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[PMID]:27776567
[Au] Autor:Roopan S; Larsen ER
[Ad] Endereço:1Psychiatric Department Kolding-Vejle,Region of Southern Denmark,Denmark.
[Ti] Título:Use of antidepressants in patients with depression and comorbid diabetes mellitus: a systematic review.
[So] Source:Acta Neuropsychiatr;29(3):127-139, 2017 Jun.
[Is] ISSN:1601-5215
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Depression may be difficult to treat and with comorbid diabetes mellitus (DM) it is an even bigger challenge. This article aims to evaluate antidepressants most suitable for patients with depression and comorbid DM. Design and methods Initially we searched for randomised, controlled double-blind trials of treatment with antidepressants in depressed with DM but there were only a few studies and many of them were small trials. Thus, we decided to include studies that were not only randomised-controlled trials. In total, we ended up with 18 articles for our purposes. RESULTS: The combination of depression and DM may be harmful as depression has a strong impact on psychosocial and medical outcomes in patients with DM. Almost all of the trials in this review showed a reduction in depressive symptoms after treatment with an antidepressant in the acute as well as during maintenance phase. It showed that depression improvement had a favourable effect on glycaemic control that was weight independent. Some studies included only subjects with minor depression or with suboptimal-controlled diabetes making it difficult to show an effect. CONCLUSION: From these data, we will recommend choosing an selective serotonin reuptake inhibitor (SSRI) if possible to treat a depression among patients with diabetes. If treatment with a tricyclic antidepressant is needed, closer glycaemic monitoring is recommended. Bear in mind that there is a possible risk of hypoglycemia when using SSRIs. Agomelatine and bupropion have shown promising results, but need to be investigated in more trials.
[Mh] Termos MeSH primário: Antidepressivos/uso terapêutico
Comorbidade
Depressão/tratamento farmacológico
Diabetes Mellitus/psicologia
[Mh] Termos MeSH secundário: Acetamidas/efeitos adversos
Acetamidas/uso terapêutico
Adulto
Idoso
Antidepressivos/efeitos adversos
Antidepressivos de Segunda Geração/administração & dosagem
Antidepressivos de Segunda Geração/uso terapêutico
Antidepressivos Tricíclicos/efeitos adversos
Antidepressivos Tricíclicos/uso terapêutico
Bupropiona/efeitos adversos
Bupropiona/uso terapêutico
Depressão/complicações
Diabetes Mellitus/tratamento farmacológico
Método Duplo-Cego
Feminino
Seres Humanos
Hiperglicemia/induzido quimicamente
Hiperglicemia/complicações
Hipnóticos e Sedativos/efeitos adversos
Hipnóticos e Sedativos/uso terapêutico
Hipoglicemia/induzido quimicamente
Hipoglicemia/complicações
Masculino
Meia-Idade
Ensaios Clínicos Controlados Aleatórios como Assunto
Inibidores da Captação de Serotonina/efeitos adversos
Inibidores da Captação de Serotonina/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Acetamides); 0 (Antidepressive Agents); 0 (Antidepressive Agents, Second-Generation); 0 (Antidepressive Agents, Tricyclic); 0 (Hypnotics and Sedatives); 0 (Serotonin Uptake Inhibitors); 01ZG3TPX31 (Bupropion); 138112-76-2 (S 20098)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1017/neu.2016.54


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[PMID]:29206852
[Au] Autor:Secades-Villa R; González-Roz A; García-Pérez Á; Becoña E
[Ad] Endereço:Department of Psychology, University of Oviedo, Oviedo, Spain.
[Ti] Título:Psychological, pharmacological, and combined smoking cessation interventions for smokers with current depression: A systematic review and meta-analysis.
[So] Source:PLoS One;12(12):e0188849, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:We conducted a systematic literature review and meta-analysis (ID: CRD42016051017) of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP). Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%), pharmacological (6/30%) or combined (8/40%). Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and long-term smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base.
