DOCSLIB.ORG

Resistant Depression: Effectiveness and Value

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Resistant Depression: Effectiveness and Value Esketamine for the Treatment of Treatment- Resistant Depression: Effectiveness and Value Draft Evidence Report March 21, 2019 Prepared for ©Institute for Clinical and Economic Review, 2019 The University of Illinois at Chicago College of ICER Staff and Consultants Pharmacy’s Center for Pharmacoepidemiology and Pharmacoeconomic Research* Steven J. Atlas, MD, MPH Daniel R. Touchette, PharmD, MA Associate Professor of Medicine Professor of Pharmacy Harvard Medical School, Boston Assistant Director, Center for Pharmacoepidemiology Director, Practice Based Research & Quality and Pharmacoeconomic Research Improvement University of Illinois at Chicago Division of General Internal Medicine Massachusetts General Hospital, Boston Nicole Boyer, PhD Research Fellow Foluso Agboola, MBBS, MPH University of Chicago Director, Evidence Synthesis Institute for Clinical and Economic Review Brian Talon, PharmD PhD Student University of Illinois at Chicago Katherine Fazioli Senior Research Assistant Bob G. Schultz, PharmD Institute for Clinical and Economic Review PhD Student and Research Fellow University of Illinois at Chicago Varun Kumar, MBBS, MPH, MSc Associate Director of Health Economics Institute for Clinical and Economic Review Ellie Adair, MPA Program Manager Institute for Clinical and Economic Review David Rind, MD Chief Medical Officer Institute for Clinical and Economic Review *The role of the University of Illinois at Chicago College of Pharmacy’s Center for Pharmacoepidemiology and Pharmacoeconomic Research is limited to the development of the Steve Pearson, MD, MSc cost-effectiveness model, and the resulting ICER reports do not President necessarily represent the views of the UIC. Institute for Clinical and Economic Review Date of Publication: March 21, 2019 Steve Atlas served as the lead author for the report. Foluso Agboola led the systematic review and authorship of the comparative clinical effectiveness section in collaboration with Katherine Fazioli and Noemi Fluetsch. Varun Kumar was responsible for oversight of the cost-effectiveness analyses and developed the budget impact model. Noemi Fluetsch and Madeline O’Grady coauthored the section on coverage policies. David Rind and Steve Pearson provided methodologic guidance on the clinical and economic evaluations. The role of the UIC modeling group is limited to the development of the cost-effectiveness model, and the resulting ICER reports do not necessarily represent the views of UIC. None of the authors above disclosed any conflicts of interest. ©Institute for Clinical and Economic Review, 2019 Page ii Draft Report – Esketamine for Treatment-Resistant Depression Return to Table of Contents About ICER The Institute for Clinical and Economic Review (ICER) is an independent non-profit research organization that evaluates medical evidence and convenes public deliberative bodies to help stakeholders interpret and apply evidence to improve patient outcomes and control costs. Through all its work, ICER seeks to help create a future in which collaborative efforts to move evidence into action provide the foundation for a more effective, efficient, and just health care system. More information about ICER is available at http://www.icer-review.org. The funding for this report comes from government grants and non-profit foundations, with the largest single funder being the Laura and John Arnold Foundation. No funding for this work comes from health insurers, pharmacy benefit managers, or life science companies. ICER receives approximately 19% of its overall revenue from these health industry organizations to run a separate Policy Summit program, with funding approximately equally split between insurers/PBMs and life science companies. Janssen is the only life science company relevant to this review that participates in this program. For a complete list of funders and for more information on ICER's support, please visit http://www.icer-review.org/about/support/. About Midwest CEPAC The Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC) – a core program of ICER – provides a public venue in which the evidence on the effectiveness and value of health care services can be discussed with the input of all stakeholders. Midwest CEPAC seeks to help patients, clinicians, insurers, and policymakers interpret and use evidence to improve the quality and value of health care. The Midwest CEPAC is an independent committee of medical evidence experts from across the Midwest, with a mix of practicing clinicians, methodologists, and leaders in patient engagement and advocacy. All Council members meet strict conflict of interest guidelines and are convened to discuss the evidence summarized in ICER reports and vote on the comparative clinical effectiveness and value of medical interventions. More information about Midwest CEPAC is available at https://icer-review.org/programs/midwest-cepac/. The findings contained within this report are current as of the date of publication. Readers should be aware that new evidence may emerge following the publication of this report that could potentially influence the results. ICER may revisit its analyses in a formal update to this report in the future. ©Institute for Clinical and Economic Review, 2019 Page iii Draft Report – Esketamine for Treatment-Resistant Depression Return to Table of Contents In the development of this report, ICER’s researchers consulted with several clinical experts, patients, manufacturers and other stakeholders. The following clinical experts provided input that helped guide the ICER team as we shaped our scope and report. None of these individuals is responsible for the final contents of this report or should be assumed to support any part of this report, which is solely