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Intramuscular short-acting Meehan order 130mg malegra dxt visa, Significant effect compared with placebo; olanzapine 2002 272 24 hours no difference between olanzapine and Lorazepam 1 mg (fair) lorazepam malegra dxt 130mg without prescription. Placebo No difference compared with placebo on Ballard malegra dxt 130mg visa, Quetiapine IR CMAI. No difference compared with placebo on Zhong, Quetiapine IR 100 mg primary outcome measure PANSS-EC. Brodaty, Risperidone superior to placebo on CMAI Risperidone 2003 309 12 weeks (total and 4 of 5 subscales) and BEHAVE- Placebo (fair) AD (total and 5 of 7 subscales) Risperidone 0. Mintzer, Risperidone No difference compared with placebo on 2006 473 8 weeks Placebo BEHAVE-AD or CGI-C (fair) Abbreviations: IR, immediate release. Because they differed in their outcome measures and other factors these trials did not provide indirect evidence for comparative efficacy among the atypical antipsychotics. There was no difference between olanzapine 406 and lorazepam in 1 of these trials. Harms The following text focuses on withdrawals and adverse events related to tolerability. For information on evidence related to mortality and cerebrovascular adverse events in patients with behavioral and psychological symptoms of dementia, see the Serious Harms section. Atypical antipsychotic drugs Page 121 of 230 Final Report Update 3 Drug Effectiveness Review Project Direct evidence Withdrawals and adverse events reported in head-to-head trials of atypical antipsychotics are shown in Evidence Table 13 and Table 26, below. In the CATIE-AD trial, there was no difference between active treatment groups or between any treatment group and placebo in 468 overall withdrawals. All treatment groups had higher rates of withdrawals due to intolerability, adverse events, or death compared with placebo, but there was no difference between treatment groups for this outcome. One trial found a higher rate of withdrawals due to adverse events with 474 olanzapine (16. No other differences in withdrawal rates were identified in head-to-head trials. In the CATIE-AD trial, the incidence of extrapyramidal symptoms or Parkinsonism was higher in the olanzapine and risperidone groups (12% in each) than in the immediate-release quetiapine (2%) and placebo (1%) groups (P<0. In another head-to-head trial of immediate- 475 release quetiapine and risperidone, there were no significant differences between groups in extrapyramidal side effects as measured by the Simpson-Angus scale. In this trial, the mean daily dose of immediate-release quetiapine was 77 mg, whereas it was somewhat lower in the CATIE- AD trial (56. The risperidone doses in these trials were similar (1. Four trials other than CATIE-AD looked at the incidence of extrapyramidal side effects with olanzapine compared with risperidone, and most found similar rates between groups. The exception was a trial in which the risperidone group showed more increase from baseline on SAS 474 than the olanzapine group. In this same trial, however, there was no difference between olanzapine and risperidone on the Abnormal Involuntary Movement Scale (AIMS) or the Barnes Akathisia Rating Scale (BARS). A recent analysis of CATIE-AD found that duration of antipsychotic use was significantly associated with weight gain in women but not men. A similar pattern was seen for body mass index, with increases in women but not men. Results for the individual atypical antipsychotics are not reported separately for men and women; overall, there was significant average weekly weight gain in the olanzapine (P=0. There was also a trend for weight gain in the risperidone group, but it was not statistically significant (P=0. Additionally, olanzapine treatment was associated with increased waist circumference and decreased high-density lipoprotein 500 cholesterol. Atypical antipsychotic drugs Page 122 of 230 Final Report Update 3 Drug Effectiveness Review Project Table 26. Adverse events in head-to-head trials of atypical antipsychotics in patients with behavioral and psychological symptoms of dementia Medications Study, compared Withdrawals due Year, (mean daily Withdrawals to adverse Duration dose) overall events Extrapyramidal symptoms Incidence of parkinsonism