From HealthDay News:

A significant percentage of small children going to emergency rooms with an "apparent life-threatening event" had ingested over-the-counter cold and cough medicines, researchers report, despite recent U.S. recommendations that these products not be used in children under 2.

Such medicines can cause apnea (cessation of breathing) in young children, noted Dr. Raymond Pitetti, lead author of a study published in the August issue of Pediatrics and associate medical director of the emergency department at Children's Hospital, Pittsburgh.

In January, the U.S. Food and Drug Administration issued a health advisory recommending that over-the-counter (OTC) cough and cold preparations not be used to treat children under the age of 2 due to the possibility of life-threatening complications. Such products include decongestants, expectorants, antihistamines, and cough suppressants.

And earlier this year, the U.S. Centers for Disease Control and Prevention reported that some 7,000 American children under the age of 11 are treated each year in hospital emergency rooms because of problems with cough and cold medications. Most of the cases were due to "unsupervised ingestion," the authors stated.

Pitetti recommended that comprehensive toxicology screens become part of routine evaluations for children presenting with apparent life-threatening events (ALTEs) at emergency rooms.

But while such drug screens could be "helpful," said Dr. G. Randall Bond, medical director of the Cincinnati Drug and Poison Information Center at Cincinnati Children's Hospital. "There are too many unknowns [in this study] to make conclusions about the relationship [between cough and cold medicine and ALTEs]."

From the Bangkok Post (Thailand):

An anti-depressant drug, proved to be effective in tackling smoking addiction, will be offered under the universal healthcare scheme to encourage long-term smokers to quit the habit.

Prateep Tanakitcharoen, deputy secretary-general of the National Health Security Office, said Nortriptyline would be added to the national drug list to help reduce the cost of treating smoking-related illnesses. It will be offered to patients under the scheme to help them quit smoking.

Katha Bunditananukul, president of Thai Pharmacy Network for Tobacco Control, said Nortriptyline had more side-effects than newer drugs, including dry mouth and throat, and headaches. However, the newer ones were also more expensive.

Tests over 20 years had shown that the drug could help tackle long-term smoking addiction.

Many domestic and international studies show a strong link between depression and smoking.

He believed making Nortriptyline - a second generation tricyclic anti-depressant marketed under the trade names Sensoval, Aventyl, Pamelor, Allegron and Nortrilen - available under the universal healthcare scheme would strengthen tobacco control efforts.

From Newswise:

It’s a Catch-22 of the highest order. People with alcohol problems often use alcohol to get to sleep -- but it actually keeps them from getting good-quality sleep all night long.

At the same time, they’re highly likely to suffer from full-blown chronic insomnia that keeps them from getting enough sleep night after night – and that condition has been shown to cut their chances of getting sober again.

Meanwhile, their doctors aren’t likely to prescribe them insomnia medications, because most sleeping pills can be habit-forming or have adverse effects due to an alcohol-damaged liver.

Now, a small new pilot study from a team of University of Michigan alcoholism and sleep researchers offers some sign of a possible way out of this conundrum.

The study, published in the August issue of the journal Alcoholism: Clinical and Experimental Research, suggests that the drug gabapentin might be able to reduce insomnia in recovering alcoholics, and help them stay away from alcohol more successfully. The drug, often used to treat epilepsy and chronic pain, is not habit-forming and is not processed by the liver.

Although the study involved only 21 insomniacs in recovery from alcohol dependence, and did not provide long-term gabapentin treatment or long-term follow-up on their sleep or their alcohol recovery, it was randomized, placebo-controlled, and double-blinded. In all, 30 percent of the patients who received gabapentin during alcohol recovery relapsed to drinking, compared with 80 percent of those who received a placebo.

Based on the results, the researchers have already launched additional studies of the potential role of gabapentin in alcohol recovery and sleep.

“We showed that the patients who got the real drug, rather than placebo, were less likely to relapse to drinking -- or if they relapsed it was later,” says lead author Kirk Brower, M.D., FASAM, the executive director of U-M Addiction Treatment Services and a professor of psychiatry at the U-M Medical School. “In other words, gabapentin prevented and delayed relapse. Meanwhile, patients reported sleeping better in both the treatment and placebo groups, which may be due to the gabapentin in the first group and the resumption of drinking in the other.”

Co-author Flavia Consens, M.D., an associate professor of neurology and member of the U-M Sleep Disorders Center, is cautiously optimistic that the new findings could open the door to better understanding of how to handle sleep problems in people who are trying to recover from their dependence on alcohol. As many as 70 percent of people with alcohol problems suffer insomnia, she says, while others cope with other sleep disturbances including breathing problems known as sleep apnea.

“There may be some underlying chemical changes in the brain that prompt alcoholics to report more insomnia as a co-existing condition than non-alcoholics,” she says. “A possible explanation of these new findings is that the gabapentin might decrease the insomnia initially, and the patient may not need or crave alcohol as a treatment for the insomnia. We’re also looking into other factors that may have an effect on the neurochemistry of the brain, and see how they could impact recovery and sleep.”

The researchers caution that they did not observe differences in brain wave data collected during sleep studies conducted before and after patients received gabapentin. Neither did the drug appear to have a greater benefit for insomnia than placebo during the first 6 weeks of receiving study medication. Six weeks after stopping medication, however, those who had taken gabapentin reported worse insomina than those on placebo. Insomnia was measured using standardized questionnaires for a total of 12 weeks

Brower notes that the medication dose and schedule used in the study may have contributed to the relatively weak effect on sleep that was seen from gabapentin. Patients took one dose each evening, rather than the three doses throughout the day that are routinely given for epilepsy or pain.

“These results raise more questions for us to explore, including the potential impact of gabapentin on people who are in recovery from alcohol dependence but do not report insomnia,” he says.