the work of the ICER team and its affiliated researchers. For a complete list of stakeholders from whom we requested input, please visit: https://icer-review.org/material/trd-stakeholder-list/ Expert Reviewers Cristina Cusin, MD Assistant Professor in Psychiatry Massachusetts General Hospital Dr. Cusin served as site PI for an esketamine trial sponsored by Janssen. Phyllis Foxworth Vice President of Advocacy Depression and Bipolar Support Alliance No relevant conflicts of interest to disclose, defined as more than $10,000 in health care company stock or more than $5,000 in honoraria or consultancies during the previous year from health care manufacturers or insurers. William S. Gilmer, MD Clinical Professor of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Dr. Gilmer has received consulting and speaker fee honorarium from Sunovion and Otsuka and owns equity in Organovo, Jounce, and Gilead Sciences. ©Institute for Clinical and Economic Review, 2019 Page iv Draft Report – Esketamine for Treatment-Resistant Depression Table of Contents 1. Introduction ....................................................................................................................................... 8 1.1 Background .................................................................................................................................. 8 1.2 Scope of the Assessment ........................................................................................................... 10 1.3 Definitions .................................................................................................................................. 14 1.4 Insights Gained from Discussions with Patients and Patient Groups ........................................ 15 1.5 Potential Cost-Saving Measures in TRD ..................................................................................... 17 2. Summary of Coverage Policies and Clinical Guidelines ................................................................... 18 2.1 Coverage Policies ....................................................................................................................... 18 2.2 Clinical Guidelines ...................................................................................................................... 19 3. Comparative Clinical Effectiveness .................................................................................................. 22 3.1 Overview .................................................................................................................................... 22 3.2 Methods ..................................................................................................................................... 22 3.3 Results ........................................................................................................................................ 24 3.4 Summary and Comment ............................................................................................................ 49 4. Long-Term Cost Effectiveness .......................................................................................................... 52 4.1 Overview .................................................................................................................................... 52 4.2 Methods ..................................................................................................................................... 53 4.3 Results ........................................................................................................................................ 69 4.4 Summary and Comment ............................................................................................................ 73 5. Potential Other
Load more

Recommended publications
  • Still the Leading Antidepressant After 40
    BRITISH JOURNAL OF PSYCHIATRY "2001), 178, 129^144 REVIEW ARTICLE Amitriptyline vv.therest:stilltheleading METHOD Inclusion criteria antidepressant after 40 years of randomised All RCTs comparing amitriptyline with any y other tricyclic,heterocyclic or SSRI were in- controlled trials cluded. Crossover studies were excluded. Studies adopting any criteria to define CORRADO BARBUI and MATTHEW HOTOPF patients suffering from depression were included; a concurrent diagnosis of another psychiatric disorder was not considered an exclusion criterion. Trials in patients with depression with a concomitant medical ill- Background Tricyclic antidepressants Amitriptyline is one of the first `reference' ness were not included in this review. have similar efficacy and slightly lower tricyclic antidepressants TCAs). Over the past 40 years a number of newer tricyclics, tolerability than selective serotonin Search strategy heterocyclics and selective serotonin re- Relevant studies were located by searching reuptakeinhibitorsreuptake inhibitors SSRIs).However, uptake inhibitors SSRIs) have been intro- the Cochrane Collaboration Depression, there are no systematic reviews assessing duced Garattini et aletal,1998). Despite Anxiety and Neurosis Controlled Trials several large systematic reviews comparing amitriptyline, the reference tricyclic drug, Register CCDANCTR). This specialised tricyclics and SSRIs there is no clear agree- vv. other tricyclics and SSRIs directly. register is regularly updated by electronic ment over first-line treatment of depression Medline,Embase,PsycINFO,LILACS, SongSong et aletal,1993; Anderson & Tomenson, Aims ToreviewTo review the tolerability and Psyndex,CINAHL,SIGLE) and non-electro- 1995; Montgomery & Kasper,1995; efficacy of amitriptyline inthe nicnicliterature searches. The register was HotopfHotopf et aletal,1996; Canadian Coordinating management of depression. searched using the following terms: Office for Health Technology Assessment, AMITRIPTYLIN**AMITRIPTYLIN oror AMITRILAMITRIL oror ELA-ELA- 19971997aa).