or All groups extrapyramidal side effects significantly Overall P=0. Overall withdrawal rates were high in short-term trials, ranging from 20% to 34% in olanzapine groups, 3% to 42% in risperidone groups, and 7% to 30% in haloperidol groups. Placebo withdrawal rates were also high, ranging from 23% to 35%. Subgroups No study reported separate analyses by demographics or comorbidities. The majority of subjects in dementia trials were frail, elderly residents of nursing homes. In 1 study comparing 484 risperidone with haloperidol conducted in Hong Kong, all patients were of Chinese ancestry. It was not possible to make conclusions about comparative efficacy in different ethnic groups from these studies. More subjects were female in all of these studies, reflecting the overall population of elderly patients with dementia. Children and Adolescents with Pervasive Developmental Disorders or Disruptive Behavior Disorders Summary of Evidence Effectiveness and Short-term Adverse Events • The comparative evidence was poor. Children and Adolescents with Pervasive Developmental Disorders Efficacy • Risperidone (5 trials), aripiprazole (2 trials), and olanzapine (1 trial) were superior to placebo for improving behavioral symptoms in children with pervasive developmental disorders. Atypical antipsychotic drugs Page 124 of 230 Final Report Update 3 Drug Effectiveness Review Project Children and Adolescents with Disruptive Behavior Disorders Efficacy • Five fair-quality, short-term placebo-controlled trials found risperidone superior to placebo. Short-term Safety • Weight gain reported in short-term trials ranged from 2. Weight gain was significantly greater than placebo with risperidone in three trials, greater than placebo with aripiprazole in two trials, and greater with olanzapine than haloperidol in one trial. Longer-term Safety • No comparative evidence exists; only risperidone has been studied. In a 2-year open-label extension study of 14 children, mean weight gain was 8. Subgroups • No conclusions about comparative effectiveness or safety based on age, gender, or comorbidities could be made from this body of evidence. Detailed Assessment for Children and Adolescents with Pervasive Developmental Disorders or Disruptive Behavior Disorders: Comparative Effectiveness, Efficacy, and Harms Efficacy There were no head-to-head trials of atypical antipsychotics in children and adolescents with pervasive developmental disorders or disruptive behavior disorders. In children or adolescents with pervasive developmental disorders, evidence of efficacy was available from 10 placebo- controlled or active-control trials of risperidone (6 trials), aripiprazole (2 trials), and olanzapine (2 trials). In children or adolescents with disruptive behavior disorders, evidence was available from 5 placebo-controlled trials of risperidone and 1 placebo-controlled trial of immediate- Atypical antipsychotic drugs Page 125 of 230 Final Report Update 3 Drug Effectiveness Review Project release quetiapine. We did not identify any studies in children or adolescents with Rett’s disorder or childhood disintegrative disorder.

Treatment- 286 related adverse effects were reported as 8 malegra dxt 130 mg on line. Are there differences in the harms of statins or fixed-dose combination products containing a statin and another lipid lowering drug when used in special populations or with other medications (drug-drug interactions)? Summary of findings • One study of fluvastatin in children with minimal change glomerulonephritis demonstrated decrease in total cholesterol and reported no side effects discount malegra dxt 130mg amex. Detailed assessment One study of children with minimal change glomerulonephritis (MCGN) assigned 36 patients to 299 20 mg of fluvastatin or dipyridamole for 2 years purchase malegra dxt 130mg with amex. The main study outcome was bone mineral density, for which there was no change over the course of the study. Hematuria decreased significantly, and creatinine clearance, total protein, and albumin increased compared to baseline in the statin group, but not the dipyridamole group. The authors observed no side effects in any of the patients over the treatment period. SUMMARY Table 15 summarizes the level and direction of evidence for each key question. Summary