Clonazepam ; C Atarax Hydroxyzine Hydrochloride ; C Ativan Lorazepam ; C Vicodin C Inderal Propranolol Hydrochloride ; C Ultram C Naprosyn Naproxen ; C Valium Diazepam ; C Risperdal Risperidone ; C Depakote Valproate Semisodium ; C Thiamine Thiamine ; C Mellaril Thioridazine Hydrochloride ; C Imitrex Sumatriptan Succinate ; C Lithium Lithium ; C Seroqquel Quetiapine ; C Cogentin Benzatropine Mesilate ; C Tylenol W Codeine No. 3 C Albuterol Salbutamol ; C Haldol Haloperidol ; Tablet C Imitrex "Glaxo" Sumatriptan ; C 21-Jul-2006 11: 35 FDA - Adverse Event Reporting System AERS ; Freedom Of Information FOI ; Report Page: 60.
Results: reducing suicidal thinking key to reducing high suicide rates1: as measured by the montgomery-asberg depression rating scale madrs ; and the hamilton rating scale for anxiety ham-a these data, from the bolder bipolar depression ; trial, an eight week, multi-centered, randomised, double-blind, placebo-controlled study involving 542 patients with a diagnosis of bipolar i or ii disorder, showed that seroquel 600 and 300 mg day ; is approximately twice as effective in reducing suicidal ideation by week eight as placebo.
Lower dose of the antipsychotic medication Singh, Muzina, & Calabrese, 2005 ; . Carbamazepine has been used less due to lower efficacy when compared to lithium and divalproex sodium and side effects of aplastic anemia and Stevens-Johnson's rash. Additionally, carbamazapine is not recommended in conjunction with sodium divalproex because of the CYP450 drug interactions Kowatch & Delbello, 2005 ; . In studies evaluating monotherapy with lithium alone or compared to divalproex sodium at 6 weeks, 14 weeks, and 20 months, researchers concluded that these mood stabilizers could not sustain a decrease in depressed or manic symptoms over time, and in some studies a second medication was warranted to achieve symptom remission Calabrese et al.; Findling et al., 2005; Geller, Williams, et al., 1998 ; . Furthermore, the evidence strongly supports the use of quetapine, risperidone, and olanzapine as monotherapy for acute short-term management of bipolar disorder in children. Response rates have been between 53% and 82%. It is difficult to do a head-tohead comparison of studies, as some are open label or retrospective chart reviews and others are doubleblind placebo-controlled studies. Nevertheless, the research data suggest that these atypical antipsychotics may be a good first-line treatment for pediatric bipolar disorder, especially in youth with psychotic symptoms. Findling and colleagues' 2003 ; findings demonstrated that youth with bipolar disorder and psychotic symptoms on lithium and divalproex sodium monotherapy did not achieve remission of symptoms. There is only one double-blind randomized 28 day study done with children DelBello et al., 2006 ; , comparing a mood stabilizer divalproex sodium ; to an antipsychotic seroquel ; . Both medications were equally effective in obtaining acute and short-term stabilization of bipolar symptoms as measured by the YMRS; however, quetiapine performed better with regards to scores on the Clinical Global Inventory for Bipolar Disorder, more rapid action, and improved response and remission rates compared to divalproex sodium.
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Smooth muscle and endothelial cells in aorta and jugular vein, which supports reports showing PAR-2 expression in these cells.9, 10, 19, 20 Clearly increased expression of PAR-2 in both the aorta and jugular veins in LPS-treated rats also was shown by RT-PCR. Moreover, the LPS-treated rats were more sensitive to the effects of both PAR-2AP and trypsin compared with normal rats, consistent with functional upregulation of PAR-2 by LPS in vivo. Indeed, after LPS treatment, the hypotension was induced with a concentration of PAR2AP 0.03 mg kg IV ; 10-fold lower than that used in normal controls to give the same effect 0.3 mg kg IV ; . Similarly, the hypotensive response to trypsin was increased significantly at both 0.2 and 0.6 mg kg. These findings raise the significant possibility that PAR-2 may play a important role in the hypotension associated with endotoxemia and septic shock. Interestingly, a drug called ulinastatin, 22, 23 a trypsin inhibitor produced by the liver in response to a range of stimuli, for instance, abilify.