    [Show full text]
  • Strategies for Managing Sexual Dysfunction Induced by Antidepressant Medication
    King’s Research Portal DOI: 10.1002/14651858.CD003382.pub3 Document Version Publisher's PDF, also known as Version of record Link to publication record in King's Research Portal Citation for published version (APA): Taylor, M. J., Rudkin, L., Bullemor-Day, P., Lubin, J., Chukwujekwu, C., & Hawton, K. (2013). Strategies for managing sexual dysfunction induced by antidepressant medication. Cochrane Database of Systematic Reviews, (5). https://doi.org/10.1002/14651858.CD003382.pub3 Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rights Copyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights. •Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research. •You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact [email protected] providing details, and we will remove access to the work immediately and investigate your claim.
    [Show full text]
  • (12) Patent Application Publication (10) Pub. No.: US 2005/0065218A1 Migeon Et Al
    US 2005.0065218A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2005/0065218A1 Migeon et al. (43) Pub. Date: Mar. 24, 2005 (54) UTILIZATION OF ALVERINE, ALONE OR IN (30) Foreign Application Priority Data COMBINATION WITH TRICYCLC ANTDEPRESSANT OR A SPECIFIC Jun. 13, 2003 (FR).............................................. O307176 SEROTONIN REUPTAKE INHIBITOR FOR Apr. 30, 2004 (FR).............................................. O404639 THE TREATMENT OF DEPRESSION Publication Classification (76) Inventors: Jacques Migeon, Seattle, WA (US); Frederic Revah, Paris (FR) (51) Int. C.7 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - A61K 31/137 (52) U.S. Cl. .............................................................. 514/649 Correspondence Address: SESD LARDNER (57) ABSTRACT 3000 KSTREET NW WASHINGTON, DC 20007 (US) The present invention relates to the utilization of Alverine or its metabolites, alone or in combination with a tricyclic (21) Appl. No.: 10/866,079 antidepressant or a Specific Serotonin reuptake inhibitor, for the preparation of pharmaceutical compositions for the (22) Filed: Jun. 14, 2004 treatment of depression. 80 120 OO 8 O 6 O 40 20 t Excipicnts Alverine Alverine Alverine Imiprannine (1% methylcellulose) Citate Citrate Citrate 10 mg/kg 3 mg/kg 10 mg/kg 30 mg/kg Patent Application Publication Mar. 24, 2005 Sheet 1 of 4 US 2005/0065218 A1 Excipients Alverine Alveline Alveline Inipramine (1% methylcellulose) Citrate Citrate Citrate 10 mg/kg 3 mg/kg 10 mg/kg 30 mg/kg Fi gure US 2005/0065218A1 Imipramine 30 mg/kg Figure 2 Patent Application Publication Mar. 24, 2005 Sheet 3 of 4 US 2005/0065218A1 20 Vehicle + Whicule -- Averine Alvérine Vehicule + Alverine Vehicule imipramine 3 ring/kg it 3 mg/kg t- Impramine 10 mg/kg + 3 mg/kg Wellicule imipramine 10 mg/kg Vehicule 3 mg/kg Figure 3 Patent Application Publication Mar.
