Paroxetine in the Treatment of Dysthymic Disorder Without Co-Morbidities: A Double-Blind, Placebo-Controlled, Flexible-Dose Study.

Paroxetine in the treatment of dysthymic disorder without co-morbidities: A double-blind, placebo-controlled, flexible-dose study.

Asian J Psychiatr. 2013 Apr; 6(2): 157-61
Ravindran AV, Cameron C, Bhatla R, Ravindran LN, da Silva TL

Few published studies have evaluated selective serotonin reuptake inhibitors in dysthymia without current co-morbid major depression. In this 12-week study, 40 dysthymic patients were randomly assigned to either placebo (n=19) or 20-40mg/day of paroxetine (n=21). At endpoint, the paroxetine group showed significantly greater improvement on the Clinical Global Impression Scale, Beck Depression Inventory, and Quality of Life Enjoyment and Satisfaction Questionnaire (p<0.05), and a trend to superiority over placebo on the Hamilton Depression Rating Scale. Response and remission were significantly higher with paroxetine than placebo (p<0.05). There were no significant differences in drop out rates or frequency of adverse effects, except for excessive sweating (greater with paroxetine, p=0.04). Reporting of multiple side effects was also higher with paroxetine than with placebo (p=0.02). Paroxetine is more effective than placebo in improving symptoms and quality of life in dysthymia, and is generally tolerable. HubMed – addiction


Misleading UK alcohol industry criticism of Canadian research on minimum pricing.

Addiction. 2013 Mar 7;
Stockwell T, Zhao J, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, Buxton J

We would like to respond to criticism of our research by the UK Wine and Spirit Trade Association (1), a UK alcohol industry trade magazine (2) and the Scotch Whisky Association (3). Our study, recently published in Addiction (4), reported a significant negative association between minimum alcohol prices and rates of wholly alcohol caused deaths. We are accused of misleading the public by reporting false estimates of the effects of minimum price changes on rates of death “hypothetically” estimated to be caused by alcohol and not “real deaths” such as those we report on our own website (5,6,7). We are also charged with publishing results which contradict official trends in alcohol-related deaths in British Columbia, the Canadian province on which our research has focused. Finally, it is claimed that minimum pricing in Canada bears no relation to what is being proposed for the United Kingdom. HubMed – addiction


Chronic back pain with possible prescription opioid misuse.

JAMA. 2013 Mar 6; 309(9): 919-25
Alford DP

Data on the effectiveness and safety of long-term opioid therapy for chronic pain are limited. Opioid adherence monitoring includes urine drug testing. Determining whether a patient’s opioid prescription should be discontinued after an unexpected urine test result can be clinically complex.To review safe opioid prescribing practices and appropriate interpretation and management of unexpected urine drug test results.Systematic reviews of the effectiveness and safety of long-term opioid therapy for chronic noncancer pain. Clinical management recommendations are derived from clinical guidelines generated by several professional medical organizations including the American Pain Society, the American Academy of Pain Medicine, and the Federation of State Medical Boards.Informed consent and patient-prescriber agreements are important strategies to ensure that patients understand treatment goals and potential opioid risks. Monitoring for benefit and opioid misuse is accomplished by having frequent face-to-face assessments, performing urine drug tests, monitoring pill counts, and reviewing prescription drug monitoring program data, when available.The underlying causes for worrisome behaviors such as urine drug test results that are negative for the prescribed opioid should be fully investigated. Subsequent opioid prescriptions should be based on the revised risk and benefit assessment. HubMed – addiction