also brings about the release of progesterone from lutein cells, which renders the uterine mucosa suited for the embedding of the ovum should fertilization occur. [NIH] Protease: Proteinase (= any enzyme that catalyses the splitting of interior peptide bonds in a protein). [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pyramidal Tracts: Fibers that arise from cells within the cerebral cortex, pass through the medullary pyramid, and descend in the spinal cord. Many authorities say the pyramidal tracts include both the corticospinal and corticobulbar tracts. [NIH] Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons,

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alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radiation therapy: The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body in the area near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Randomized clinical trial: A study in which the participants are assigned by chance to separate groups that compare different treatments; neither the researchers nor the participants can choose which group. Using chance to assign people to groups means that the groups will be similar and that the treatments they receive can be compared objectively. At the time of the trial, it is not known which treatment is best. It is the patient's choice to be in a randomized trial. [NIH] Rape: Unlawful sexual intercourse without consent of the victim. [NIH] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Recurrence: The return of a sign, symptom, or disease after a remission. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reflex: An involuntary movement or exercise of function in a part, excited in response to a stimulus applied to the periphery and transmitted to the brain or spinal cord. [NIH] Refractory: Not readily yielding to treatment. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Remission: A decrease in or disappearance of signs and symptoms of cancer. In partial remission, some, but not all, signs and symptoms of cancer have disappeared. In complete remission, all signs and symptoms of cancer have disappeared, although there still may be cancer in the body. [NIH] Remoxipride: An antipsychotic agent that is specific for dopamine D2 receptors. It has been shown to be effective in the treatment of schizophrenia. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Risperidone: A selective blocker of dopamine D2 and serotonin-5-HT-2 receptors that acts as an atypical antipsychotic agent. It has been shown to improve both positive and negative symptoms in the treatment of schizophrenia. [NIH] Ritanserin: A selective and potent serotonin-2 antagonist that is effective in the treatment of

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a variety of syndromes related to anxiety and depression. The drug also improves the subjective quality of sleep and decreases portal pressure. [NIH] Ritonavir: An HIV protease inhibitor that works by interfering with the reproductive cycle of HIV. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Satellite: Applied to a vein which closely accompanies an artery for some distance; in cytogenetics, a chromosomal agent separated by a secondary constriction from the main body of the chromosome. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Semisynthetic: Produced by chemical manipulation of naturally occurring substances. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serotonin Syndrome: An adverse drug interaction characterized by altered mental status, autonomic dysfunction, and neuromuscular abnormalities. It is most frequently caused by use of both serotonin reuptake inhibitors and monoamine oxidase inhibitors, leading to excess serotonin availability in the CNS at the serotonin 1A receptor. [NIH] Sertraline: A selective serotonin uptake inhibitor that is used in the treatment of depression. [NIH]

Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Skeletal: Having to do with the skeleton (boney part of the body). [NIH] Skeleton: The framework that supports the soft tissues of vertebrate animals and protects many of their internal organs. The skeletons of vertebrates are made of bone and/or cartilage. [NIH]

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Smooth muscle: Muscle that performs automatic tasks, such as constricting blood vessels. [NIH]

Social Environment: The aggregate of social and cultural institutions, forms, patterns, and processes that influence the life of an individual or community. [NIH] Social Isolation: The separation of individuals or groups resulting in the lack of or minimizing of social contact and/or communication. This separation may be accomplished by physical separation, by social barriers and by psychological mechanisms. In the latter, there may be interaction but no real communication. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Channels: Cell membrane glycoproteins selective for sodium ions. Fast sodium current is associated with the action potential in neural membranes. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Somnolence: Sleepiness; also unnatural drowsiness. [EU] Sorbitol: A polyhydric alcohol with about half the sweetness of sucrose. Sorbitol occurs naturally and is also produced synthetically from glucose. It was formerly used as a diuretic and may still be used as a laxative and in irrigating solutions for some surgical procedures. It is also used in many manufacturing processes, as a pharmaceutical aid, and in several research applications. [NIH] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Stabilizer: A device for maintaining constant X-ray tube voltage or current. [NIH] Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Stroke: Sudden loss of function of part of the brain because of loss of blood flow. Stroke may be caused by a clot (thrombosis) or rupture (hemorrhage) of a blood vessel to the brain. [NIH] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

