The largest trial to date of the antioxidant N-acetylcysteine for the treatment of co-occurring post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) showed no significant difference from placebo on numerous PTSD- and drinking-related outcomes. Both the N-acetylcysteine and placebo groups showed marked improvement on most studied measures.
Fluoxetine, like other selective serotonin reuptake inhibitors (SSRIs), is commonly prescribed for patients with depression, anxiety, and obsessive-compulsive disorder. Cytochrome P-450 2D6 (CYP2D6) is the primary isoenzyme responsible for the metabolism of fluoxetine to the active metabolite norfluoxetine. As a result of genetic inheritance of normal versus abnormal variants of the gene that controls activity of the CYP2D6 isoenzyme, CYP2D6 activity is significantly different among four phenotypes of individuals: ultra-rapid metabolizers (UM) with high enzyme activity, normal metabolizers (NM) with normal enzyme activity, intermediate metabolizers (IM) with below-normal enzyme activity, and poor metabolizers (PM) with very low or complete absence of enzyme activity.
A meta-analysis comprising 17 randomized trials has found that rates of control group improvement in depression studies were lower in psilocybin trials than in studies of esketamine or a selective serotonin reuptake inhibitor (SSRI). The results suggest that psilocybin's overall efficacy in the treatment of depression might be overestimated.
The significant cost savings associated with generic versions of medications continues to fuel demand for these formulations vis-à-vis brand-name products. The Food and Drug Administration (FDA) only requires evidence of bioequivalence, showing similar concentration-time profiles within acceptable predetermined limits between brand-name and generic versions of the same medication, as the primary determinant for approving generic drugs.
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