    [Show full text]
  • Properties and Units in Clinical Pharmacology and Toxicology
    Pure Appl. Chem., Vol. 72, No. 3, pp. 479–552, 2000. © 2000 IUPAC INTERNATIONAL FEDERATION OF CLINICAL CHEMISTRY AND LABORATORY MEDICINE SCIENTIFIC DIVISION COMMITTEE ON NOMENCLATURE, PROPERTIES, AND UNITS (C-NPU)# and INTERNATIONAL UNION OF PURE AND APPLIED CHEMISTRY CHEMISTRY AND HUMAN HEALTH DIVISION CLINICAL CHEMISTRY SECTION COMMISSION ON NOMENCLATURE, PROPERTIES, AND UNITS (C-NPU)§ PROPERTIES AND UNITS IN THE CLINICAL LABORATORY SCIENCES PART XII. PROPERTIES AND UNITS IN CLINICAL PHARMACOLOGY AND TOXICOLOGY (Technical Report) (IFCC–IUPAC 1999) Prepared for publication by HENRIK OLESEN1, DAVID COWAN2, RAFAEL DE LA TORRE3 , IVAN BRUUNSHUUS1, MORTEN ROHDE1, and DESMOND KENNY4 1Office of Laboratory Informatics, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; 2Drug Control Centre, London University, King’s College, London, UK; 3IMIM, Dr. Aiguader 80, Barcelona, Spain; 4Dept. of Clinical Biochemistry, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, Ireland #§The combined Memberships of the Committee and the Commission (C-NPU) during the preparation of this report (1994–1996) were as follows: Chairman: H. Olesen (Denmark, 1989–1995); D. Kenny (Ireland, 1996); Members: X. Fuentes-Arderiu (Spain, 1991–1997); J. G. Hill (Canada, 1987–1997); D. Kenny (Ireland, 1994–1997); H. Olesen (Denmark, 1985–1995); P. L. Storring (UK, 1989–1995); P. Soares de Araujo (Brazil, 1994–1997); R. Dybkær (Denmark, 1996–1997); C. McDonald (USA, 1996–1997). Please forward comments to: H. Olesen, Office of Laboratory Informatics 76-6-1, Copenhagen University Hospital (Rigshospitalet), 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. E-mail: [email protected] Republication or reproduction of this report or its storage and/or dissemination by electronic means is permitted without the need for formal IUPAC permission on condition that an acknowledgment, with full reference to the source, along with use of the copyright symbol ©, the name IUPAC, and the year of publication, are prominently visible.
    [Show full text]
  • WO 2012/148799 Al 1 November 2012 (01.11.2012) P O P C T
    (12) INTERNATIONAL APPLICATION PUBLISHED UNDER THE PATENT COOPERATION TREATY (PCT) (19) World Intellectual Property Organization International Bureau (10) International Publication Number (43) International Publication Date WO 2012/148799 Al 1 November 2012 (01.11.2012) P O P C T (51) International Patent Classification: (81) Designated States (unless otherwise indicated, for every A61K 9/107 (2006.01) A61K 9/00 (2006.01) kind of national protection available): AE, AG, AL, AM, A 61 47/10 (2006.0V) AO, AT, AU, AZ, BA, BB, BG, BH, BR, BW, BY, BZ, CA, CH, CL, CN, CO, CR, CU, CZ, DE, DK, DM, DO, (21) International Application Number: DZ, EC, EE, EG, ES, FI, GB, GD, GE, GH, GM, GT, HN, PCT/US2012/034361 HR, HU, ID, IL, IN, IS, JP, KE, KG, KM, KN, KP, KR, (22) International Filing Date: KZ, LA, LC, LK, LR, LS, LT, LU, LY, MA, MD, ME, 20 April 2012 (20.04.2012) MG, MK, MN, MW, MX, MY, MZ, NA, NG, NI, NO, NZ, OM, PE, PG, PH, PL, PT, QA, RO, RS, RU, RW, SC, SD, (25) Filing Language: English SE, SG, SK, SL, SM, ST, SV, SY, TH, TJ, TM, TN, TR, (26) Publication Language: English TT, TZ, UA, UG, US, UZ, VC, VN, ZA, ZM, ZW. (30) Priority Data: (84) Designated States (unless otherwise indicated, for every 61/480,259 28 April 201 1 (28.04.201 1) US kind of regional protection available): ARIPO (BW, GH, GM, KE, LR, LS, MW, MZ, NA, RW, SD, SL, SZ, TZ, (71) Applicant (for all designated States except US): BOARD UG, ZM, ZW), Eurasian (AM, AZ, BY, KG, KZ, MD, RU, OF REGENTS, THE UNIVERSITY OF TEXAS SYS¬ TJ, TM), European (AL, AT, BE, BG, CH, CY, CZ, DE, TEM [US/US]; 201 West 7th St., Austin, TX 78701 (US).