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Superoxide: Derivative of molecular oxygen that can damage cells. [NIH] Superoxide Dismutase: An oxidoreductase that catalyzes the reaction between superoxide anions and hydrogen to yield molecular oxygen and hydrogen peroxide. The enzyme protects the cell against dangerous levels of superoxide. EC 1.15.1.1. [NIH] Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Systemic: Affecting the entire body. [NIH] Tardive: Marked by lateness, late; said of a disease in which the characteristic lesion is late in appearing. [EU] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Temporal Lobe: Lower lateral part of the cerebral hemisphere. [NIH] Thalamus: Paired bodies containing mostly gray substance and forming part of the lateral wall of the third ventricle of the brain. The thalamus represents the major portion of the diencephalon and is commonly divided into cellular aggregates known as nuclear groups. [NIH]

Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thromboembolism: Obstruction of a vessel by a blood clot that has been transported from a distant site by the blood stream. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tonic: 1. Producing and restoring the normal tone. 2. Characterized by continuous tension. 3. A term formerly used for a class of medicinal preparations believed to have the power of restoring normal tone to tissue. [EU] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH]

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Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, practicability, etc., of these interventions in individual cases or series. [NIH]

Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of Parkinson disease. [NIH] Trigger zone: Dolorogenic zone (= producing or causing pain). [EU] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Type 2 diabetes: Usually characterized by a gradual onset with minimal or no symptoms of metabolic disturbance and no requirement for exogenous insulin. The peak age of onset is 50 to 60 years. Obesity and possibly a genetic factor are usually present. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urinary: Having to do with urine or the organs of the body that produce and get rid of urine. [NIH] Urinary tract: The organs of the body that produce and discharge urine. These include the kidneys, ureters, bladder, and urethra. [NIH] Urinary tract infection: An illness caused by harmful bacteria growing in the urinary tract. [NIH]

Urinate: To release urine from the bladder to the outside. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Valproic Acid: A fatty acid with anticonvulsant properties used in the treatment of epilepsy. The mechanisms of its therapeutic actions are not well understood. It may act by increasing GABA levels in the brain or by altering the properties of voltage dependent sodium channels. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and treatment of diseases in animals. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or

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viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Void: To urinate, empty the bladder. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] War: Hostile conflict between organized groups of people. [NIH] Weight Gain: Increase in body weight over existing weight. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH]

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INDEX A Aberrant, 7, 19, 73 Adenosine, 73, 76 Adjunctive Therapy, 16, 73 Adrenergic, 73, 74, 81, 82, 95 Adverse Effect, 4, 6, 73, 75, 78, 93 Afferent, 73, 90 Affinity, 73, 75, 78, 81, 94 Age of Onset, 73, 96 Aggressiveness, 6, 73 Agonist, 32, 73, 75, 76, 81 Akathisia, 73, 74 Alertness, 73, 76 Algorithms, 73, 76 Alkaloid, 73, 76, 78, 87 Alternative medicine, 48, 74 Amenorrhea, 74, 76 Amino Acid Sequence, 74, 82 Amphetamine, 20, 39, 74, 80 Amygdala, 7, 74, 86 Analgesic, 74, 79, 86, 87, 89 Analog, 74, 81 Animal model, 31, 74 Anions, 74, 95 Antagonism, 74, 76, 78 Anticonvulsant, 74, 77, 87, 96 Antidepressant, 5, 74 Antiemetic, 74 Antipsychotic, 6, 7, 13, 14, 16, 19, 22, 28, 30, 36, 43, 46, 74, 75, 78, 81, 88, 92 Antipsychotic Agents, 75, 81 Antitussive, 75, 81, 89 Anxiety, 5, 73, 75, 89, 93 Apathy, 75, 88 Apomorphine, 42, 75 Aqueous, 42, 75, 84 Arterial, 75, 84, 91 Arteries, 75, 76, 79, 87 Aspartate, 75, 81 Assay, 8, 75 Astrocytes, 75, 87 Attenuated, 19, 75 Atypical, 6, 8, 14, 16, 19, 23, 24, 32, 38, 75, 78, 92 Auditory, 75, 90 Autonomic, 74, 75, 88, 93 B Bactericidal, 75, 82

