Journal of clinical psychopharmacology
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J Clin Psychopharmacol · Oct 2006
Comparative StudyModification of behavior with 50% nitrous oxide/oxygen conscious sedation over repeated visits for dental treatment a 3-year prospective study.
In various medical domains, inhalation of nitrous oxide (N2O) in oxygen (O2) is indicated to alleviate pain and anxiety during routine treatment. Repeat treatment may often be indicated. Little data are available, however, to evaluate the long-term efficacy and side effects of reiterated N2O/O2 sedation. ⋯ Patient cooperation significantly improved during visits at first contact with the dentist and when applying the mask (P < 0.0001, between sessions 1 and 2). Between the first and the third sessions, the percentage of very uncooperative patients decreased from 23% to 3.7% at first contact with the dentist and from 22.3% to 8.5% on application of the mask. Experience of reiterated dental treatment under sedation with 50% N2O/O2 premix helps uncooperative patients to cope with dental treatment in the long term.
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J Clin Psychopharmacol · Jun 2006
Randomized Controlled TrialInteractions on mixing diazepam with methadone or buprenorphine in maintenance patients.
Benzodiazepine use by patients in methadone and buprenorphine substitution treatment is common, despite safety concerns regarding these drug interactions. The relative safety of diazepam use by methadone- or buprenorphine-treated patients has not been systematically examined. This study aimed to examine the effect of single diazepam doses, within normal therapeutic range (doses: 0, 10, and 20 mg), upon physiological, subjective, and performance measures in stable methadone and buprenorphine-treated patients. ⋯ The 10- and 20-mg diazepam doses resulted in comparable subjective experiences of greater sedation and strength of drug effects in both patient groups, and had minimal impact on physiological parameters. However, diazepam had greater peak effects on performance measures (simple reaction time, digit symbol substitution task, and cancellation time) in methadone-treated than in buprenorphine-treated patients. Diazepam may significantly alter the response to opioid substitution treatment with methadone or buprenorphine.
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J Clin Psychopharmacol · Jun 2006
Randomized Controlled Trial Multicenter Study Comparative StudyVenlafaxine extended release in posttraumatic stress disorder: a sertraline- and placebo-controlled study.
This 12-week, double-blind, multicenter trial evaluated the efficacy of venlafaxine extended release (ER), sertraline, and placebo in adult outpatients (N = 538) with a primary diagnosis of posttraumatic stress disorder (PTSD), as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, symptoms for 6 months or more and 17-item Clinician-administered PTSD Scale (CAPS-SX17) score of 60 or more. Patients were randomly assigned to receive placebo or flexible doses of venlafaxine ER (37.5-300 mg/d) or sertraline (25-200 mg/d) for 12 weeks or less. The primary outcome was the baseline-to-end point change in total CAPS-SX17 score (last observation carried forward). ⋯ Mean maximum daily doses were 225-mg venlafaxine ER and 151-mg sertraline. Both treatments were generally well tolerated. Study results suggest that venlafaxine ER is effective and well tolerated in the short-term treatment of PTSD.
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J Clin Psychopharmacol · Apr 2006
Risk factors for extrapyramidal symptoms during treatment with selective serotonin reuptake inhibitors, including cytochrome P-450 enzyme, and serotonin and dopamine transporter and receptor polymorphisms.
Extrapyramidal symptoms (EPS) are rare adverse drug reactions to selective serotonin reuptake inhibitors (SSRIs). This study aimed to investigate the potential risk factors for EPS associated with SSRIs including polymorphisms of cytochrome P-450 isoenzymes, and serotonin and dopamine transporters and receptors. ⋯ The risk of EPS with SSRIs seems to increase with advanced age and with the presence of the A1 allele of DRD2 Taq1A polymorphism. Because of the small sample size of our study and the use of historical controls rather than patients who did not experience EPS during SSRIs treatment, the DRD2 finding is preliminary and needs to be replicated in other studies before firm conclusions can be drawn. At least 1 additional potential risk factor was found in almost all cases.