The Journal of clinical psychiatry
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomized, double-blind, fixed-dose comparison of paroxetine and placebo in the treatment of generalized social anxiety disorder.
This multicenter, double-blind, placebo-controlled study was carried out to determine the effectiveness and safety of various daily dosages of paroxetine for the treatment of generalized social anxiety disorder. ⋯ Paroxetine, 20 mg/day, is an effective and safe treatment for patients with generalized social anxiety disorder and significantly improves social anxiety, avoidance of social interactions, social disability, and overall clinical condition. Further data analyses are needed to determine whether more specific guidelines for paroxetine dosage escalation in social anxiety disorder can be drawn.
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Women often seek clinical consultation for antidepressant use both prior to conception and during pregnancy. Some women experience a new onset of symptoms during pregnancy, while those with a history of depressive symptoms are at increased risk. ⋯ This review discusses risk factors for depression during pregnancy and the consequences of untreated depression. Nonpharmacologic and pharmacologic treatment options are reviewed, and guidelines for treating depression during pregnancy are presented.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative efficacy of SSRIs and amisulpride in burning mouth syndrome: a single-blind study.
Although a significant amount of evidence indicates the efficacy of some antidepressants in treating psychogenic pain and somatoform disorder, very few studies have investigated their possible therapeutic action in burning mouth syndrome (BMS). The purpose of this 8-week, single-blind study was to provide preliminary data on the efficacy and tolerability of amisulpride and the selective serotonin reuptake inhibitors (SSRIs) paroxetine and sertraline for patients with BMS. ⋯ The data suggest that amisulpride and SSRIs may be effective treatments for BMS; they are equally effective and equally well tolerated in the short-term treatment of BMS. Amisulpride is associated with better compliance within the first week of treatment and with a shorter response latency in comparison with SSRIs. This finding may indicate that amisulpride is especially useful at the beginning of drug therapy of BMS. Double-blind, placebo-controlled trials are needed to further document the efficacy of amisulpride and SSRIs in the treatment of BMS.
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This article reviews cardiac electrophysiology, with a focus on the assessment of the electrocardiographically determined corrected QT (QTc) interval and its role as a marker for potentially life-threatening cardiac arrhythmias such as torsades de pointes. Presently, using the QTc interval as a surrogate for polymorphic ventricular tachycardia is handicapped, in part, by the limitations of currently available group-derived formulas to estimate the QTc interval. ⋯ Until this refinement arrives, clinicians are advised to exercise caution when administering antipsychotic drugs with the potential to significantly prolong the QT interval. Caution is particularly urged in patients with cardiovascular disease or risk factors for cardiovascular disease.
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This article reviews the drug development process in the United States, focusing on practical issues and new U. S. ⋯ Atomoxetine, a novel treatment for attention-deficit/ hyperactivity disorder (ADHD), is used to illustrate how the modern drug development process works and to highlight changes in the development of ADHD treatments since the introduction of the stimulants over 50 years ago. In addition to dealing with unique regulatory requirements and guidance, developing a drug for use in a pediatric population poses novel challenges in diverse areas including biomedical ethics, developmental pharmacology, and clinical trial design and implementation.