Basal Ganglia, 74, 75, 78, 86 Base, 75, 80, 85, 95 Behavioral Symptoms, 4, 6, 75 Benign, 31, 75, 84 Bioavailability, 75, 85 Biochemical, 28, 76, 93 Biotechnology, 10, 45, 48, 57, 76 Bipolar Disorder, 7, 28, 47, 62, 76 Bladder, 76, 78, 96, 97 Blood Coagulation, 76 Blood Platelets, 9, 76, 93 Blood pressure, 76, 77, 78, 84, 94 Blood vessel, 76, 77, 94, 95, 96 Blood Volume, 76, 77 Body Composition, 28, 76 Body Fluids, 76, 94 Bowel, 76, 81, 86 Bowel Movement, 76, 81 Branch, 69, 76, 80, 91, 94, 95 Bromocriptine, 32, 76 C Caffeine, 30, 76 Calcium, 76 Cannabis, 6, 12, 35, 77 Carbamazepine, 30, 77 Carbohydrate, 77, 83 Cardiac, 76, 77, 82, 87 Cardiovascular, 5, 74, 77, 93 Cardiovascular Agents, 5, 77 Cardiovascular disease, 5, 77 Case report, 9, 19, 77, 78 Case series, 11, 23, 77, 78 Catecholamine, 77, 81, 89 Cell, 73, 76, 77, 78, 80, 83, 85, 88, 90, 92, 94, 95 Central Nervous System, 74, 76, 77, 78, 80, 84, 87, 93 Cerebellar, 77, 96 Cerebellar Diseases, 77, 96 Cerebral, 14, 75, 77, 80, 82, 83, 91, 95 Cerebrovascular, 10, 20, 77 Cerebrum, 77 Chemoreceptor, 74, 77 Cholinergic, 74, 78 Cholinesterase Inhibitors, 78, 81 Chorea, 74, 78 Chromosomal, 78, 93 Chromosome, 78, 93

100 Risperdal

Chronic, 13, 16, 22, 29, 46, 78, 85, 86 Circadian, 13, 78 Circadian Rhythm, 13, 78 Clinical study, 21, 37, 78 Clinical trial, 6, 7, 9, 13, 14, 35, 39, 57, 78, 79, 92 Clonic, 78, 87 Cloning, 76, 78 Clozapine, 6, 11, 12, 13, 24, 28, 29, 30, 32, 35, 36, 46, 78 Coca, 78 Cocaine, 31, 37, 38, 39, 78 Codeine, 79, 81, 89 Cofactor, 79, 91 Cognition, 14, 79, 88 Combination Therapy, 29, 79 Computational Biology, 57, 79 Concomitant, 4, 79 Confusion, 79, 81, 84, 88 Congestion, 74, 79 Conjugated, 79, 80 Consciousness, 74, 79, 80 Constipation, 74, 79 Constriction, 79, 93 Contraindications, ii, 79 Controlled study, 6, 32, 79 Coronary, 77, 79, 87 Coronary heart disease, 77, 79 Coronary Thrombosis, 79, 87 Cortical, 79, 90, 93 Crystallization, 43, 79 Curative, 79, 95 Cyclic, 76, 79 Cycloserine, 28, 30, 79 Cytochrome, 30, 80 Cytogenetics, 80, 93 D Databases, Bibliographic, 57, 80 Delirium, 19, 25, 74, 80 Delusions, 3, 4, 5, 12, 62, 80, 91 Dementia, 3, 4, 5, 6, 10, 11, 12, 19, 20, 23, 29, 37, 48, 74, 75, 80 Density, 23, 80, 88 Depersonalization, 80, 93 Depressive Disorder, 16, 80, 86 Dextroamphetamine, 74, 80 Dextromethorphan, 30, 81 Diabetes Mellitus, 23, 81, 83 Diagnostic procedure, 41, 49, 81 Diencephalon, 81, 90, 95 Digestive system, 40, 81 Direct, iii, 51, 81, 92