Volume 2 published - utc est 09-january-2001 issue 9 next update - utc est 10-january-2001 uk hospitals told to clean up: new worldwide phase iii clinical trials examine efficacy of seroquel in treatment of symptoms of bipolar disorder astrazeneca plans to launch three worldwide phase iii clinical trials for its antipsychotic seroquel in treating patients with bipolar disorder.
Patients with more than one arrhythmia are counted only once in this category. Ventricular arrhythmias and ventricular tachycardia include all cases of torsade de pointes. In the DIAMOND trials a total of 1511 patients were exposed to TIKOSYN for 1757 patient years. The incidence of torsade de pointes was 3.3% in CHF patients and 0.9% in patients with a recent MI. Table 7 shows the incidence of serious arrhythmias and conduction disturbances reported as adverse events in the DIAMOND subpopulation that had AF at entry to these trials. Table 7: Incidence of Serious Arrhythmias and Conduction Disturbances in Patients with AF at Entry to the DIAMOND Studies TIKOSYN N 249 Ventricular arrhythmias * Ventricular fibrillation Ventricular tachycardia Torsade de pointes Various forms of block AV block Left ; bundle branch block Heart block 0.8% 0 1.2% 2.7% 0.4% Placebo N 257 13.6% 3.1% 0 and quinine.
Freezing may be detrimental, particularly for solutions, leading to the precipitation of active substances or the shattering of ampoules. Vaccines, immunoglobulins and antisera are products that are sensitive to heat and light. Even though new techniques produce vaccines that are less sensitive to heat called "thermostable" ; , they still have to be stored in the refrigerator between 2C and 8C, and the cold chain must be strictly respected during transport.
IL041 Skin Type And Apoptosis A. R. Young; King's College London, London, United Kingdom. Fitzpatrick defined skin type by sensitivity to sunburn and ability to tan, which is related to skin cancer risk. We hypothesized that the lower risk of skin cancer in skin types III IV compared with types I II might be due to a better apoptotic response. We investigated parameters of apoptosis in skin types IIV in vivo. These include epidermal DNA damage and its repair, apoptosis sunburn cell formation SBC ; and TUNEL ; and related proteins p53 and Bcl 2 ; . Studies were done with solar simulating radiation SSR ; on previously unexposed buttock skin. DNA photodamage was a function of SSR dose and was independent of skin type. We found no skin type differences in DNA repair from a single SSR exposure but evidence of inducible repair in skin types III IV, but not I II, after repeated exposures. There were no differences in apoptosis assessed by SBC or TUNEL ; or suppression of Bcl 2 but skin type dependent p53 expression was observed with III IV I II. p53 is important for DNA repair and we suggest that greater p53 expression in skin types III IV may signify better DNA repair from a single SSR exposure that is not detectable by the immunostaining techniques that we used and rebetol, because bipolar.
