Journal of clinical psychopharmacology
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J Clin Psychopharmacol · Aug 2007
Randomized Controlled TrialA 12-week double-blind, placebo-controlled study of bupropion sr added to high-dose dual nicotine replacement therapy for smoking cessation or reduction in schizophrenia.
The objective of this study was to examine whether there is a benefit of adding bupropion SR to high-dose combination nicotine replacement therapy (NRT) and weekly group cognitive behavioral therapy (CBT) for smoking reduction or cessation in schizophrenia. Fifty-one adult smokers with schizophrenia were randomly assigned to a 12-week trial of bupropion SR 300 mg/d or placebo added to transdermal nicotine patch, nicotine polacrilex gum, and CBT. The treatment goal was smoking cessation. ⋯ However, relapse rates in subjects on bupropion + dual NRT were 31% during NRT taper (weeks 8-12) and 77% at the 12-month follow-up. Abstinence rates did not differ by treatment group at weeks 12 (36% vs. 19%), 24 (20% vs. 8%), or 52 (12% vs. 8%). Because abstinence rates were high during treatment with combination pharmacotherapy and relapse rates were very high during taper and after discontinuation of treatment, study of longer term treatment with combination pharmacotherapy and CBT for sustained abstinence is warranted in those who attain initial abstinence with this intervention.
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J Clin Psychopharmacol · Jun 2007
Selective serotonin reuptake inhibitors and risk of acute pancreatitis: a population-based case-control study.
To examine whether use of selective serotonin reuptake inhibitors (SSRIs) is associated with acute pancreatitis, a population-based case-control study was conducted in the counties of North Jutland (data 1991-2003), Aarhus (data 1996-2003), and Viborg (data 1998-2003), Denmark. Through hospital discharge registries, we identified all patients with an incident hospitalization of acute pancreatitis. From the Civil Registration System, we selected 10 sex- and age-matched population controls per case using risk set sampling. ⋯ We found use of SSRIs to be associated with increased risk for acute pancreatitis. However, the estimate did not differ between present or former users of SSRI and was not materially different from the estimate in users of other antidepressant drugs. Therefore, our data suggest that the increased risk is related to confounding by lifestyle factors or the underlying depression.
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J Clin Psychopharmacol · Apr 2007
Randomized Controlled TrialEfficacy of noradrenergic and serotonergic antidepressants in chronic back pain: a preliminary concentration-controlled trial.
Although antidepressants are widely prescribed as analgesics in chronic back pain, their clinical pharmacology is not well established. Norepinephrine transporter blockade seems to be essential for analgesia, but optimal concentrations are unknown. Fixed-dose studies of serotonin reuptake inhibitors are generally negative, but such studies cannot be interpreted clearly because efficacy might be detected if concentration-response relationships were known. We evaluated (1) the feasibility of conducting a controlled-concentration study of a norepinephrine (desipramine) and a serotonin reuptake (fluoxetine) inhibitor and (2) the relationship between achieved concentrations and analgesic response. ⋯ Preliminary evidence for a low-concentration "therapeutic window" for noradrenergic analgesia may warrant additional study.