Disinfectant, 81, 82 Disorientation, 79, 80, 81 Diuresis, 76, 81 Diuretic, 81, 94 Donepezil, 18, 81 Dopamine, 7, 29, 30, 32, 74, 75, 76, 78, 79, 80, 81, 87, 92 Dopamine Agonists, 32, 81 Dopamine Antagonists, 29, 81 Dose-dependent, 6, 81 Drug Interactions, 52, 81 Drug Monitoring, 24, 82 Dyskinesia, 8, 20, 74, 82 Dysphoric, 80, 82 Dystonia, 74, 82 E Edema, 6, 82 Efficacy, 4, 5, 6, 7, 9, 15, 16, 28, 29, 36, 37, 38, 39, 82, 96 Electrolyte, 80, 82, 94 Emesis, 42, 75, 82 Emetic, 75, 82 Endocrine Glands, 82 Enuresis, 28, 82 Environmental Health, 56, 58, 82 Enzyme, 19, 82, 85, 87, 91, 95, 97 Epinephrine, 73, 81, 82, 88, 96 Erection, 82, 90 Ergot, 76, 82 Esophagus, 81, 82, 94 Ethanol, 43, 82 Evoke, 82, 94 Exogenous, 81, 82, 96 Exon, 15, 82 Extracellular, 75, 83, 94 Extraction, 24, 43, 83 Extrapyramidal, 4, 5, 6, 8, 13, 29, 73, 74, 81, 83 F Family Planning, 57, 83 Fat, 76, 79, 83, 86 Fissure, 83, 90 Frontal Lobe, 83, 90 G Galactorrhoea, 23, 83 Gallbladder, 81, 83 Gastrointestinal, 78, 82, 83, 93, 94 Gastrointestinal tract, 78, 82, 83, 93 Gene, 45, 76, 83 Geriatric, 4, 12, 14, 19, 24, 83 Gland, 83, 89, 93, 94 Glucose, 28, 36, 81, 83, 84, 85, 94

Index 101

Glucose Intolerance, 81, 83 Glucose tolerance, 28, 83 Glucose Tolerance Test, 83 Glutamate, 81, 83 Governing Board, 83, 90 Growth, 74, 83, 86, 90, 96 H Haematemesis, 82, 83 Haloperidol, 4, 13, 16, 17, 28, 29, 30, 31, 83 Headache, 76, 84 Heart attack, 77, 84 Heme, 80, 84 Hemorrhage, 84, 94 Hemostasis, 84, 93 Hepatic, 80, 83, 84, 87 Heredity, 83, 84 Hiccup, 81, 84 Histamine, 74, 84 Hormone, 78, 82, 84, 85, 91 Hydrogen, 75, 77, 84, 89, 95 Hydrogen Peroxide, 84, 95 Hypertension, 77, 84 Hypoglycaemia, 80, 84 Hypotension, 74, 84 Hypoxia, 80, 84 I Id, 33, 63, 68, 70, 84 Illusions, 84, 93 Impairment, 80, 82, 84, 87, 91 In vitro, 32, 85 In vivo, 85 Indicative, 45, 85 Indinavir, 29, 85 Induction, 74, 85, 91 Infarction, 75, 79, 85, 87 Infection, 80, 85 Infertility, 76, 85 Ingestion, 83, 85, 90 Inotropic, 81, 85 Inpatients, 3, 22, 28, 85 Insulin, 36, 83, 85, 96 Insulin-dependent diabetes mellitus, 85 Intermittent, 85, 86 Intestinal, 83, 85 Intoxication, 80, 85, 97 Intracellular, 76, 85, 92 Involuntary, 78, 82, 85, 87, 92 Isozymes, 30, 85 K Kb, 56, 85 L Large Intestine, 81, 85, 92

