Prognosis
A lifelong condition with periods of partial or full recovery in between recurrent episodes of relapse, bipolar disorder is considered to be a major health problem worldwide because of the increased rates of disability and premature mortality. It is also associated with co-occurring psychiatric and medical problems, higher rates of death from natural causes (e.g., cardiovascular disease), and high rates of initial under- or misdiagnosis, causing a delay in appropriate treatment and contributing to poorer prognoses. When compared to the general population, people with bipolar disorder also have higher rates of other serious medical comorbidities including diabetes mellitus, respiratory diseases, HIV, and Hepatitis C virus infection. After a diagnosis is made, it remains difficult to achieve complete remission of all symptoms with the currently available psychiatric medications and symptoms often become progressively more severe over time.Compliance with medications is one of the most significant factors that can decrease the rate and severity of relapse and have a positive impact on overall prognosis. However, the types of medications used in treating BD commonly cause side effects and more than 75% of individuals with BD inconsistently take their medications for various reasons. Of the various types of the disorder, rapid cycling (four or more episodes in one year) is associated with the worst prognosis due to higher rates of self-harm and suicide. Individuals diagnosed with bipolar who have a family history of bipolar disorder are at a greater risk for more frequent manic/hypomanic episodes.
Its unclear how the plant first arrived in Paris and the details of its origins in Madagascar beyond reports of its transport from Madagascar by early European explorers. Vincristine was initially distributed at cost to increase accessibility, though later switched to a for-profit model to recover the costs of production and development. According to Michael Brown, vincristine may not be a tidy example of pharmaceutical bioprospecting, but it demonstrates how pharmaceuticals with a history of use in folk medicine have intellectual property claims which are difficult to untangle.Since ethnobotanical studies and pharmaceutical bioprospecting depend on traditional knowledge from indigenous communities, the process of sourcing botanical and biological knowledge raises issues of the proper representation of the indigenous and local knowledge. Vincristine and confusion with other drugs in administration
Vincristine has been involved in a number of medical errors. If given into the spine (intrathecal) it causes paralysis and usually death. Multiple instances of it being given wrongly, having been confused with other drugs, have occurred. Research
In 2012, the FDA approved a liposomal formulation of vincristine branded as Marqibo. Marqibo was voluntarily withdrawn from the US market in November, 2021.A nano-particle bound version of vincristine was under development as of 2014. References
External links
"Vincristine". Drug Information Portal. U.S. National Library of Medicine. Vincristine and vinblastine
Description and Natural History of the Periwinkle
The Boger Route to (−)-Vindoline