With a number of changes that will directly impact providers being implemented for the TennCare Program, this notice is being sent as a reminder of those changes. We encourage you to read this notice thoroughly and contact First Health's Technical Call Center 866-434-5520 ; should you have additional questions. Content: 1. Preferred Drug List Changes 2. Miscellaneous Information: Medical Audits and TennCare List Service PREFERRED DRUG LIST PDL ; FOR TENNCARE EFFECTIVE 3 01 07: TennCare is continuing the process of reviewing all covered drug classes over a 2 year period. Changes will occur to the PDL and the preferred and non-preferred status of agents as new classes are reviewed and previously reviewed classes are revisited. As a result of these changes, some medications your patients are now taking may be considered non-preferred agents in the future. Please inform your patients who are on one of these medications that switching to a preferred medication will decrease delays in receiving their medications. For medications with existing prior authorizations in place, the PA will remain active through the current expiration date. A copy of the new PDL will be posted March 1, 2007 to : tennessee.fhsc . Feel free to share this information with all TennCare providers. The individual changes to the PDL are listed below. For more details on clinical criteria, please visit: s: tennessee.fhsc Downloads provider TNRx PDL CC ST QLL . Below is a summary of PDL changes that will be effective March 1, 2007 Antipsychotics: AtypicalClass CC o Invega will become non-preferred new to PDL ; CC o ClozapineCC, FazoClo ODT CC, Geodon CC, Risperdal CC, QL, and S4roquel CC, QL will remain preferred o Abilify CC, QL, Abilify Discmelt CC, QL, Clozaril CC, Risperdal M-Tab CC, QL, Risperdal Consta CC, QL, Zyprexa CC, QL, and Zyprexa Zydis CC, QL will remain non-preferred Dermatologics: Topical Antibiotic Agents o Generic metronidazole 0.75% lotion and cream, MetroGel 0.75% and 1%, and Finacea 15% gel will become preferred new to PDL ; o MetroLotion, Metrocream, Noritate 1% cream, Nydamax 0.75% gel, and Metrogel 1% Kit will become non-preferred new to PDL ; Dermatologics: Topical Retinoids and Combination Products o Ziana will become non-preferred new to PDL ; ST o Generic tretinoin, Avita and Retin-A will remain preferred o Differin, Retin-A Micro, Tazorac CC, and Tretin-X will remain non-preferred.
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1. The emotional center of the limbic brain, with its amygdaloid complex, composed of the amygdala and thalamus is overactive. This creates emotional extremes and hypersensitivities to outside stimulation. Malfunction of these centers in the limbic system are also involved in creating the unpleasant sense of drivenness and penned-up energy that powers hypomania in Bipolar Disorder. 2. The brain's control centers in the frontal lobes may underfunction and the frontal cortex's reward circuits may not function very efficiently. This causes impulsivity, a tendency to seek stimulation, and a predilection for depression. 3. And the cerebellum in the base brain, the seat of control of the involuntary nervous system, may be less efficient. New research is indicating that this structure has responsibility for enabling us to roll with the punches, to have a good emotional rhythmicity. This may be another reason why some people with BD are over-reactive. Drugs used to treat Bipolar Disorder Medication used to treat Bipolar Disorder helps the brain restore its emotional equilibrium so that it is not swamped by rapid mood swing and an excess of bad feelings or agitated, hypomanic energy. Mood stabilizers--Lithium--and the anti-convulsants. These are the primary medications used to treat Bipolar Disorder. They are called 1'mood stabilizers" in that they reduce mania and hypomania, calm rage, and reduce impulsivity. They include lithium carbonate, which is most often used to treat adolescent onset BD or BD which there are clear states of mania and depression. With the exception of lithium and lamotrigine b. Lamictal ; , the anti-convulsant medications stabilize mood but do not generally reduce depression. These drugs include valproic acid and divalproex sodium b. Depakote, ; carbamazepine b. Tegretol ; , gabapentin b. Neurontin ; , topiramate b. Topamax ; , and oxcarbazepine b. Trileptal ; . Antipsychotic medications are also called "neuroleptics" because they down-regulate the brain's use of the neurotransmitters, serotonin and dopamine. This enables the child to screen out intrusive thoughts or emotions that can take over consciousness. Drugs in this classification include risperidone b. Risperdal ; clonazepam b. Klonopin ; , olanzapine b. Zeprexa ; , quetiapine b. Sedoquel ; , ziprasidone Geodon ; and aripiprazole Abilify ; . Antipsychotic drugs are used to resolve the child's most severe symptoms and restore some calm to his life. They reduce mania, psychotic thinking, hallucinations, and the paranoid behavior that he may experience. Zyprexa has shown promise helping children with Bipolar challenges regulate mood as well as diminish psychotic thinking. But it also is associated with more weight gain and then other medications of this type. Abilify is a very new neuroleptic that is much less sedating than other drugs in this class. A common side effect of all neuroleptics is akathisia, an inner sense of agitation, of feeling like one 5 and ribavirin.