[Mh] Termos MeSH primário: Depressão/complicações
Abandono do Hábito de Fumar/métodos
Fumar
[Mh] Termos MeSH secundário: Antidepressivos de Segunda Geração/uso terapêutico
Bupropiona/uso terapêutico
Feminino
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 01ZG3TPX31 (Bupropion)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0188849


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[PMID]:29049178
[Au] Autor:Zhou C; Wu L; Liu Q; An H; Jiang B; Zuo F; Zhang L; He Y
[Ad] Endereço:aDepartment of Respiration, Chinese PLA General Hospital bDepartment of Epidemiology, Institute of Geriatrics cCentral Laboratory of Navy General Hospital dDepartment of Acupuncture eDepartment of Rehabilitation, Chinese PLA General Hospital, Beijing, China.
[Ti] Título:Evaluation of smoking cessation intervention in patients with chronic diseases in smoking cessation clinics.
[So] Source:Medicine (Baltimore);96(42):e7459, 2017 Oct.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate the effects of psychological intervention and psychological plus drug intervention on smoking cessation among male smokers with single chronic diseases.A total of 509 male smokers were divided into psychological group (n = 290) and psychological plus drugs (n = 219) groups according to their will. The physicians provided free individual counseling and follow-up interviews with brief counseling for all the subjects. In addition to mental intervention, patients in psychological plus drug group also received bupropion hydrochloride or varenicline tartrate to quit smoking. Outcomes were self-reported, regarding the 7-day point prevalence on abstinence rate and continuous abstinence rates at 1-, 3-, and 6-month follow-up period. Data analyses were performed using intention-to-treat analysis and per protocol analysis.With regards to the 3 follow-up time points, 7-day point-prevalence abstinence rate in psychological plus drugs group was all higher than that in the psychological intervention group. Additionally, the 3-month continuous abstinence rate (21.4%) of the 6-month follow-up in the psychological group was not significantly higher than that (26.9%) in the psychological plus drugs group (P >.05 for all). Fagerström test score, stage of quitting smoking, perceived confidence or difficulty in quitting, and chronic disease types were independently correlated with 3-month continuous abstinence in the 6-month follow up (P <.05 for all). The results were similar between intentional analysis and protocol analysis.The psychological intervention and psychological plus drugs intervention exerted good effects on smoking cessation in a short time (1 month). Nevertheless, the advantages did not appear during long-time (6 months) follow-up.
[Mh] Termos MeSH primário: Doença Crônica/psicologia
Aconselhamento/métodos
Agonistas Nicotínicos/uso terapêutico
Abandono do Hábito de Fumar/métodos
Fumar/terapia
[Mh] Termos MeSH secundário: Adulto
Bupropiona/uso terapêutico
Terapia Combinada
Seguimentos
Seres Humanos
Análise de Intenção de Tratamento
Masculino
Meia-Idade
Fumar/psicologia
Abandono do Hábito de Fumar/psicologia
Resultado do Tratamento
Vareniclina/uso terapêutico
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Nicotinic Agonists); 01ZG3TPX31 (Bupropion); W6HS99O8ZO (Varenicline)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171122
[Lr] Data última revisão:
171122
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007459


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[PMID]:28697253
[Au] Autor:Mohamed S; Johnson GR; Chen P; Hicks PB; Davis LL; Yoon J; Gleason TC; Vertrees JE; Weingart K; Tal I; Scrymgeour A; Lawrence DD; Planeta B; Thase ME; Huang GD; Zisook S; Rao SD; Pilkinton PD; Wilcox JA; Iranmanesh A; Sapra M; Jurjus G; Michalets JP; Aslam M; Beresford T; Anderson KD; Fernando R; Ramaswamy S; Kasckow J; Westermeyer J; Yoon G; D'Souza DC; Larson G; Anderson WG; Klatt M; Fareed A; Thompson SI; Carrera CJ; Williams SS; Juergens TM; Albers LJ; Nasdahl CS; Villarreal G; Winston JL; Nogues CA; Connolly KR; Tapp A; Jones KA; Khatkhate G; Marri S; and the VAST-D Investigators
[Ad] Endereço:Veterans Affairs (VA) New England Mental Illness Research, Education, and Clinical Center, VA Connecticut Healthcare System, West Haven2Yale University School of Medicine, West Haven, Connecticut.
[Ti] Título:Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial.
