The Journal of clinical psychiatry
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To determine whether patient expectancy plays a role in observed placebo and nocebo effects in 2 clinical trials. ⋯ The possibility of receiving placebo following 12 weeks of open fluoxetine was associated with significant symptom worsening in 2 large fluoxetine discontinuation studies. Worsening depression scores following randomization were significantly associated with the degree of improvement participants experienced during weeks 1-3 of open treatment. These results suggest that treatment changes influence patients' expectations of improvement, which, in turn, affect their depressive symptoms.
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Three FDA-approved oral medications are available for the treatment of relapsing forms of multiple sclerosis: fingolimod, teriflunomide, and dimethyl fumarate. While injection and IV treatments have proven to be beneficial, these newer oral agents also offer positive outcomes for patients. ⋯ Despite possible side effects, oral agents provide convenience, ease of use, and the elimination of injection/IV administration-site pain. To ensure MS patients receive the most appropriate individualized care, clinicians should present all of the available treatment options to both newly diagnosed and established patients.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of adjunctive armodafinil in adults with major depressive episodes associated with bipolar I disorder: a randomized, double-blind, placebo-controlled, multicenter trial.
To examine the efficacy and safety of adjunctive armodafinil for major depressive episodes associated with bipolar I disorder. ⋯ Adjunctive armodafinil 150 mg significantly improved symptoms of major depressive episodes associated with bipolar I disorder versus placebo and was generally well tolerated.
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The authors reviewed the published literature on the acute and long-term neurobehavioral effects on infants and children of either in utero exposure to maternal depression or in utero exposure to antidepressants. ⋯ In utero exposure to either maternal depression or antidepressants carries risks to the developing fetus. Treatment decisions regarding whether and how to treat depression during pregnancy must be made on an individual basis, with careful consideration of the impact of these decisions on both mother and infant.