Doxacurium (Nuromax - Burroughs Wellcome), a new, long-acting, nondepolarizing neuromuscular blocking agent, is now available in the USA for use as a skeletal muscle relaxant during general anesthesia and for endotracheal intubation. Although small decreases in heart rate and mean arterial pressure occur in some patients who receive doxacurium, clinical studies have found no adverse cardiovascular effects in patients with heart disease receiving up to three times the usual effective dose (CM Stoops et al, Anesthesiology, 69:365, 1988; DJ Murray et al, Anesthesiology, 69:472, 1988; RS...

The FDA has approved ezogabine (ee-ZOE-ga-been; Potiga – GSK/Valeant) for oral adjunctive treatment of partial-onset seizures in adults. Ezogabine is available in Europe as retigabine (Trobalt).

Felbamate (Felbatol - Wallace Laboratories), a phenyl dicarbamate structurally similar to meprobamate (Equanil, and others), was recently approved by the US Food and Drug Administration for use alone or with other drugs in adults with partial seizures with or without secondary generalization. It was also approved for use in addition to other drugs in children with the multiple types of seizures associated with the Lennox-Gastaut syndrome, a severe epileptic encephalopathy.

Paroxetine (Paxil - SmithKline Beecham), a new selective serotonin reuptake inhibitor (SSRI), is now available in the USA. Two other SSRIs, fluoxetine (Prozac - Medical Letter, 30:45, 1988; 32:83, 1990) and sertraline (Zoloft - Medical Letter, 34:47, 1992), were approved previously.

The Norplant System (Wyeth-Ayerst) for subdermal delivery of the synthetic progestin levonorgestrel was recently approved by the US Food and Drug Administration for use as a long-term contraceptive.

Bromfenac sodium (Duract - Wyeth-Ayerst), a nonsteroidal anti-inflammatory drug (NSAID), has been approved by the US Food and Drug Administration (FDA) and is being heavily advertised as an alternative to narcotics for short-term treatment of pain.

Although lithium (Eskalith, and others) is the standard treatment for bipolar (manic-depressive) disorder, 20% to 40% of patients do not respond adequately or cannot tolerate its adverse effects (Medical Letter, 33:43, 1991). Results of recent studies suggest that valproate (Depakene - valproic acid; Depakote - divalproex sodium), a widely used anticonvulsant (Medical Letter, 31:1, 1989), might be an effective alternative. Other anticonvulsants, particularly carbamazepine (Tegretol, and others), have also been used as second-line drugs for treatment of mania and other psychiatric ...

Patients may be asking their physicians about use of histamine H2-receptor antagonists for treatment and prevention of heartburn. Cimetidine and famotidine have recently been released for over-the-counter sale and are being heavily advertised on television and in the print media.

Quetiapine (Seroquel - Zeneca), a dibenzothiazepine derivative, has been approved by the FDA for treatment of schizophrenia and other psychotic disorders. It is a new addition to the 'atypical' antipsychotics, which include olanzapine (Zyprexa - Medical Letter, 39:5, 1997), risperidone (Risperdal) and clozapine (Clozaril). Atypical antipsychotic drugs generally are less likely to cause extrapyramidal symptoms than older drugs such as haloperidol (Haldol, and others) or the phenothiazines.

The FDA has approved lacosamide (Vimpat - UCB Pharma) for oral or intravenous (IV) use as add-on therapy in adults with partial-onset seizures.