[So] Source:JAMA;318(2):132-145, 2017 Jul 11.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Less than one-third of patients with major depressive disorder (MDD) achieve remission with their first antidepressant. Objective: To determine the relative effectiveness and safety of 3 common alternate treatments for MDD. Design, Setting, and Participants: From December 2012 to May 2015, 1522 patients at 35 US Veterans Health Administration medical centers who were diagnosed with nonpsychotic MDD, unresponsive to at least 1 antidepressant course meeting minimal standards for treatment dose and duration, participated in the study. Patients were randomly assigned (1:1:1) to 1 of 3 treatments and evaluated for up to 36 weeks. Interventions: Switch to a different antidepressant, bupropion (switch group, n = 511); augment current treatment with bupropion (augment-bupropion group, n = 506); or augment with an atypical antipsychotic, aripiprazole (augment-aripiprazole group, n = 505) for 12 weeks (acute treatment phase) and up to 36 weeks for longer-term follow-up (continuation phase). Main Outcomes and Measures: The primary outcome was remission during the acute treatment phase (16-item Quick Inventory of Depressive Symptomatology-Clinician Rated [QIDS-C16] score ≤5 at 2 consecutive visits). Secondary outcomes included response (≥50% reduction in QIDS-C16 score or improvement on the Clinical Global Impression Improvement scale), relapse, and adverse effects. Results: Among 1522 randomized patients (mean age, 54.4 years; men, 1296 [85.2%]), 1137 (74.7%) completed the acute treatment phase. Remission rates at 12 weeks were 22.3% (n = 114) for the switch group, 26.9% (n = 136)for the augment-bupropion group, and 28.9% (n = 146) for the augment-aripiprazole group. The augment-aripiprazole group exceeded the switch group in remission (relative risk [RR], 1.30 [95% CI, 1.05-1.60]; P = .02), but other remission comparisons were not significant. Response was greater for the augment-aripiprazole group (74.3%) than for either the switch group (62.4%; RR, 1.19 [95% CI, 1.09-1.29]) or the augment-bupropion group (65.6%; RR, 1.13 [95% CI, 1.04-1.23]). No significant treatment differences were observed for relapse. Anxiety was more frequent in the 2 bupropion groups (24.3% in the switch group [n = 124] vs 16.6% in the augment-aripiprazole group [n = 84]; and 22.5% in augment-bupropion group [n = 114]). Adverse effects more frequent in the augment-aripiprazole group included somnolence, akathisia, and weight gain. Conclusions and Relevance: Among a predominantly male population with major depressive disorder unresponsive to antidepressant treatment, augmentation with aripiprazole resulted in a statistically significant but only modestly increased likelihood of remission during 12 weeks of treatment compared with switching to bupropion monotherapy. Given the small effect size and adverse effects associated with aripiprazole, further analysis including cost-effectiveness is needed to understand the net utility of this approach. Trial Registration: clinicaltrials.gov Identifier: NCT01421342.
[Mh] Termos MeSH primário: Antidepressivos/administração & dosagem
Antipsicóticos/uso terapêutico
Aripiprazol/uso terapêutico
Bupropiona/administração & dosagem
Transtorno Depressivo Maior/tratamento farmacológico
Substituição de Medicamentos
[Mh] Termos MeSH secundário: Adulto
Antidepressivos/uso terapêutico
Resistência a Medicamentos
Sinergismo Farmacológico
Quimioterapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Indução de Remissão
Estados Unidos
Veteranos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antidepressive Agents); 0 (Antipsychotic Agents); 01ZG3TPX31 (Bupropion); 82VFR53I78 (Aripiprazole)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.8036


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[PMID]:28645576
[Au] Autor:Luethi D; Liechti ME; Krähenbühl S
[Ad] Endereço:Division of Clinical Pharmacology & Toxicology, University Hospital Basel, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland; Swiss Centre of Applied Human Toxicology, Basel, Switzerland.
[Ti] Título:Mechanisms of hepatocellular toxicity associated with new psychoactive synthetic cathinones.
[So] Source:Toxicology;387:57-66, 2017 Jul 15.