Laxative, 86, 94 Lesion, 86, 95 Levorphanol, 81, 86 Library Services, 68, 86 Limbic, 74, 86, 90 Limbic System, 74, 86, 90 Lipid, 28, 85, 86 Lithium, 17, 25, 31, 74, 86 Liver, 23, 81, 83, 84, 86, 87 Locomotion, 86, 90 Locomotor, 32, 86 Long-Term Care, 23, 86 M Malignant, 11, 17, 29, 31, 86 Mania, 17, 21, 22, 28, 30, 31, 86 Manic, 7, 11, 74, 76, 86, 91 Manic-depressive psychosis, 86, 91 Mediate, 81, 86 Mediator, 86, 93 MEDLINE, 57, 86 Medullary, 81, 86, 91 Megacolon, 20, 86 Memory, 30, 80, 87 Menopause, 87, 90 Mental Disorders, 40, 87, 91 Mental Health, iv, 6, 31, 35, 36, 40, 56, 58, 62, 87, 91 Mental Retardation, 19, 32, 87 Mentors, 7, 87 Mephenytoin, 30, 87 Mesolimbic, 74, 87 Metabolite, 8, 42, 87 MI, 71, 87 Microbiology, 75, 87 Microspheres, 38, 87 Modification, 87, 91 Molecular, 57, 59, 76, 79, 80, 87, 91, 92, 95 Monoamine, 30, 74, 81, 87, 93 Monoamine Oxidase, 74, 81, 87, 93 Morphine, 29, 75, 79, 87, 88, 89 Motility, 87, 93 Movement Disorders, 74, 87 Myocardium, 87 N Narcotic, 86, 87, 88 Nausea, 74, 75, 88 NCI, 1, 40, 55, 88 Necrosis, 85, 87, 88 Need, 3, 7, 9, 46, 64, 88, 95 Nerve, 73, 86, 87, 88, 94, 95 Nervous System, 73, 74, 77, 86, 88, 94, 95 Networks, 8, 88

102 Risperdal

Neuroleptic, 8, 11, 17, 19, 29, 31, 38, 42, 73, 74, 78, 88 Neuromuscular, 88, 93 Neurons, 79, 88 Neurotoxic, 38, 88 Neurotoxicity, 81, 88 Norepinephrine, 73, 81, 88 Nuclei, 74, 86, 88 Nucleus, 79, 88, 90 Nursing Staff, 5, 88 O Opacity, 80, 88 Opium, 87, 88 Orthostatic, 74, 89 Outpatient, 8, 89 Overdose, 12, 89 Oxidation, 80, 89 P Palliative, 89, 95 Pancreas, 81, 85, 89 Panic, 30, 89 Parkinsonism, 29, 74, 75, 89 Paroxysmal, 20, 89 Partial response, 4, 89 Patient Education, 62, 66, 68, 71, 89 Penis, 89, 90 Perception, 80, 89, 93 Pharmacodynamic, 9, 89 Pharmacokinetic, 8, 18, 30, 89 Pharmacologic, 89, 95 Pharmacotherapy, 7, 14, 18, 20, 23, 89 Physiologic, 73, 89, 92, 96 Pilot study, 7, 13, 22, 90 Plants, 73, 78, 83, 88, 90 Plasma, 9, 15, 18, 19, 25, 30, 42, 76, 83, 84, 90 Poisoning, 75, 80, 82, 85, 88, 90 Polymorphic, 43, 90 Polymorphism, 15, 90 Portal Pressure, 90, 93 Post-traumatic, 12, 87, 90 Post-traumatic stress disorder, 12, 90 Practicability, 90, 96 Practice Guidelines, 58, 90 Precipitation, 43, 90 Precursor, 81, 88, 90, 96 Prefrontal Cortex, 7, 90 Premenopausal, 23, 90 Priapism, 11, 19, 90 Progression, 74, 90 Progressive, 80, 83, 88, 90, 92 Projection, 88, 90