    [Show full text]
  • 2019 Instrumentation and Consumable Catalog 2 INSTRUMENTATION and CONSUMABLE CATALOG
    PRODUCT CATALOG 2019 Instrumentation and Consumable Catalog 2 INSTRUMENTATION AND CONSUMABLE CATALOG Resolvex® A200 Part Numbers: A200 96: 253-1160 Resolvex® A200 96 Resolvex A200 Standalone work station for automated sample preparation. The compact benchtop offers the one stop solution for automating sample preparation utilizing creation of multiple work flows, and programmable dispensing of up to 11 solvents. Along with its innovative positive pressure system leading to clean samples, improving accuracy, throughput and enhancing the Life time of your analytical instrument. The A200 comes with an easy to use touch screen interface allowing for easy set up of multiple work flows. In addition the light curtain safety feature will release gas pressure when manifold is activated to prevent any injuries. INSTRUMENTATION AND CONSUMABLE CATALOG 3 Resolvex® A100 Part Numbers: A100 96: 253-0019 A100 48: 253-0014 Resolvex® A100 Standalone work station for automated sample preparation. The compact benchtop offers the one stop solution for automating sample preparation utilizing creation of multiple work flows, and programmable dispensing of up to 11 solvents. Along with its innovative positive pressure system leading to clean samples, improving accuracy, throughput and enhancing the Life time of your analytical instrument. The A100 comes in 96 and 4 configuration allowing for for automated Work Flow solutions in multiple SPE formats. 4 INSTRUMENTATION AND CONSUMABLE CATALOG Resolvex® M10 96/M10 96 XT/M10 48 Part Numbers: M10 96 XT: 288-0006 M10 96: 288-0001 M10 48: 289-0004 Resolvex® M10 Standalone work station for Positive Pressure solid phase extraction. The manual Resolvex M10 48 and 96 are positive pressure manifold for 1, 3, and 6 ml cartridges, or 1ml 96 well plates.
    [Show full text]
  • Rp-Hplc Method for the Estimation of Nitroxazepine Hydrochloride in Pharmaceutical Dosage Forms
    Volume: I: Issue-3: Nov-Dec -2010 ISSN 0976-4550 RP-HPLC METHOD FOR THE ESTIMATION OF NITROXAZEPINE HYDROCHLORIDE IN PHARMACEUTICAL DOSAGE FORMS P.Sai Praveen1, B.Anupama*1, P.Sirisha2, Hanuma Reddy.Y3, T.V.B.Reddy4 1KVSR Siddhartha college of Pharmaceutical Sciences, Vijayawada-520010. 2GIET School of Pharmacy, Rajahmundry-533294 3Global college of Pharmacy 4Dept. of QA, Dr.Reddy’s Laboratories Ltd, Hyderabad ABSTRACT : A simple and sensitive isocratic RP‐HPLC method was developed for the determination of Nitroxazepine hydrochloride in bulk drug and its pharmaceutical tablet formulations where the mobile phase optimized was Phosphate buffer : Acetonitrile (70:30) and Phenomenex C18 column (250 mm length, 4.6 mm internal diameter and particle size 5 µm) was used as the stationary phase. The flow rate and detection wavelength was 1.0 mL min‐1 and 265 nm respectively. The developed method was validated as per ICH guidelines for specificity, linearity and range, precision, accuracy, robustness, limit of quantification and limit of detection. The results of all the validation parameters were well within their acceptance values. The method gave good recovery in the range of 98.95‐99.43 % for Nitroxazepine hydrochloride when it was applied for its determination in pharmaceutical tablet formulations. Keywords: Nitroxazepine hydrochloride, RP‐HPLC, Validation, Pharmaceutical formulation INTRODUCTION Nitroxazepine (Goodman and Gilman 1996, William O Foye 1989) chemically 10-[3- (dimethylamino) propyl-2-nitrobenzo [1,4] oxazepine-11(10H)-one, (Figure-1) is a major antidepressant drug (Jain AN et al. 1984, Bhatt AD et al. 1991). It is a tricyclic antidepressant (Balani ND et al.