of the evidence by key question Strength of Key question evidence Conclusion ADULTS 1. How do statins and fixed-dose Fair The ideal study would be a double-blind, intention-to-treat combination products containing a randomized trial in which equipotent doses of different statin and another lipid-lowering statins were compared with regard to low-density drug compare in their ability to lipoprotein-lowering, withdrawals, and adverse effects. No reduce low-density lipoprotein studies met these stringent criteria. Are their doses for each statin or Fair-to-good Results of a large number of trials are generally consistent fixed-dose combination product with information from the manufacturer. When statins are containing a statin and another lipid- provided in doses that are approximately equipotent, a lowering drug that produce similar similar percent reduction in low-density lipoprotein percent reduction in low-density cholesterol can be achieved. Is there a difference in the ability Good for most For patients who require low-density lipoprotein cholesterol of a statin or fixed-dose combination comparisons reductions of up to 35% to meet their goal, any of the statins product containing a statin and (see text) are effective. In patients requiring a low-density lipoprotein another lipid-lowering drug to cholesterol reduction of 35% to 50% to meet the National achieve National Cholesterol Cholesterol Education Program goal, atorvastatin 20 mg or Education Panel goals? Atorvastatin 80 mg daily and rosuvastatin 20 mg or more can reduce low-density lipoprotein cholesterol by 50% or more. Based on fair-quality studies, atorvastatin 80 mg daily resulted in 5 to 6 additional percentage points of low-density lipoprotein reduction than simvastatin 80 mg (53% to 54% vs. In head-to-head studies rosuvastatin 40 mg had greater reduction in low-density lipoprotein cholesterol than atorvastatin 80 mg with similar frequency of adverse events. In patients requiring a low-density lipoprotein cholesterol reduction of greater than 50%, the higher doses of ezetimibe-simvastatin at 10/40 mg and 10/80 mg are more likely to meet the National Cholesterol Education Program Adult Treatment Panel III goal than an equivalent high potency statin. How do statins and fixed-dose Fair-to-good When statins are provided in doses that are approximately combination products containing a equipotent for lowering LDL-C, a similar percent increase in statin and another lipid-lowering high-density lipoprotein cholesterol can be achieved. There drug compare in their ability to raise is conflicting evidence about simvastatin vs. Some studies found greater increases in high-density lipoprotein cholesterol with rosuvastatin compared with atorvastatin, while other studies found no difference. How do statins and fixed-dose NA There are no controlled trials comparing equivalent doses of combination products containing a 2 or more statins to reduce the risk of coronary events, statin and another lipid-lowering stroke, or death. Which statins have been shown to Good Patients who have never had CHD: pravastatin (high-risk reduce all-cause mortality? Patients with CHD: simvastatin, atorvastatin Which statins have been shown to Fair-to-good Patients who have never had CHD: atorvastatin (high-risk reduce CHD events? Which statins have been shown to Good Atorvastatin, pravastatin, simvastatin, rosuvastatin (patients reduce strokes? Atorva 10 mg reduced cardiovascular events in a primary prevention trial of patients with diabetes (CARDS), and simvastatin 40 mg reduced cardiovascular events in patients with diabetes (Heart Protection Study). In a subgroup analysis of the LIPS trial, there was a reduction in coronary events (cardiac death, nonfatal MI, CABG, or repeat PCI) with fluvastatin 80 mg in patients with diabetes who had undergone successful PCI. Studies that included people with diabetes had rates of adverse effects similar to other studies. Are there differences in Good (elderly, The benefits of statins have been documented in women effectiveness of statins and fixed- women)-to- and the elderly. There are almost no data about African dose combination products Fair to Poor Americans, Hispanics, or other ethnic groups. In short-term containing a statin and another lipid- (African