Prolactin, 76, 91 Protease, 79, 85, 91, 93 Protein S, 45, 76, 91 Proteins, 74, 90, 91, 92, 93 Psychiatric, 4, 5, 7, 19, 36, 39, 87, 91 Psychomotor, 77, 80, 88, 91 Psychosis, 4, 5, 6, 12, 15, 19, 36, 37, 38, 74, 75, 91 Psychotomimetic, 74, 81, 91 Psychotropic, 5, 91 Public Health, 7, 9, 58, 91 Public Policy, 57, 91 Publishing, 10, 91 Pulmonary, 12, 76, 91, 96 Pyramidal Tracts, 83, 91 Q Quality of Life, 7, 16, 24, 91 R Radiation, 81, 91, 92 Radiation therapy, 81, 92 Randomized, 4, 5, 7, 12, 31, 38, 82, 92 Randomized clinical trial, 7, 92 Rape, 90, 92 Reality Testing, 91, 92 Receptor, 77, 78, 81, 92, 93 Receptors, Serotonin, 92, 93 Rectum, 76, 81, 85, 92 Recurrence, 76, 78, 86, 92 Refer, 1, 86, 88, 91, 92 Reflex, 29, 92 Refractory, 46, 92 Regimen, 79, 82, 89, 92 Remission, 76, 86, 92 Remoxipride, 32, 92 Renal failure, 80, 92 Retrospective, 24, 28, 92 Ritanserin, 32, 92 Ritonavir, 29, 93 S Salivary, 81, 93 Salivary glands, 81, 93 Satellite, 46, 93 Schizotypal Personality Disorder, 22, 80, 93, 97 Screening, 78, 93 Secretion, 76, 78, 83, 84, 85, 93 Seizures, 77, 80, 89, 93 Semisynthetic, 76, 93 Serotonin, 5, 9, 14, 30, 31, 74, 78, 87, 89, 92, 93, 96 Serotonin Syndrome, 14, 31, 93 Sertraline, 28, 93

Index 103

Serum, 24, 93 Side effect, 4, 8, 9, 24, 51, 62, 73, 74, 75, 81, 93, 95 Skeletal, 32, 78, 93 Skeleton, 93 Smooth muscle, 76, 84, 87, 94 Social Environment, 91, 94 Social Isolation, 93, 94 Sodium, 7, 94, 96 Sodium Channels, 94, 96 Solvent, 42, 82, 94 Somatic, 86, 90, 94 Somnolence, 6, 94 Sorbitol, 42, 94 Specialist, 63, 94 Spinal cord, 75, 77, 88, 90, 91, 92, 94 Stabilizer, 28, 94 Stimulant, 74, 76, 80, 84, 94 Stimulus, 20, 92, 94 Stomach, 81, 82, 83, 84, 88, 94 Stress, 16, 77, 88, 94 Stroke, 40, 47, 48, 56, 77, 94 Subcutaneous, 82, 94 Substance P, 79, 87, 93, 94 Superoxide, 24, 95 Superoxide Dismutase, 24, 95 Suppression, 4, 32, 95 Sympathomimetic, 74, 80, 81, 82, 88, 95 Systemic, 52, 76, 80, 82, 85, 92, 95 T Tardive, 8, 74, 95 Temporal, 74, 95 Temporal Lobe, 74, 95 Thalamus, 81, 86, 90, 95 Therapeutics, 18, 20, 52, 87, 95 Thromboembolism, 12, 95 Thrombosis, 91, 94, 95 Tissue, 75, 82, 84, 86, 87, 88, 89, 93, 94, 95 Tolerance, 83, 95

Tonic, 87, 95 Topical, 82, 84, 95 Toxic, iv, 8, 95 Toxicity, 81, 95 Toxicology, 58, 95 Transfection, 76, 95 Transmitter, 75, 81, 86, 88, 95 Trauma, 80, 84, 88, 96 Treatment Outcome, 38, 96 Tremor, 20, 89, 96 Trigger zone, 74, 96 Tryptophan, 93, 96 Tuberculosis, 79, 96 Type 2 diabetes, 36, 96 Tyrosine, 81, 96 U Unconscious, 84, 96 Urinary, 23, 78, 79, 82, 96 Urinary tract, 79, 96 Urinary tract infection, 79, 96 Urinate, 96, 97 Urine, 76, 81, 82, 96 V Valproic Acid, 25, 28, 96 Vasodilator, 81, 84, 96 Vein, 90, 93, 96 Venous, 90, 91, 96 Ventricle, 74, 95, 96 Veterinary Medicine, 57, 96 Virulence, 75, 95, 96 Vitro, 97 Void, 7, 97 W Wakefulness, 80, 97 War, 90, 97 Weight Gain, 36, 97 Withdrawal, 80, 97 X Xenograft, 74, 97

104 Risperdal

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