Farzaneh Karami; Fateme Assarian; Fatemeh Sadat Ghoreishi; Mojtaba Sehat
Volume 22, Issue 7 , 2020
Abstract
Background: Methamphetamine dependence is a growing global problem. Currently, there are no approved pharmacotherapy options for the management of methamphetamine dependence. One of the alternatives to manage this addiction is the use of N acetylcysteine (NAC) due to its capacity to restore homeostasis ...
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Background: Methamphetamine dependence is a growing global problem. Currently, there are no approved pharmacotherapy options for the management of methamphetamine dependence. One of the alternatives to manage this addiction is the use of N acetylcysteine (NAC) due to its capacity to restore homeostasis in the brain glutamate systems disrupted in addiction and its ability to reduce craving and the risk of relapse.
Methods: Methamphetamine-dependentvolunteersundermethadonetreatment(n= 38) wererandomizedtoreceivedailydosesof 1200 mg of NAC, or placebo. The participants were followed for 12 weeks (two visits weekly). Craving and Beck Inventory Depression (BDI) was determined at the beginning of the study and also after one month, two months, and three months. Addiction severity index (ASI) was recorded at the beginning of the study and after three months. The data were analyzed via SPSS version 16.0 (SPSS Inc. Chicago, Illinios, USA)
Results: The mean score of craving and BDI reduced after two months with NAC treatment. ASI (e.g., substance, familial, and psy- chiatric categories) was significantly reduced at the end of the study in the NAC group compared to placebo (P < 0.001). The success of the treatment in groups of NAC and placebo were 84% and 73%, respectively (P = 0.001). 63.2% of the NAC group patients avoided substance use for more than a month, but this was 10.5% in the placebo group (P = 0.001).
Conclusions: The NAC showed good efficacy in suppressing methamphetamine craving, addiction severity index, and depression. It may be a useful pharmacological treatment for methamphetamine dependency.
Zahra Sepehrmanesh; Mehdi Adel; Afshin Ahmadvand; Mojtaba Sehat
Volume 22, Issue 5 , 2020
Abstract
Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased ...
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Background: Serotonin and dopamine are involved in the development of obsessive-compulsive disorder (OCD). Approximately 40% of OCD patients do not respond to the first-line therapy of treatment using selective serotonin reuptake inhibitors. Reportedly, the response to the treatment is increased by enhancing dopamine blockers.
Objectives: The purpose of this study was to evaluate the efficacy and immunogenicity of ondansetron as a booster in the treatment of OCD patients.
Methods: The present double-blind, randomized clinical trial (RCT) was conducted on 40 patients (16 males and 24 females) aged 18 to 60 years who met the DSM-V-TR-based OCD diagnostic criteria and had a minimum score of 16 on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). The patients were randomized to receive standard treatment and ondansetron (8 mg/day) or placebo for 12 weeks. They were examined using Y-BOCS and side-effect checklist at baseline, fourth, eighth, and twelfth weeks.
Results: The patients in both groups were homogeneous and comparable in terms of age, marital sex status, type of obsession, anxiety, depression, age at the onset of disease, and the duration of disease. The Y-BOCS scores in the intervention and placebo groups were 27.15 ± 3.94 vs. 26.15 ± 4.94 at baseline, 25.40 ± 3.75 vs. 25.00 ± 4.79 in the fourth week, 20.85 ± 3.69 vs. 24.05 ± 4.97 (P = 0.026) in the eighth week, and 17.95 ± 3.43 vs. 21.65 ± 4.85 (P = 0.008) in the twelfth week, respectively. Significant changes occurred between the two groups at weeks 8 and 12; the difference between the two groups was significant (P = 0.015), whereas no significant difference was observed between the two groups before week 8.