head-to-head trials, reductions in LDL-C and frequency of lowering drug in different Americans, adverse events with rosuvastatin 10 to 20 mg and demographic groups or in patients Hispanics, and atorvastatin 10 to 20 mg in Hispanic, South Asian, and with comorbid conditions (e. Are there differences in safety of Poor There are no data from clinical trials comparing the safety of statins in different demographic different statins in women, the elderly, or African Americans. A pharmacokinetic study of rosuvastatin conducted in the United States demonstrated an approximate 2-fold elevation in median exposure in Asian subjects (having either Filipino, Chinese, Japanese, Korean, Vietnamese, or Asian-Indian origin) compared with a Caucasian control group. Are there differences in the harms Good for Although creatine kinase elevations are common, the risk of of statins or fixed-dose combination statins symptomatic myopathy is low. All of the available statins products containing a statin and monotherapy (simvastatin, lovastatin, atorvastatin, fluvastatin, pravastatin, another lipid-lowering drug when rosuvastatin), when administered alone, have been used in the general population of Fair to poor for associated with infrequent myotoxic adverse effects ranging children or adults? There is no evidence that elevated transaminases Statins Page 80 of 128 Final Report Update 5 Drug Effectiveness Review Project Strength of Key question evidence Conclusion associated with statin use increase the risk of clinically significant liver failure. In a trial of 2 doses of atorvastatin, the incidence of persistent elevations in liver aminotransferase levels 2 per 1000 in patients taking atorvastatin 10 mg daily, vs. There is insufficient evidence to determine which statin or statins are safer with regard to muscle toxicity or elevated liver enzymes. Among high potency statins, at doses below 80 mg, rates of adverse events and withdrawals due to adverse events were similar in patients taking atorvastatin or simvastatin. Atorvastatin 80 mg had a higher rate of some adverse effects (gastrointestinal disturbances and transaminase elevation) than simvastatin 80 mg daily in a trial in which the low-density lipoprotein lowering of atorvastatin was greater than that of simvastatin. Adverse event rates in patients using rosuvastatin 40 mg were similar to rates in patients using atorvastatin 80 mg in short-term trials. We identified very little evidence of harms in the trials of the fixed dose combination product trials.

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Risk categories and refractory CLL in the era of 21 generic malegra dxt 130 mg overnight delivery. Graft-versus-leukemia effects of transplantation and function in chronic lymphocytic leukemia that can be blocked donor lymphocytes discount 130mg malegra dxt free shipping. Stem cell transplantation in chronic lymphocytic mechanism in human cancer 130 mg malegra dxt mastercard. Ramsay AG, Evans R, Kiaii S, Svensson L, Hogg N, Gribben 58. Chronic lymphocytic leukemia cells induce defective 8. TP53, SF3B1, and LFA-1-directed T-cell motility by altering Rho GTPase signal- NOTCH1 mutations and outcome of allotransplantation for ing that is reversible with lenalidomide. Nonmyeloablative and suppressive function of CD4 CD25high regulatory T allogeneic stem cell transplantation in relapsed/refractory chronic cells in patients with chronic lymphocytic leukemia after lymphocytic leukemia: long-term follow-up, prognostic fac- therapy with fludarabine. Pallasch CP, Ulbrich S, Brinker R, Hallek M, Uger RA, subtype on outcome. Five-year fol- lymphocytic leukemia by CD200 blockade. A novel adoptive after nonmyeloablative conditioning. High-level lymphocytic leukemia: prognostic model to predict outcome. Indications for alloge- tures and after BCR stimulation. Allogeneic hematopoi- plasma levels and the risk for disease progression in chronic etic stem-cell transplantation for chronic lymphocytic leukemia lymphocytic leukemia. The PD-1/PD-L1 axis and Marrow Transplantation analysis. Restoring function in etic stem cell transplantation in chronic lymphocytic leukemia: exhausted CD8 T cells during chronic viral infection. HIV-specific T cells is associated with T-cell exhaustion and 15. The blockade of immune checkpoints