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Marcantonio

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cited other factors that argued against stopping statins. The researchers reported that the

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incidence of delirium was 1 out of every 90 patients, but it was 30 percent more likely to occur in those taking statins before surgery. "It's quite striking how some people are

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unable to recognize family members and don't know where they are," Redelmeier said. Redelmeier, professor of medicine at the University of Toronto. Measures of depression were found to

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improve significantly, including suicidal ideation and most of the DSM-III-R symptoms of major overdose sleeping pills death depression. There was a small but significant improvement on the Children's Global Assessment Scale between baseline

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and week 12, but the Family Global Assessment Scale sho no significant change; neither global assessment scale sho significant effects between weeks 1 and 12. The sample included 7 adolescents with nonendogenous depression and 6 with endogenous depression, as diagnosed by both Research Diagnostic Criteria (RDC) and Kiddie-SADS-P DSM-III-R endogenous subtype criteria.

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prescription sleeping pills list People who are taking cholesterol-lowering statin drugs -- which include Crestor, Lipitor, Pravachol and Zocor -- are more likely to suffer delirium after surgery, a Canadian study indicates. "It is sometimes prolonged and severe."

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His team published its findings in the issue of the Canadian Medical Association Journal. "Certainly, such a study is doable, perhaps within a couple of years.". Statins might increase the risk of delirium by shunting blood away from the brain to the heart, the

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report proposed. These statistics

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are almost certainly too low, however, because "there is no question that delirium is often overlooked by the surgeon or family members or even the patient himself," Redelmeier said. "Before making a change in clinical management, I usually like to see stronger

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evidence in doing so," he said. Sertraline HCL ( Zoloft )(mean 110 mg or 1.96 mg/kg daily) significantly decreased scores on the 24-item Cale Depression Rating Scale and Montgomery-Asberg Depression Rating Scale from premedication baseline to treatment week 12, and also between weeks 1 (after a large week 1 improvement, presumably due to nondrug effects) and 12.

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Delirium is a com and commonly neglected, experience for older people after any sort of surgery, according to study lead Donald A. "It is plausible, but

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there are no biological data to support it," said one expert, Dr. "It is an expanding area of research -- ongoing studies of delirium where data may be available to do this sort of evaluation," he said. His estimate is that delirium occurs after about 10 percent of all surgical procedures, and that the incidence is 13 percent among people taking statins.

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Delirium has been underreported in the past because of reliance on reviews of medical records "or even abstraction into databases," he said. An open study of the effects of Sertraline HCL ( Zoloft )on adolescent major depression.This open study investigated the effects of Sertraline HCL ( Zoloft )in treating 13 adolescents, ages 12 to 18, who were hospitalized for treatment of a major depressive episode. The study included more than 284,000 people, 65 years of age and older, who had surgery in Ontario hospitals. Adverse effects, mainly insomnia and drowsiness, were relatively com but usually manageable. "They may have cardiovascular benefits above and beyond their lipid-lowering effects." And, Marcantonio said, "There is always the risk of the drug never getting

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restarted." Redelmeier has no such doubts. Marcantonio, associate professor of medicine at Harvard Medical School and the Marcantonio was also cautious about stopping statin therapy before surgery. These patients were follo for an inpatient length of stay ranging from 9 to 38 days (mean 19 days), with later outpatient follow-up for a total of 12 weeks. Redelmeier said he looked for a possible arty between

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statins and post-op delirium, because "all clinical trials of statins focus on otherwise healthy outpatients under normal circumstances. "One of the real advances has been development of interview tools to enable assessment of delirium in a reliable way." Marcantonio has done such studies himself. This open-label prospective study suggests that Sertraline HCL ( Zoloft )might be useful in

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treating adolescents with major depression. Sleep disturbance was com (69%) after 12 weeks of treatment, but clinically significant improvements in sleep patterns were also observed. One patient developed mania after 8 days of Sertraline HCL ( Zoloft )treatment at a dose of 100 mg daily.

"I take the position that a brief interruption, for one or two days prior to surgery, is extremely simple, and if desired, you could restart the statin right there in the recovery room after surgery, so you get protection without any interaction with anesthetics," he reasoned. Whereas, from my work in hospitals, I have found that medications that are safe under normal circumstances might not be safe at the time of surgery." Blood-thinning medications such as Coumadin, as well as sleeping pills, are other examples of drugs that raise delirium risks, he said. "We certainly don't know the effect of taking patients off these drugs on outcomes other than delirium, such as cardiovascular conditions," he said. More study is needed to settle the issue, Marcantonio said, and such a study would use better tools than those in the new report. An internist, he does not do surgery himself but is often called in for consultation by surgeons.