The Annals of pharmacotherapy
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To report a case of tremors and agitation associated with the administration of low doses of intravenous hydromorphone in a patient with acute kidney injury in the setting of chronic kidney disease. ⋯ Neurotoxicity can occur in patients with kidney dysfunction while they receive low doses of intravenous hydromorphone over short periods. Diligent monitoring and reporting of such effects are necessary to better understand risk factors and a mechanism.
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Randomized Controlled Trial Comparative Study
Gabapentin versus chlordiazepoxide for outpatient alcohol detoxification treatment.
Benzodiazepines are used to treat alcohol withdrawal (AW) but cause cognitive impairment, sedation, and ataxia, and interact with alcohol. Nonbenzodiazepine anticonvulsants are promising and possibly safer alternatives for the treatment of AW. ⋯ In ambulatory veterans with symptoms of alcohol withdrawal, gabapentin treatment resulted in significantly greater reduction in sedation (ESS) and a trend to reduced alcohol craving (PACS) by the end of treatment compared to chlordiazepoxide treatment. Although limited by the small sample size, the suggestion of reduction in sleepiness and less craving warrants replication of the study with a larger sample.
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Randomized Controlled Trial
Efficacy and safety of mirtazapine in fibromyalgia syndrome patients: a randomized placebo-controlled pilot study.
Data from an open-label trial suggest that mirtazapine might prove useful in treatment of fibromyalgia syndrome (FMS). ⋯ Patients with FMS taking mirtazapine exhibited within-group significant improvement in most of the measured outcomes. Between-group analysis was predictably compromised by the small sample size. Mirtazapine was well tolerated. Further study with a larger sample size is likely to be useful.
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To evaluate the evidence for lorcaserin and phentermine/topiramate in the treatment of obesity. ⋯ With lifestyle modification, phentermine/topiramate appears most effective in terms of weight loss. Lorcaserin demonstrates moderate efficacy. Long-term cardiovascular outcomes studies are needed to confirm the safety and benefit of these new obesity agents.
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Industry-sponsored ghost- and guest-authored clinical research publications are a continuing problem in medical journals. These communications are written by unacknowledged medical communication companies and submitted to peer-reviewed journals by academicians who may not have participated in the writing process. ⋯ Since peer-reviewed data are used to develop health care paradigms, misleading information can have catastrophic effects. A failure to curb ghost and guest authorship will result in an erosion of trust in the peer-review system, academic research, and health care paradigms.