ADHD Meds Ritalin and Concerta

A study from Radiology states that Methylphenidate (MPH), sold under trade names including Ritalin and Concerta,  appears to affect the development of the brain's signal-carrying white matter in children with ADHD, while the same effects were not found in adults using MPH for ADHD.  "What our data already underscore is that the use of ADHD medications in children must be carefully considered until more is known about the long-term consequences of prescribing methylphenidate at a young age," the authors said.

Androgen Deprivation Therapy

Among elderly patients with prostate cancer, androgen deprivation therapy exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years, according to a new JAMA Network Open study.

In addition, a study in Bone showed not only an accelerated decline in areal bone mineral density, the treatment also affects bone in other ways, such as reduced bone strength at bone sites of the forearm and lower leg, with the honeycomb-like trabecular bone, rather than the dense cortical bone, mostly affected by this treatment.

Antibiotic

A new report from Journal of Medical Case Reports found a suggestive causal link between use of ciprofloxacin ("Cipro") and hypoglycemia in patients without diabetes. Cipro is an antibiotic from the fluoroquinolone class, which contains myriad side effects, some devastating. For example, in a recent JAMA Neurology study, oral fluoroquinolone therapy was associated with an increased risk of incident peripheral neuropathy.

In a new study from Current Opinion in Nephrology and Hypertension, evidence suggests a possible, causal role of antibiotics in the development of kidney stones. A possible explanation for this finding includes alterations in the microbiome, especially effects on oxalate-degrading bacteria. Ample reasons to encourage antibiotic stewardship already exist, but the possible role of antibiotic exposure in contributing to the increasing prevalence of kidney stones in children and adults is another rationale.

Women in middle or late life who use antibiotics on a long-term basis have a higher risk for cardiovascular disease (CVD) events, new research in European Heart Journal suggests. Women 60 years or older who took antibiotics for 2 months or more had the greatest risk for CVD, but long-term use of antibiotics was also associated with increased cardiovascular risk if taken by women at midlife (40-59 years).

Anticholinergics
A JAMA Internal Medicine study confirms that exposure to several types of strong anticholinergic drugs is associated with an increased risk of dementia. These findings highlight the importance of reducing exposure to anticholinergic drugs in middle-aged and older people.

Antidepressants

Common antidepressants interact with the opioid pain medication tramadol to make it less effective for pain relief, according to a study from Pharmacotherapy . These findings have important implications for the opioid epidemic, suggesting that some patients suspected of drug-seeking may in fact be under-medicated and just are seeking more effective pain relief. They also could help explain why some people exceed the prescribed dose of tramadol, increasing their risk of addiction.

Antipsychotics

More evidence is linking use of antipsychotics to an increased mortality risk in patients with dementia. In a study of patients with dementia, those who received an antipsychotic drug had a 35% increased risk of mortality compared with their peers who did not receive this type of medication. The research was presented recently at the Congress of the European Academy of Neurology 2019.

Aspirin

According to a new study in JAMA Neurology, among people without symptomatic cardiovascular disease, use of low-dose aspirin was associated with an overall increased risk of intracranial hemorrhage, and heightened risk of intracerebral hemorrhage for those of Asian race/ethnicity or any ethnicity with a low body mass index.

Benzodiazepines

In a JAMA Psychiatry study of 442,066 pregnancies, an association between benzodiazepine exposure during early pregnancy and risk of spontaneous abortion was found for short and long-acting benzodiazepines and all specific benzodiazepine agents. Insomnia, anxiety, and mood disorders are prevalent during pregnancy, so you should carefully evaluate the risk/benefit ratio of taking benzodiazepines in early pregnancy since alternative nonpharmacologic treatments exist.

Cannabis

People who have recently used cannabis may be more likely to experience memory deficits or difficulties with cognitive function than those who don't use the drug, a recent study in Journal of Psychiatry and Neuroscience suggests. In the study, people who tested positive for THC scored worse on tests of so-called episodic memory and of mental processing speed. This is yet another example why one needs to screen for their genetic compatibility to cannabis with THC.

A new study in the Journal of the American Academy of Child and Adolescent Psychiatry reports that alterations in cognitive control, an ensemble of processes by which the mind governs, regulates and guides behaviors, impulses, and decision-making based on goals are directly affected by marijuana use in young persons. The researchers found greater and more persistent alterations in individuals who initiated cannabis use earlier, while the brain is still developing.

Dietary Supplements
Consumption of dietary supplements sold for weight loss, muscle building, and energy was associated with increased risk for severe medical events in children and young adults compared to consumption of vitamins, according to new research in Journal of Adolescent Health. The study found that, compared with vitamins, these types of supplements were linked to nearly three times as many severe medical outcomes in young people. These supplements have, and will continue to give the industry a bad name.

Fecal Transplants 
The FDA is alerting healthcare providers and patients that fecal microbiota for transplant (FMT) may transmit multidrug-resistant organisms, leading to serious or life-threatening infections. The FDA said two immunocompromised adults who received FMT developed invasive bacterial infections from the same fecal donor. The donor stool was not tested for ESBL-producing gram-negative organisms prior to use, which is customary protocol.

Hepatitis B

The U.S. Preventive Services Task Force recently gave an 'A' level recommendation to screening women for hepatitis B in their first trimester of pregnancy, according to a recent report in JAMA.

Iron

The FDA approved a new source of iron, oral ferric maltol (Accrufer), to treat iron deficiency in adults. It is 30 mg. per dose and contains the following horrific inactive ingredients: colloidal anhydrous silica, crospovidone (Type A), lactose monohydrate, magnesium stearate and sodium lauryl sulfate as inactive ingredients. In addition, the capsule shell contains FD&C Blue No. 1, FD&C Red No. 40, FD&C Yellow No.6, gelatin and titanium dioxide. The ink used for printing the marking contains ammonium hydroxide, ethanol, iron oxide black and propylene glycol. PLEASE AVOID!

Metformin