in cancer chronic lymphocytic leukemia:a risk-matched analysis based immunotherapy. Safety, activity, and improves expansion and persistence of chimeric antigen recep- immune correlates of anti-PD-1 antibody in cancer. Brentjens R, Yeh R, Bernal Y, Riviere I, Sadelain M. Phase I safety and autologous T cells:case report of an unforeseen adverse event in pharmacokinetic study of CT-011, a humanized antibody a phase I clinical trial. Receptor pharmacotherapy after allogeneic stem cell transplantation. Wierda WG, Cantwell MJ, Woods SJ, Rassenti LZ, Prussak to express a ROR1-specific chimeric antigen receptor. CD40-ligand(CD154) gene therapy for chronic 2010;116(22):4532-4541. A phase I study of of autologous Ad-CD154-leukemia B cells identify ROR1 as an immune gene therapy for patients with CLL using a membrane- oncofetal antigen and receptor for Wnt5a. Castro JE, Melo-Cardenas J, Urquiza M, Barajas-Gamboa JS, 40. Gene immunotherapy of chronic lympho- regression in patients after transfer of genetically engineered cytic leukemia: a phase I study of intranodally injected lymphocytes. Engineering lymphocyte subsets: tools, trials and tribulations. Chimeric mide in the treatment of previously untreated chronic lympho- antigen receptor-engineered T cells for immunotherapy of cytic leukemia. Safety and persistence of therapy of elderly patients with chronic lymphocytic leukemia. Chimeric relapsed or refractory chronic lymphocytic leukemia. J Clin antigen receptor-modified T cells in chronic lymphoid leuke- Oncol. T cells with chimeric T-cell synapse activity in a phase 2 trial of chemoimmuno- antigen receptors have potent antitumor effects and can estab- therapy followed by lenalidomide consolidation in previously lish memory in patients with advanced leukemia. Sci Transl untreated chronic lymphocytic leukemia (CLL). Immune dysfunction in chronic depletion and remissions of malignancy along with cytokine- lymphocytic leukemia T cells and lenalidomide as an immuno- associated toxicity in a clinical trial of anti-CD19 chimeric- modulatory drug. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine, and the monoclonal antibodies alemtuzumab, rituximab, and ofatumumab) and many more drugs are in advanced clinical development to be approved for this disease. In addition, the extreme heterogeneity of the clinical course and our improved ability to foresee the prognosis of this leukemia by the use of clinical, biological, and genetic parameters now allow us to characterize patients with a very mild onset and course, an intermediate prognosis, or a very aggressive course with high-risk leukemia. Therefore, it becomes increasingly challenging to select the right treatment strategy for each condition. This article summarizes the currently available diagnostic and therapeutic tools and gives an integrated recommendation of how to manage CLL in 2013. Moreover, I propose a strategy how we might integrate the novel agents for CLL therapy into sequential treatment approaches in the near future. Overview of different tyrosine kinases, such as Bruton tyrosine kinase (BTK), With an age-adjusted incidence of 4. More than 15 000 which stimulate malignant B-cell survival via activation of transcrip- newly diagnosed cases and 4500 deaths are currently estimated. More underscored by the fact that different features of the BCR have been male than female patients are affected by this disease. These pathways mature, typically CD5-positive B cells within the blood, BM, lymph have recently gained in importance because they can be inhibited by nodes, and spleen. The leukemic transformation is initiated by specific small-molecule inhibitors that show clinical efficacy in specific genomic alterations, in particular deletions on the long arm lymphoid malignancies. In addition, whole-genome sequencing has uncovered recurrent somatic gene mutations that Standard of care using the currently approved agents occur in CLL cells in parallel to the above-mentioned structural genomic aberrations. Of these, mutations affecting the genes Cytostatic agents NOTCH1, MYD88, TP53, ATM, and SF3B1 seem to be more Monotherapy with alkylating agents has served as initial, frontline common and to have prognostic impact. The advantages cell-autonomous, genetically determined process.