    [Show full text]
  • Gps' Drug Treatment for Depression by Patients' Educational Level
    RESEARCH GPs’ drug treatment for depression by patients’ educational level: registry- based study Anneli Borge Hansen, MD1,2*, Valborg Baste, MSc. Statistics, PhD1, Oystein Hetlevik, MD, PhD1,2, Inger Haukenes, MSc. Philosophy, PhD1,2, Tone Smith- Sivertsen, MD, PhD1,3, Sabine Ruths, MD, PhD1,2 1Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway; 2Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; 3Division of Psychiatry, Haukeland University Hospital, Bergen, Norway Abstract Background: Antidepressant drugs are often prescribed in general practice. Evidence is conflicting on how patient education influences antidepressant treatment. Aim: To investigate the association between educational attainment and drug treatment in adult patients with a new depression diagnosis, and to what extent sex and age influence the association. Design & setting: A nationwide registry- based cohort study was undertaken in Norway from 2014– 2016. Method: The study comprised all residents of Norway born before 1996 and alive in 2015. Information was obtained on all new depression diagnoses in general practice in 2015 (primary care database) and data on all dispensed depression medication (Norwegian Prescription Database [NorPD]) 12 months after the date of diagnosis. Independent variables were education, sex, and age. Associations with drug treatment were estimated using a Cox proportional hazard model and performed separately for sex. *For correspondence: ahan@ Results: Out of 49 967 patients with new depression (61.6% women), 15 678 were dispensed drugs norceresearch. no (30.4% women, 33.0% men). Highly educated women were less likely to receive medication (hazard ratio [HR] = 0.93; 95% confidence interval [CI] = 0.88 to 0.98) than women with low education.
    [Show full text]
  • Still the Leading Antidepressant After 40 Years of Randomised Controlle
    BRITISH JOURNAL OF PSYCHIATRY "2001), 178, 129^144 REVIEW ARTICLE Amitriptyline vv.therest:stilltheleading METHOD Inclusion criteria antidepressant after 40 years of randomised All RCTs comparing amitriptyline with any y other tricyclic,heterocyclic or SSRI were in- controlled trials cluded. Crossover studies were excluded. Studies adopting any criteria to define CORRADO BARBUI and MATTHEW HOTOPF patients suffering from depression were included; a concurrent diagnosis of another psychiatric disorder was not considered an exclusion criterion. Trials in patients with depression with a concomitant medical ill- Background Tricyclic antidepressants Amitriptyline is one of the first `reference' ness were not included in this review. have similar efficacy and slightly lower tricyclic antidepressants TCAs). Over the past 40 years a number of newer tricyclics, tolerability than selective serotonin Search strategy heterocyclics and selective serotonin re- Relevant studies were located by searching reuptakeinhibitorsreuptake inhibitors SSRIs).However, uptake inhibitors SSRIs) have been intro- the Cochrane Collaboration Depression, there are no systematic reviews assessing duced Garattini et aletal,1998). Despite Anxiety and Neurosis Controlled Trials several large systematic reviews comparing amitriptyline, the reference tricyclic drug, Register CCDANCTR). This specialised tricyclics and SSRIs there is no clear agree- vv. other tricyclics and SSRIs directly. register is regularly updated by electronic ment over first-line treatment of depression Medline,Embase,PsycINFO,LILACS, SongSong et aletal,1993; Anderson & Tomenson, Aims ToreviewTo review the tolerability and Psyndex,CINAHL,SIGLE) and non-electro- 1995; Montgomery & Kasper,1995; efficacy of amitriptyline inthe nicnicliterature searches. The register was HotopfHotopf et aletal,1996; Canadian Coordinating management of depression. searched using the following terms: Office for Health Technology Assessment, AMITRIPTYLIN**AMITRIPTYLIN oror AMITRILAMITRIL oror ELA-ELA- 19971997aa).