[Is] ISSN:1879-3185
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Synthetic cathinones are a new class of psychostimulant substances. Rarely, they can cause liver injury but associated mechanisms are not completely elucidated. In order to increase our knowledge about mechanisms of hepatotoxicity, we investigated the effect of five frequently used cathinones on two human cell lines. Bupropion was included as structurally related drug used therapeutically. In HepG2 cells, bupropion, MDPV, mephedrone and naphyrone depleted the cellular ATP content at lower concentrations (0.2-1mM) than cytotoxicity occurred (0.5-2mM), suggesting mitochondrial toxicity. In comparison, methedrone and methylone depleted the cellular ATP pool and induced cytotoxicity at similar concentrations (≥2mM). In HepaRG cells, cytotoxicity and ATP depletion could also be demonstrated, but cytochrome P450 induction did not increase the toxicity of the compounds investigated. The mitochondrial membrane potential was decreased in HepG2 cells by bupropion, MDPV and naphyrone, confirming mitochondrial toxicity. Bupropion, but not the other compounds, uncoupled oxidative phosphorylation. Bupropion, MDPV, mephedrone and naphyrone inhibited complex I and II of the electron transport chain, naphyrone also complex III. All four mitochondrial toxicants were associated with increased mitochondrial ROS and increased lactate production, which was accompanied by a decrease in the cellular total GSH pool for naphyrone and MDPV. In conclusion, bupropion, MDPV, mephedrone and naphyrone are mitochondrial toxicants impairing the function of the electron transport chain and depleting cellular ATP stores. Since liver injury is rare in users of these drugs, affected persons must have susceptibility factors rendering them more sensitive for these drugs.
[Mh] Termos MeSH primário: Alcaloides/toxicidade
Doença Hepática Induzida por Substâncias e Drogas/etiologia
Hepatócitos/efeitos dos fármacos
Psicotrópicos/toxicidade
[Mh] Termos MeSH secundário: Trifosfato de Adenosina/metabolismo
Benzodioxóis/toxicidade
Bupropiona/toxicidade
Doença Hepática Induzida por Substâncias e Drogas/metabolismo
Doença Hepática Induzida por Substâncias e Drogas/patologia
Relação Dose-Resposta a Droga
Complexo de Proteínas da Cadeia de Transporte de Elétrons/metabolismo
Células Hep G2
Hepatócitos/metabolismo
Hepatócitos/patologia
Seres Humanos
Ácido Láctico/metabolismo
Potencial da Membrana Mitocondrial/efeitos dos fármacos
Metanfetamina/análogos & derivados
Metanfetamina/toxicidade
Mitocôndrias Hepáticas/efeitos dos fármacos
Mitocôndrias Hepáticas/metabolismo
Mitocôndrias Hepáticas/patologia
Fosforilação Oxidativa/efeitos dos fármacos
Estresse Oxidativo/efeitos dos fármacos
Consumo de Oxigênio/efeitos dos fármacos
Pentanonas/toxicidade
Pirrolidinas/toxicidade
Espécies Reativas de Oxigênio/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (1-naphthalen-2-yl-2-pyrrolidin-1-ylpentan-1-one); 0 (3,4-methylenedioxypyrovalerone); 0 (Alkaloids); 0 (Benzodioxoles); 0 (Electron Transport Chain Complex Proteins); 0 (Pentanones); 0 (Psychotropic Drugs); 0 (Pyrrolidines); 0 (Reactive Oxygen Species); 01ZG3TPX31 (Bupropion); 33X04XA5AT (Lactic Acid); 44RAL3456C (Methamphetamine); 540EI4406J (cathinone); 8BA8T27317 (mephedrone); 8L70Q75FXE (Adenosine Triphosphate)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170625
[St] Status:MEDLINE


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[PMID]:28473506
[Au] Autor:Kotz D; Viechtbauer W; Simpson CR; van Schayck OCP; West R; Sheikh A
[Ad] Endereço:Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine, Institute of General Practice, University Düsseldorf, Düsseldorf, Germany.
[Ti] Título:Cardiovascular and neuropsychiatric risks of varenicline and bupropion in smokers with chronic obstructive pulmonary disease.
[So] Source:Thorax;72(10):905-911, 2017 Oct.