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Jamieson AO order 130mg malegra dxt, Zammit GK purchase malegra dxt 130 mg without a prescription, Rosenberg RS discount malegra dxt 130 mg with amex, Davis JR, Walsh JK. Zolpidem reduces 4 the sleep disturbance of jet lag. Jobert M, Poiseau E, Jahnig P, Gaillard P, Schulz H. ECG activity in the sleep of insomniac patients under the influence of lormetazepam and zopiclone. Polygraphical sleep recordings in insomniac patients 6 under zopiclone or nitrazepam. Effects of zopiclone on sleep and symptoms in schizophrenia: Comparison with benzodiazepine hypnotics. Progress 4 in Neuro-Psychopharmacology and Biological Psychiatry. Kajimura N, Kato M, Okuma T, Sekimoto M, Watanabe T, Takahashi K. A comparative study of benzodiazepine hypnotics and zopiclone in schizophrenia: 4 Effects on polysomnograms and BPRS scores. Effects of zopiclone, flunitrazepam, triazolam and levomepromazine on the transient change in sleep-wake schedule: 4 polygraphic study, and the evaluation of sleep and daytime condition. Progress in Neuro-Psychopharmacology & Biological Psychiatry. Effects of zolpidem and triazolam on sleep and daytime activities in normal young volunteers. Karst M, Salim K, Burstein S, Conrad I, Hoy L, Schneider U. Analgesic Effect of the Synthetic Cannabinoid CT-3 on Chronic Neuropathic Pain: A Randomized 4 Controlled Trial. Katsunuma H, Shimizu T, Ogawa K, Kubo H, Ishida H, Yoshihama A. Clinical evaluation of zolpidem on insomnia of patients with schizophrenia and manic-depressive psychosis double- 1 blind trial in comparison with nitrazepam. Kim YD, Zhuang HY, Tsutsumi M, Okabe A, Kurachi M, Kamikawa Y. Comparison of the effect of zopiclone and brotizolam on sleep EEG by quantitative evaluation 4 in healthy young women. Insomnia Page 73 of 86 Final Report Update 2 Drug Effectiveness Review Project Trials Code Kintz P, Villain M, Concheiro M, Cirimele V. Screening and confirmatory method for benzodiazepines and hypnotics in oral fluid by LC-MS/MS. Kitajima T, Tomita S, Hayakawa T, Kayukawa Y, Ohta T. Successful treatment of non-24-hour sleep-wake syndrome with melatonin. Sixth World Congress of 3 Biological Psychiatry, Nice, France. Kratzsch C, Tenberken O, Peters FT, Weber AA, Kraemer T, Maurer HH. Screening, library-assisted identification and validated quantification of 23 benzodiazepines, flumazenil, zaleplone, zolpidem and zopiclone in plasma by 2 liquid chromatography/mass spectrometry with atmospheric pressure chemical ionization. High-dose zolpidem dependence in a patient 4 with chronic facial pain. Kryger MH, Steljes D, Pouliot Z, Neufeld H, Odynski T. Subjective versus objective evaluation of hypnotic efficacy: Experience with zolpidem. Clinical efficacy and safety of zolpidem on insomnia: a double-blind comparative study with zolpidem and nitrazepam. Kuitunen T, Mattila MJ, Seppala T, Aranko K, Mattila ME. Actions of zopiclone and carbamazepine, alone and in combination, on human skilled performance in 4 laboratory and clinical tests. Drug and ethanol effects on the clinical test for drunkenness: single doses of ethanol, hypnotic drugs and antidepressant drugs. On the sleep promoting effects of BR-16A: interaction with GABAergic modulators. Long-term polysomnographic study of the efficacy and safety of zolpidem in elderly psychiatric in-patients with insomnia. A double-blind study to establish the residual effects of zopiclone on performance in healthy volunteers. Subjective effects during administration and on discontinuation of zopiclone and temazepam in normal subjects. Lamphere JK, Roehrs TA, Zorick FJ, Koshorek G, Roth T. Landolt HP, Finelli LA, Roth C, Buck A, Achermann P, Borbely AA. Zolpidem and sleep deprivation: Different effect on EEG power spectra. Journal of the American 4 Academy of Child & Adolescent Psychiatry. Differential effects of zolpidem (Zp) (10mg), zopiclone (Zc) (7. Insomnia Page 74 of 86 Final Report Update 2 Drug Effectiveness Review Project Trials Code Lebrault C, Chauvin M, Guirimand F, Gauneau P, Duvaldestin P. Randomized double blind comparison of zoldipem and lorazepam versus placebo in 4 premedication.