Continued PHASE The PHASE initiative Personal Hygiene And Sanitation Education ; , initiated by GSK in 1998, is now providing education to thousands of school children in Kenya, Uganda, Zambia, Nicaragua and Peru to improve their health and hygiene to fight infectious diseases. In 2005 the Group committed three year funding of 300, 000 to extend the programme to Bangladesh in partnership with Save the Children, USA. Humanitarian product donations During 2005, GSK donated essential products, such as antibiotics, through non-profit partners including AmeriCares, MAP International and Project HOPE, to support humanitarian relief efforts and community healthcare. In December 2004, medicines donated by the Group were among the first to be shipped to support the south Asia tsunami relief efforts. In 2005, GSK continued to donate these lifesaving medicines to tsunami-affected countries and to those affected by other disasters, including hurricanes in the USA.
For which the seroquel incidence was equal to or less than placebo are not listed in the table, but included the following: akathisia, diarrhea, insomnia, and nausea and requip.
I was switched to another antipsychotic seroquel ; and placed on artane and propranolol.
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Criteria and edits spot problem Interact through local druggist Effective intervention protocols established Follow-up monitoring is done. Clinically-Based Formularies. Formularies are cost containing and are more and more being used in managed care programs. Drugs are preferred based on these features: Cost effectiveness Quality Efficiency. Education and Intervention. This program seeks to identify and educate physicians who do not prescribe properly. This technique results in formulary compliance and generic substitution. Case Management. The pharmacists and physicians tag team using technology to best treat an individual patient. The determination of an individual for case management is based upon certain factors, such as cost of therapy, established treatment guidelines, and difficulty of disease accident. Performance Expectations and Product Savings. These guarantees such as: Relate guarantee from manufacturer What is counted toward product savings is clearly defined Clear definition of what is counted toward product savings Accurate reports that measure performance guarantees Recovery of cost of first time medications. Capitaled Drug programs. While attracted to employers, the vendors must make certain accommodations: Good cost price models Accurate projections Manufacturers must come into the program. Control. Certain tools to control drug costs are required: Data analysis Good formulary management Working relationship with providers Coordinating use review. Drug Utilization Review. The review must be convenient and on-line. Inappropriate drug use must be spotted. Good Service. The service must be both efficient and effective. Provider and Manufacturer Partnership. Between these two there must be agreements; medical care and drug therapy must be integrated; both performance standards and outcomes research must be factored in. Geriatric Drugs. The older population are the biggest users of drugs. There should be special geriatric-based formularies, capitation programs, utilization review services and support services. Therapy Compliance. There must be considerable effort to see that drug regiments are followed. The noncompliance problem is a major one - particularly with the older population. Reimbursement to Pharmacists. Typically a drug card plan will pay the pharmacist the sum of A and B where: A is ingredient cost not to exceed the average wholesale price, for instance, prednisone.
Low doses of atypical antipsychotics such as seeoquel are also sometimes prescribed for their sedative effect and tretinoin.
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January 19: Investigators from the Vermont Attorney General issued an order to Eli Lilly & Co. to produce internal documents regarding its marketing of Zyprexa.[xxvi] February: In a preliminary annual report, AstraZeneca stated that approximately 10, 000 lawsuits against it alleged the company had not adequately warned users about the side effects of Seroquel, which includes severe weight gain and risk of diabetes.[xxvii].