[Is] ISSN:1468-3296
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Varenicline and bupropion are effective smoking cessation treatments, but there are concerns about their safety in smokers with COPD. OBJECTIVE: To investigate whether varenicline and bupropion are associated with serious adverse cardiovascular and neuropsychiatric events in smokers with COPD. METHODS: In a retrospective cohort study, we used data from 14 350 patients with COPD included in the QResearch database, which holds data from 753 National Health Service general practices across England. We identified patients with COPD who received a prescription of nicotine replacement therapy (NRT; N=10 426; reference group), bupropion (N=350) or varenicline (N=3574) in the period between January 2007 and June 2012. Patients were followed up for 6 months to compare incident cardiovascular (ie, ischaemic heart disease, stroke, heart failure, peripheral vascular disease and cardiac arrhythmias) and neuropsychiatric (ie, depression and self-harm) events using Cox proportional hazards models, adjusted for potential confounders. Propensity score analysis was used as an additional approach to account for potential confounding by indication. We also modelled the effects of possible unmeasured confounders. RESULTS: Neither bupropion nor varenicline showed an increased risk of adverse events compared with NRT. Varenicline was associated with a significantly reduced risk of heart failure (HR=0.56, 95% CI 0.34 to 0.92) and depression (HR=0.73, 95% CI 0.61 to 0.86). Similar results were obtained from the propensity score analysis. Modelling of unmeasured confounding provided additional evidence that an increased risk of these adverse events was very unlikely. CONCLUSION: In smokers with COPD, varenicline and bupropion do not appear to be associated with an increased risk of cardiovascular events, depression or self-harm in comparison with NRT.
[Mh] Termos MeSH primário: Bupropiona/efeitos adversos
Doenças Cardiovasculares/epidemiologia
Inibidores da Captação de Dopamina/efeitos adversos
Transtornos Mentais/epidemiologia
Agonistas Nicotínicos/efeitos adversos
Doença Pulmonar Obstrutiva Crônica/complicações
Abandono do Hábito de Fumar/métodos
Produtos para o Abandono do Uso de Tabaco/efeitos adversos
Vareniclina/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Inglaterra/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Pontuação de Propensão
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dopamine Uptake Inhibitors); 0 (Nicotinic Agonists); 01ZG3TPX31 (Bupropion); W6HS99O8ZO (Varenicline)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170506
[St] Status:MEDLINE
[do] DOI:10.1136/thoraxjnl-2017-210067


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[PMID]:28403462
[Au] Autor:Scheuermann TS; Richter KP; Jacobson LT; Shireman TI
[Ad] Endereço:Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS.
[Ti] Título:Medicaid Coverage of Smoking Cessation Counseling and Medication Is Underutilized for Pregnant Women.
[So] Source:Nicotine Tob Res;19(5):656-659, 2017 May 01.
[Is] ISSN:1469-994X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013. We analyzed the number of pregnant women who received physician-provided smoking cessation counseling indicated by procedure billing codes (ie, G0436 and G0437) and medication (ie, nicotine replacement therapy, bupropion, or varenicline) located in outpatient managed care encounter and fee-for-service claims data. We estimated the number of Medicaid-insured pregnant smokers using the national smoking prevalence (14%) in this population and the number of live births reported in Kansas. Results: Annually from 2010 to 2013, approximately 27.2%-31.6% of pregnant smokers had claims for nicotine replacement therapy, bupropion, or varenicline. Excluding claims for bupropion, a medication commonly prescribed to treat depression, claims ranged from 9.3% to 11.1%. Following implementation of Medicaid coverage for smoking cessation counseling, less than 1% of estimated smokers had claims for counseling. Conclusions: This low claims rate suggests that simply changing policy is not sufficient to ensure use of newly implemented benefits, and that there probably remain critical gaps in smoking cessation treatment. Implications: This study evaluates the use of Medicaid reimbursement for smoking cessation counseling among low-income pregnant women in Kansas. We describe the Medicaid claims rates of physician-provided smoking cessation counseling for pregnant women, an evidence-based and universally recommended treatment approach for smoking cessation in this population. Our findings show that claims rates for smoking cessation benefits in this population are very low, even after policy changes to support provision of cessation assistance were implemented. Additional studies are needed to determine whether reimbursement is functioning as intended and identify potential gaps between policy and implementation of evidence-based smoking cessation treatment.