    [Show full text]
  • Allergy Skin Testing: Patient Instructions and Consent Form
    ALLERGY SKIN TESTING: PATIENT INSTRUCTIONS AND CONSENT FORM Skin tests are a method of testing for allergic reactions to substances, or allergens, in the environment. A test consists of introducing small amounts of allergens into the skin and noting the development of a positive reaction, which consists of a wheal (swelling) and flare (surrounding area of redness). We employ the prick method, where the skin is pricked with a sharp device that introduces the allergen into the skin. Other allergy testing options include injecting the allergen with needles or going to a lab for blood tests. The entire testing process will take about 30 minutes. We test a variety of important allergens that are found in the Central Florida area including trees, grasses, weeds, molds, dust mites, and animal dander. After administering the allergens, we wait approximately 20 minutes to review the results. A positive reaction occurs when the skin becomes red, raised, and itchy. This skin reaction will gradually dissipate within 30‐60 minutes. Some people will experience local swelling beginning 4‐8 hours after testing. This is not serious and typically no treatment is required. It should disappear in the next few days. Less than 1% of patients may develop a systemic reaction to skin testing, which may consist of any or all of the following symptoms: itchy eyes, nose, or throat, nasal congestion, runny nose, tightness in the throat or chest, wheezing, lightheadedness, nausea or vomiting, hives, or anaphylactic shock. This is very rare, but in the event of such reactions, the staff is fully prepared and emergency equipment is readily available.
    [Show full text]
  • The Use of Stems in the Selection of International Nonproprietary Names (INN) for Pharmaceutical Substances
    WHO/PSM/QSM/2006.3 The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances 2006 Programme on International Nonproprietary Names (INN) Quality Assurance and Safety: Medicines Medicines Policy and Standards The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances FORMER DOCUMENT NUMBER: WHO/PHARM S/NOM 15 © World Health Organization 2006 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
    [Show full text]
  • Use of Amitriptyline for the Treatment of Chronic Tension-Type Headache
    Med Oral Patol Oral Cir Bucal. 2008 Sep1;13(9):E567-72. Amitriptyline and chronic tension-type headache Med Oral Patol Oral Cir Bucal. 2008 Sep1;13(9):E567-72. Amitriptyline and chronic tension-type headache Publication Types: Review Use of amitriptyline for the treatment of chronic tension-type headache. Review of the literature Eulalia Torrente Castells 1, Eduardo Vázquez Delgado 2, Cosme Gay Escoda 3 (1) Odontóloga. Residente del Máster de Cirugía Bucal e Implantología Bucofacial. Facultad de Odontología de la Universidad de Barcelona (2) Odontólogo. Profesor Asociado de Cirugía Bucal. Profesor responsable de la Unidad de Patología de la ATM y Dolor Bucofacial del Máster de Cirugía Bucal e Implantología Bucofacial. Facultad de Odontología de la Universidad de Barcelona. Especialista de la Unidad de Patología de la ATM y Dolor Bucofacial del Centro Médico Teknon. Barcelona (3) Médico-Estomatólogo y Cirujano Maxilofacial. Catedrático de Patología Quirúrgica Bucal y Maxilofacial. Director del Máster de Cirugía Bucal e Implantología Bucofacial. Facultad de Odontología de la Universidad de Barcelona. Co-director de la Unidad de Patología de la ATM y Dolor Bucofacial del Centro Médico Teknon. Barcelona Correspondence: Prof. Cosme Gay Escoda Centro Médico Teknon C/Vilana nº 12 08022 Barcelona E-mail: [email protected] Torrente-Castells E, Vázquez-Delgado E, Gay-Escoda C. Use of amitrip- Received: 28/09/2007 tyline for the treatment of chronic tension-type headache. Review of the Accepted: 11/07/2008 literature. Med Oral Patol Oral Cir Bucal. 2008 Sep1;13(9):E567-72. © Medicina Oral S. L. C.I.F. B 96689336 - ISSN 1698-6946 Indexed in: http://www.medicinaoral.com/medoralfree01/v13i9/medoralv13i9p567.pdf -Index Medicus / MEDLINE / PubMed -EMBASE, Excerpta Medica -SCOPUS -Indice Médico Español -IBECS Abstract Amitriptyline is a tricyclic antidepressant, considered the treatment of choice for different types of chronic pain, including chronic myofascial pain.
    [Show full text]