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Professor of Psychiatry at U.T. Health Science Center San Antonio to gain further insight into the results. 1. What is the CATIE study? The initial finding of the CATIE Clinical Antipsychotic Trials of Intervention Effectiveness ; study were published in September in The New England Journal of Medicine. The study was widely anticipated because it was to be the first headto-head trial of the newer antipsychotic drugs to treat schizophrenia not financed by the drug industry. The study included four new generation drugs, called atypical antipsychotics, and one older drug, to treat schizophrenia. It was funded by the National Institute of Mental Health NIMH ; and included over 1400 subjects who were considered to be in need of a change in antipsychotic medication. The Phase 1 findings that three-fourths of the patients who participated stopped taking the drugs they were first started on, brought banner headlines in the national press. Many journalists quickly claimed that there was little difference found between the highly promoted and widely prescribed and more costly new schizophrenia drugs and the older ones that sell for a fraction of the cost. To shed "Texas Light" on the topic, I took the opportunity to interview an investigator in the study, Dr. Alec Miller, A: CATIE is the largest, longest, and most comprehensive independent trial ever done to examine medications for the treatment of schizophrenia. It was designed to show the effectiveness of the older medications first available in the 1950s ; and newer medications available since the 1990s ; . 2. What medications were studied? A: New medications in the study included olanzapine Zyprexa ; , quetiapine Seoquel ; , risperidone Risperdal ; , and ziprasidone Geodon ; . Perphenazine Trilafon ; was included as a representative of the older generation of anti-psychotics. Clozapine was studied as a second or third option. Results so far are only for the first treatment started in the study. 3. Why was perphenazine chosen as the older medication rather than haloperidol Haldol ; ? A. Many patients have had bad experiences with haloperidol and refuse to take part in studies where they may receive it. Perphenazine is typical of the older medications, but does not have the same reputation for causing problems as haloperidol, mainly because it was never as widely used. 4. Were there any CATIE sites in Texas and describe the characteristic of the patients included in the study? A. There were 5 sites in Texas San Antonio, El Paso, Conroe, Dallas, and Houston. There were no "1st break" patients in the study. These were all patients who had a history of treatment majority male, avg. age 40; avg. age of 1st treatment 24; majority never married; other medical conditions. These participants would be seen as the "typical patient" in a community mental health center in Texas. 5. What was the Primary Question to be addressed by Phase 1 of the CATIE Study? A. Phase 1 of the study was designed to measure the rate of discontinuing the first treatment received in the study, by patient or doctor choice. 6. How were the trials conducted? A. A total of 1493 patients with schizophrenia were recruited at 57 U.S. sites and randomly assigned to receive olanzapine, perphenazine, quetiapine, risperidone and ziprasidone for up to 18 months. Everyone received identicalappearing capsules. Neither patients nor their doctors were told which antipsychotic they were taking. Continued on next page and retrovir.
Some additional funding for the Barton scheme, but only if delivered by 2006. The allocations had been determined by the Strategic Health Authority on a weighted capitation basis. Lengthy discussion followed on the potential of securing some additional funding through the LDP but it was acknowledged that this was not a reality as there were lots of bids which could not all be funded and at some point, some difficult decisions in terms of priorities would have to be made. It was also noted that bids for potential additional funding could also be put forward via West Hull PCT, who was leading the process. It was noted that although an Estates Strategy had been developed, there was not a Strategic Service Delivery Plan in place to monitor how services would be delivered in the future. It was acknowledged that this was a major piece of work, but would be a valuable document that enabled strategies to be developed and updated. Lengthy discussion took place around the Barton scheme and other potential options for funding. It was suggested that this scheme might be a priority in terms of teaching being delivered in conjunction with the Hull York Medical School. Other issues around capacity, the likelihood of the risks; adequate space for community teams and the difficulties in securing suitable premises in Barton, were also flagged up. Mr Ablett stated that there had been a national announcement around branded medicines, when it was anticipated that there would be a 7% reduction the following financial year and he asked if it might be possible to ring-fence any of that windfall to use for development. Miss Carey stressed that the PCT had a duty to achieve current financial balance and if the financial situation was not resolved, there would be a serious impact on patient services. Miss Carey advised that it was therefore important to ensure that the funding for the Barton scheme was secured, within the given timescales and she suggested that it might mean putting some pressure on the builders to ensure that the deadline was met, in order to secure the funding. The PEC formally approved the following recommendations, taking into account the financial concerns raised: the move to expedite the building of the Barton project within 2005 2006, noting the potential risks associated with the funding and agreed to include a caveat for the developers to ensure that the deadline was met supported the development of a scheme for the Scunthorpe project, noting the desire to develop the scheme in conjunction with other partner organisations. The final scheme to be brought back to the PEC for further discussion. approved the lease of sufficient property to accommodate the community teams should the need arise. Considered the need for the PCT to have a Strategic Service Delivery Plan in place as a matter of some urgency. Dr Sanderson thanked Mr Day for his input, at which point Mr Day left the meeting. Dr Birtwhistle returned to the meeting and re-convened as Chairman ; It was noted that there was no Financial Performance Report for the PEC to 31 October 2004. A new financial system had been installed on 1 October 2004 and there had been difficulties experienced in generating reports. The situation had now been rectified and a report would be presented to the January PEC meeting. It was noted that the new system had not had an adverse effect on payments etc. Dr Falk asked about superannuation in terms of the GP element of the QOF and Miss Carey agreed to report back to Dr Falk outside of the meeting. 11. PERFORMANCE REPORT TO 31 OCTOBER 2004 Mr Janvier spoke to Paper I, a report setting out performance and progress as at 31 October 2004 against the various targets. It was noted that performance continued to be good, with a number of exceptions identified in the report.