[Mh] Termos MeSH primário: Bupropiona/uso terapêutico
Aconselhamento/utilização
Inibidores da Captação de Dopamina/uso terapêutico
Agonistas Nicotínicos/uso terapêutico
Abandono do Hábito de Fumar/estatística & dados numéricos
Fumar/terapia
Produtos para o Abandono do Uso de Tabaco/utilização
Vareniclina/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Bases de Dados Factuais
Feminino
Seres Humanos
Cobertura do Seguro
Kansas
Medicaid
Pobreza
Gravidez
Gestantes
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dopamine Uptake Inhibitors); 0 (Nicotinic Agonists); 01ZG3TPX31 (Bupropion); W6HS99O8ZO (Varenicline)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1093/ntr/ntw263


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[PMID]:28323838
[Au] Autor:Gelderblom H; Wüstenberg T; McLean T; Mütze L; Fischer W; Saft C; Hoffmann R; Süssmuth S; Schlattmann P; van Duijn E; Landwehrmeyer B; Priller J
[Ad] Endereço:Department of Neuropsychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany.
[Ti] Título:Bupropion for the treatment of apathy in Huntington's disease: A multicenter, randomised, double-blind, placebo-controlled, prospective crossover trial.
[So] Source:PLoS One;12(3):e0173872, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the efficacy and safety of bupropion in the treatment of apathy in Huntington's disease (HD). METHODS: In this phase 2b multicentre, double-blind, placebo-controlled crossover trial, individuals with HD and clinical signs of apathy according to the Structured Clinical Interview for Apathy-Dementia (SCIA-D), but not depression (n = 40) were randomized to receive either bupropion 150/300mg or placebo daily for 10 weeks. The primary outcome parameter was a significant change of the Apathy Evaluation Scale (AES) score after ten weeks of treatment as judged by an informant (AES-I) living in close proximity with the study participant. The secondary outcome parameters included changes of 1. AES scores determined by the patient (AES-S) or the clinical investigator (AES-C), 2. psychiatric symptoms (NPI, HADS-SIS, UHDRS-Behavior), 3. cognitive performance (SDMT, Stroop, VFT, MMSE), 4. motor symptoms (UHDRS-Motor), 5. activities of daily function (TFC, UHDRS-Function), and 6. caregiver distress (NPI-D). In addition, we investigated the effect of bupropion on brain structure as well as brain responses and functional connectivity during reward processing in a gambling task using magnetic resonance imaging (MRI). RESULTS: At baseline, there were no significant treatment group differences in the clinical primary and secondary outcome parameters. At endpoint, there was no statistically significant difference between treatment groups for all clinical primary and secondary outcome variables. Study participation, irrespective of the intervention, lessened symptoms of apathy according to the informant and the clinical investigator. CONCLUSION: Bupropion does not alleviate apathy in HD. However, study participation/placebo effects were observed, which document the need for carefully controlled trials when investigating therapeutic interventions for the neuropsychiatric symptoms of HD. TRIAL REGISTRATION: ClinicalTrials.gov 01914965.
[Mh] Termos MeSH primário: Antidepressivos de Segunda Geração/uso terapêutico
Apatia/efeitos dos fármacos
Bupropiona/uso terapêutico
Doença de Huntington/tratamento farmacológico
Doença de Huntington/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Encéfalo/diagnóstico por imagem
Encéfalo/fisiopatologia
Estudos Cross-Over
Método Duplo-Cego
Feminino
Neuroimagem Funcional
Seres Humanos
Doença de Huntington/diagnóstico por imagem
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Estudos Prospectivos
Recompensa
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; CLINICAL TRIAL, PHASE II; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 01ZG3TPX31 (Bupropion)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0173872


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[PMID]:28253826
[Au] Autor:Wang S; Dong Y; Su K; Zhang J; Wang L; Han A; Wen C; Wang X; He Y
[Ad] Endereço:a The Laboratory of Clinical Pharmacy , The People's Hospital of Lishui , Lishui , China.
[Ti] Título:Effect of codeine on CYP450 isoform activity of rats.
[So] Source:Pharm Biol;55(1):1223-1227, 2017 Dec.