A double-blind randomised comparison of risperidone and haloperidol in the treatment of behavioural and psychological symptoms in Chinese dementia patients cheap malegra dxt 130mg with visa. A randomized trial of risperidone generic 130 mg malegra dxt overnight delivery, placebo cheap malegra dxt 130 mg mastercard, and haloperidol for behavioral symptoms of dementia. Comparative efficacy of risperidone versus haloperidol on behavioural and psychological symptoms of dementia. A multicentre, double-blind, randomised, parallel-group comparison of quetiapine and haloperidol in the treatment of elderly patients presenting with dementia and psychoses (5077IL/0049). Mintzer J, Tune LE, Breder CD, Swanink R, Marcus RN, McQuade RD. Aripiprazole for the treatment of psychosis in institutionalized patients with alzheimer dementia: A multicenter, randomized, double-blind placebo controlled assessment of three fixed doses. A randomized, double-blind, placebo- controlled study of aripiprazole for the treatment of psychosis in nursing home patients with Alzheimer disease. Olanzapine treatment of psychotic and behavioral symptoms in patients with Alzheimer disease in nursing care facilities: a double-blind, randomized, placebo-controlled trial. Zhong KX, Tariot PN, Mintzer J, Minkwitz MC, Devine NA. Quetiapine to treat agitation in dementia: a randomized, double-blind, placebo-controlled study. Atypical antipsychotic drugs Page 190 of 230 Final Report Update 3 Drug Effectiveness Review Project 495. A randomized placebo-controlled trial of risperidone for the treatment of aggression, agitation, and psychosis of dementia. Katz IR, Jeste DV, Mintzer JE, Clyde C, Napolitano J, Brecher M. Comparison of risperidone and placebo for psychosis and behavioral disturbances associated with dementia: a randomized, double-blind trial. Risperidone in the treatment of psychosis of Alzheimer Disease: Results from a prospective clinical trial. Comparison of rapidly acting intramuscular olanzapine, lorazepam, and placebo: a double-blind, randomized study in acutely agitated patients with dementia. Rappaport SA, Marcus RN, Manos G, McQuade RD, Oren DA. Journal of the American Medical Directors Association. Systematic review of randomized controlled trials of atypical antipsychotics and selective serotonin reuptake inhibitors for behavioural problems associated with pervasive developmental disorders. Jensen PS, Buitelaar J, Pandina GJ, Binder C, Haas M. Management of psychiatric disorders in children and adolescents with atypical antipsychotics: a systematic review of published clinical trials. Risperidone in the treatment of behavioral disorders associated with autism in children and adolescents. Psychopharmacology of aggression in children and adolescents with autism: a critical review of efficacy and tolerability. Risperidone for the core symptom domains of autism: results from the study by the autism network of the research units on pediatric psychopharmacology. Research Units on Pediatric Psychopharmacology Autism Network. Risperidone treatment of autistic disorder: longer-term benefits and blinded discontinuation after 6 months. Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Risperidone in children with autism and serious behavioral problems. Atypical antipsychotic drugs Page 191 of 230 Final Report Update 3 Drug Effectiveness Review Project 510. Risperidone in preschool children with autistic spectrum disorders: an investigation of safety and efficacy. Risperidone in children with autism: randomized, placebo- controlled, double-blind study. Long-term effects of risperidone in children with autism spectrum disorders: a placebo discontinuation study. A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder. A double-blind placebo-controlled pilot study of olanzapine in childhood/adolescent pervasive developmental disorder. Malone RP, Cater J, Sheikh RM, Choudhury MS, Delaney MA. Olanzapine versus haloperidol in children with autistic disorder: an open pilot study. Effect of aripiprazole on quality of life and caregiver strain in the treatment of irritability associated with autistic disorder (CN139- 178/179) [poster]. Paper presented at: 162nd American Psychiatric Association (APA) Annual Meeting; May 16-21, 2009; San Francisco, CA. Safety and tolerability of aripiprazole in the treatment of irritability associated with autistic disorder. Paper presented at: 162nd American Psychiatric Association (APA) Annual Meeting, 2009; San Francisco, CA. Miral S, Gencer O, Inal-Emiroglu FN, Baykara B, Baykara A, Dirik E. Risperidone versus haloperidol in children and adolescents with AD : a randomized, controlled, double-blind trial.