| Seroquel use in childrenThis later proved to be untrue astrazeneca pharmaceuticals is a global multi-billion dollar pharmaceutical company serowuel is astrazeneca's second biggest-selling product what is seroquel and rifater.
Table 1- the association between age and the increase in breast density.
The studies examined risperidone risperdal ; , quetiapine sfroquel ; and olanzapinet zyprexa and rifampin and seroquel.
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Supplemented basal diet restored the tissue level of glutathione peroxidase or the plasma level of vitamin E to that observed in the selenium- or vitamin Fe. supplemented mice Table 5 ; . However, neither di.
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A newer class of antipsychotic drugs called atypical antipsychotics, have been demonstrated to alleviate the psychotic symptoms without worsening motor problems. The most effective drug in this class for use with PD is the drug clozapine Clozaril ; . Very small doses, x of a 25 mg. tablet, given at bedtime is a common starting dose. Higher doses of this medication can cause excessive sedation, drooling and low blood pressure. Unfortunately, the use of clozapine requires frequent blood tests; the medication has been rarely associated with agranulocytosis, a depletion in the white blood cells which fight infection. Quetiapine Seroquel ; is similar to clozapine in its ability to reduce hallucinations without dramatically worsening the motor symptoms of Parkinson's disease. Unlike clozapine, quetiapine does not carry the risk of lowering white blood cells. The common starting dose is 12.5 mg. at bedtime. In addition to decreasing hallucinations and confusion, quetiapine often improves sleep. Other similar drugs that are not considered as effective quite as effective as clozapine and quetiapine include olanzapine Zyprexa ; and risperidone Risperdal ; . The following table summarizes antipsychotic drugs and their relevance to the Parkinson population.
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Measures to combat counterfeit drugs The Committee noted that the guidelines for the development of measures to combat counterfeit and substandard products are approaching finalization. It emphasized the importance of communication among all the bodies involved. Vigilance and the reporting of counterfeit drugs were necessary at all times, rather than only in response to isolated incidents or when special requests for information were made. The Committee encouraged the sharing of information by national regulatory authorities through the network of liaison officers established to combat counterfeit pharmaceuticals.