[Is] ISSN:1744-5116
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Codeine, also known as 3-methylmorphine, is an opiate used to treat pain, as a cough medicine and for diarrhoea. No study on the effects of codeine on the metabolic capacity of CYP enzyme is reported. OBJECTIVE: In order to investigate the effects of codeine on the metabolic capacity of cytochrome P450 (CYP) enzymes, a cocktail method was employed to evaluate the activities of CYP2B1, CYP2D1, CYP1A2, CYP3A2 and CYP2C11. MATERIALS AND METHODS: Sprague-Dawley rats were randomly divided into codeine group (low, medium, high) and control group. The codeine group rats were given 4, 8, 16 mg/kg (low, medium, high) codeine by continuous intragastric administration for 14 days. Five probe drugs bupropion, metroprolol, phenacetin, midazolam and tolbutamide were given to rats through intragastric administration, and the plasma concentrations were determined by UPLC-MS/MS. RESULTS AND CONCLUSION: The pharmacokinetic parameters of bupropion and metroprolol experienced obvious change with AUC , C increased and CL decreased for bupropion in medium dosage group and midazolam low dosage group. This result indicates that the 14 day-intragastric administration of codeine may inhibit the metabolism of bupropion (CYP2B1) and midazolam (CYP3A2) in rat. Additional, there are no statistical differences for albumin (ALB), alkaline phosphatase (ALP), creatinine (Cr) after 14 intragastric administration of codeine, while alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA) increased compared to control group. The biomedical test results show continuous 14 day-intragastric administration of codeine would cause liver damage.
[Mh] Termos MeSH primário: Codeína/metabolismo
Codeína/farmacologia
Sistema Enzimático do Citocromo P-450/metabolismo
[Mh] Termos MeSH secundário: Animais
Bupropiona/metabolismo
Relação Dose-Resposta a Droga
Interações Medicamentosas/fisiologia
Ativação Enzimática/efeitos dos fármacos
Ativação Enzimática/fisiologia
Isoenzimas/metabolismo
Masculino
Distribuição Aleatória
Ratos
Ratos Sprague-Dawley
Tolbutamida/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Isoenzymes); 01ZG3TPX31 (Bupropion); 9035-51-2 (Cytochrome P-450 Enzyme System); 982XCM1FOI (Tolbutamide); Q830PW7520 (Codeine)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.1080/13880209.2017.1297466


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[PMID]:28246654
[Au] Autor:Curry SA
[Ad] Endereço:Division of Endocrinology, Diabetes and Metabolism, CharterCARE Medical Associates, Providence RI.
[Ti] Título:Obesity Epidemic: Pharmaceutical Weight Loss.
[So] Source:R I Med J (2013);100(2):18-20, 2017 Mar 01.
[Is] ISSN:2327-2228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Obesity is a chronic disease universally defined as an excess of adipose tissue resulting in body mass index (BMI) > 30.0 kg/m2. Over the past few years, the concept of prevention has gained increased awareness, thus leading to the development of additional pharmaceutical options for the treatment of obesity since 2012. Treating obesity revolves around an individualized, multi-disciplinary approach with additional focus on a healthy and supportive lifestyle to maintain the weight loss. [Full article available at http://rimed.org/rimedicaljournal-2017-03.asp].
[Mh] Termos MeSH primário: Fármacos Antiobesidade/uso terapêutico
Obesidade/tratamento farmacológico
Perda de Peso/efeitos dos fármacos
[Mh] Termos MeSH secundário: Fármacos Antiobesidade/efeitos adversos
Benzazepinas/efeitos adversos
Benzazepinas/uso terapêutico
Índice de Massa Corporal
Bupropiona/efeitos adversos
Bupropiona/uso terapêutico
Combinação de Medicamentos
Frutose/efeitos adversos
Frutose/análogos & derivados
Frutose/uso terapêutico
Seres Humanos
Lactonas/efeitos adversos
Lactonas/uso terapêutico
Liraglutida/efeitos adversos
Liraglutida/uso terapêutico
Naltrexona/efeitos adversos
Naltrexona/uso terapêutico
Fentermina/efeitos adversos
Fentermina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Obesity Agents); 0 (Benzazepines); 0 (Drug Combinations); 0 (Lactones); 0 (Qsymia); 0 (bupropion hydrochloride, naltrexone hydrochoride drug combination); 01ZG3TPX31 (Bupropion); 30237-26-4 (Fructose); 5S6W795CQM (Naltrexone); 637E494O0Z (lorcaserin); 839I73S42A (Liraglutide); 95M8R751W8 (orlistat); C045TQL4WP (Phentermine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170602
[Lr] Data última revisão:
170602
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170302
[St] Status:MEDLINE



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