Abstract | OBJECTIVE: METHODS: This single-center, 12-week, double-blind, prospective, controlled-concentration study randomized 121 chronic back pain patients without major depression to active placebo ( benztropine mesylate) or to predetermined low, medium, or high concentrations of desipramine (targets were 50, 110, and 150 ng/mL, respectively) or fluoxetine (targets were 100, 200, and 400 ng/mL, respectively). Of these, 83 completed the trial: 38 withdrew primarily due to side effects. RESULTS: Manipulation check revealed significant overlap of assigned and achieved concentrations related to drug intolerability. Completers' analysis of achieved concentrations revealed reduction in pain intensity was significantly greater for low-concentration desipramine (<60 ng/mL, mean Descriptor Differential Scale [DDS], 4.5) compared with placebo (DDS 6.2), higher concentrations of desipramine (>60 ng/mL, DDS 7.9), and all concentrations of fluoxetine (P < 0.05, DDS 7.1). Significant improvement in everyday function mirrored findings for pain intensity. CONCLUSIONS: Preliminary evidence for a low-concentration "therapeutic window" for noradrenergic analgesia may warrant additional study.
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Authors | J Hampton Atkinson, Mark A Slater, Edmund V Capparelli, Mark S Wallace, Sidney Zisook, Ian Abramson, Scott C Matthews, Steven R Garfin |
Journal | Journal of clinical psychopharmacology
(J Clin Psychopharmacol)
Vol. 27
Issue 2
Pg. 135-42
(Apr 2007)
ISSN: 0271-0749 [Print] United States |
PMID | 17414235
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Adrenergic Uptake Inhibitors
- Capsules
- Serotonin Uptake Inhibitors
- Fluoxetine
- Desipramine
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Topics |
- Adrenergic Uptake Inhibitors
(administration & dosage, adverse effects, therapeutic use)
- Adult
- Aged
- Back Pain
(drug therapy)
- Capsules
- Chronic Disease
- Constipation
(chemically induced)
- Desipramine
(administration & dosage, adverse effects, therapeutic use)
- Dose-Response Relationship, Drug
- Double-Blind Method
- Fluoxetine
(administration & dosage, adverse effects, therapeutic use)
- Humans
- Middle Aged
- Pain Measurement
(methods)
- Patient Dropouts
(statistics & numerical data)
- Prospective Studies
- Selective Serotonin Reuptake Inhibitors
(administration & dosage, adverse effects, therapeutic use)
- Sexual Dysfunction, Physiological
(chemically induced)
- Time Factors
- Treatment Outcome
- Xerostomia
(chemically induced)
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