Drug names: aripiprazole Abilify ; , bupropion Wellbutrin and others ; , carbamazepine Carbatrol, Equetro, and others ; , citalopram Celexa and others ; , clonidine Catapres and others ; , clozapine Clozaril, FazaClo, and others ; , divalproex Depakote ; , escitalopram Lexapro ; , fluoxetine Prozac and others ; , gabapentin Neurontin ; , haloperidol Haldol and others ; , lamotrigine Lamictal ; , lithium Eskalith, Lithobid, and others ; , olanzapine Zyprexa ; , olanzapinefluoxetine Symbyax ; , oxcarbazepine Trileptal ; , paroxetine Paxil, Pexeva, and others ; , pramipexole Mirapex ; , quetiapine Seroquel ; , risperidone Risperdal ; , sertraline Zoloft ; , topiramate Topamax ; , valproic acid Depakene and others ; , venlafaxine Effexor ; , ziprasidone Geodon ; . Financial disclosure: Dr. Suppes has received grant research support from Abbott, AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen, National Institute of Mental Health, Novartis, Robert Wood Johnson, and the Stanley Medical Research Institute; has received honoraria from Novartis; and is a consultant for or on the speakers advisory board of Abbott, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen, Johnson & Johnson, Novartis, Pfizer, Pharmaceutical Research Institute, Ortho-McNeil, Shire, Solvay, and UCB Pharma. Dr. Hirschfeld is a consultant for or on the advisory board of Abbott, AstraZeneca, Bristol-Myers Squibb, Forest, GlaxoSmithKline, Janssen, Eli Lilly, Novartis, Organon, Pfizer, Shire, UCB Pharma, and Wyeth-Ayerst and has received grant research support from Wyeth-Ayerst. Dr. Altshuler is a consultant for Abbott, Bristol-Myers Squibb, Eli Lilly, Forest, Janssen, AstraZeneca, and Pfizer; has received grant research support from Abbott; has received honoraria from Abbott, Bristol-Myers Squibb, Eli Lilly, Forest, and Janssen; and is on the speakers advisory board of Abbott, BristolMyers Squibb, Eli Lilly, Forest, Janssen, AstraZeneca, and Pfizer. Dr. Bowden is a consultant for Abbott, GlaxoSmithKline, Janssen, Lilly Research, Sanofi-Synthelabo, and UCB Pharma; has received grant research support from Abbott, Bristol-Myers Squibb, Elan, GlaxoSmithKline, Janssen, Lilly Research, Parke-Davis, Robert Wood Johnson, and Smith Kline Beecham; and is on the speakers advisory board of Abbott, AstraZeneca, GlaxoSmithKline, Janssen, Lilly Research, and Pfizer. Dr. Calabrese has received grant research support from Abbott, AstraZeneca, Merck, GlaxoSmithKline, Janssen, Eli Lilly, and Pfizer and is a consultant for or on the advisory board of Abbott, AstraZeneca, Bristol-Myers Squibb Otsuka, Eli Lilly, GlaxoSmithKline, Janssen, and Teva. Dr. Crismon is a consultant for Bristol-Myers Squibb; has received grant research support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Forest, and Janssen; and is on the speakers advisory board of AstraZeneca, Eli Lilly, Forest, Janssen, McNeil Specialty and Consumer Products, Pfizer, and Pharmacia. Dr. Ketter is a consultant for Abbott, AstraZeneca, BristolMyers Squibb, Cephalon, Elan, Eli Lilly, GlaxoSmithKline, Janssen, Novartis, Pfizer, and Shire; has received grant research support from Abbott, AstraZeneca, Bristol-Myers Squibb, Elan, Eli Lilly, GlaxoSmithKline, Janssen, Novartis, and Shire; and has received honoraria from Abbott, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, GlaxoSmithKline, Janssen, Novartis, and Pfizer. Dr. Sachs has been a consultant to Abbott, GlaxoSmithKline, Janssen, Eli Lilly, BristolMyers Squibb, Novartis, Elan, Sanofi, Sigma-Tau, and AstraZeneca; has received grant research support from Abbott and Janssen; and has received honoraria from Abbott, GlaxoSmithKline, Janssen, Eli Lilly, Bristol-Myers Squibb, Solvay, Novartis, Sanofi, AstraZeneca, and Pfizer. Dr. Swann is a consultant for Abbott, AstraZeneca, UCB, Shire, GlaxoSmithKline, Novartis, and Ortho-McNeil; has received grant research support from Abbott, Bristol-Myers Squibb, UCB, Shire, and Novartis; and has received honoraria from and is on the speakers advisory boards of Abbott, Eli Lilly, AstraZeneca, GlaxoSmithKline, Janssen, Pfizer, and Ortho-McNeil. Dr. Dennehy has no significant financial relationships to disclose. Acknowledgments: Besides the authors, the following individuals contributed to the development of the updated treatment algorithms. The Texas Consensus Conference Panel on Medication Treatment of Bipolar Disorder 2004: Kinike Bermudez, representative to the Texas Depression and Bipolar Support Alliance; Cindy Hopkins, Texas Department of State Health Services TDSHS Steven P. Shon, M.D., TDSHS, Austin; Ross Taylor, M.D., Lubbock Regional; Joseph.
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