Conclusions: This 12-week, double-blind, and randomized clinical trial showed that ondansetron was a booster agent with a significant effect on patients with moderate to severe OCD. This study also showed that ondansetron is generally well tolerated by OCD patients. The response to the treatment also increased from the eighth week of treatment onwards. The severity of the disease was decreased at the end of the ondansetron intervention. The adjunct ondansetron treatment was recommended for OCD patients
Hassan Khazraee; Abdollah Omidi; Reza Daneshvar Kakhki; Zahra Zanjani; Mojtaba Sehat
Volume 20, s1 , December 2018, , Pages 1-10
Abstract
Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than ...
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Background: Chronic daily headache is a serious disease, causing significant problems such as disability. It is characterized by pain localized to the head (headache) and headaches occurring on 15 or more days per month for more than 3 months (> 180 days per year). Programs for pain and health improvement in patients with painful diseases, such as headache, are not still fully developed. Acceptance and commitment therapy (ACT) is a new psychotherapy, which appears to be effective in the treatment of chronic pain. Objectives: This study aimed to examine the effectiveness of ACT in cognitive emotion regulation strategies, headache-related dis- ability, and headache intensity in patients with chronic daily headaches. Methods: In the current study, a semi-experimental method was applied. The study was conducted at Shahid Beheshti Govern- mental hospital of Kashan, Iran in 2016. The sample consisted of 40 patients with chronic daily headache, who were selected via convenience sampling. The participants were randomly allocated into medical treatment as usual (MTAU) and ACT groups (20 sam- ples per group) via block randomization. The ACT group received eight 90-minute weekly treatments, based on the ACT protocol. The cognitive emotion regulation questionnaire (CERQ), diary of headache severity, and headache-related disability inventory (HDI) were administered at pretreatment, posttreatment, and three-month follow-up in both groups. Results: In the current study, no significant differences were found between the groups in terms of demographic variables (P > 0.05). In the ACT group, the mean (SD) scores of emotional and functional aspects of headache disability were 26.87 ± 10.11 and 28.50 ± 9.04, respectively before the intervention, which decreased to 17.75 ± 8.32 and 18.12 ± 9.42 after the intervention and 21.37 ± 8.53 and 21.37 ± 9.87 in the follow-up, respectively (P < 0.05). In addition, the mean (SD) score of nonadjustment cognitive emotion regulation strategies was 54.31 ± 10.02 at pretreatment, which significantly reduced to 44.43 ± 7.7 at posttreatment and 49.78 ± 9.1 in the follow-up (P < 0.05). Furthermore, the mean (SD) score of adjustment cognitive emotion regulation strategies was 61.43±12.02 in the pretest, which significantly increased to 72.06 ± 8.66 in the posttest and 69.62 ± 11.84 in the follow-up (P < 0.05). The mean score of headache intensity decreased from 6.40 ± 1.19 to 5.00 ± 1.09, compared to the pretest (P < 0.05); however, there was no significant difference between the groups in the follow-up (P > 0.05). Conclusions: The results of the present study suggested that ACT is an effective treatment for reducing nonadjustment cognitive emotion regulation strategies, headache-related disability, and headache intensity and improving adjustment emotion regulation strategies in patients with chronic daily headache.
Sareh Bagheri Josheghani; Rezvan Moniri; Farzaneh Firoozeh; Mojtaba Sehat; Kamran Dastehgoli; Hasan Koosha; Reza Khaltabadi Farahani
Volume 19, Issue 5 , May 2017, , Pages 1-7
Abstract
Background: Emergence of multidrug-resistant (MDR) Acinetobacter baumannii infections is becoming a worldwide threat to hospitalized patients, particularly in intensive care units.Objectives: The aim of this study was to investigate the antimicrobial susceptibility patterns and prevalence of blaOXA-type ...
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Background: Emergence of multidrug-resistant (MDR) Acinetobacter baumannii infections is becoming a worldwide threat to hospitalized patients, particularly in intensive care units.Objectives: The aim of this study was to investigate the antimicrobial susceptibility patterns and prevalence of blaOXA-type carbapenemases of A. baumannii isolates in a teaching hospital in Iran.Patients and Methods: The study included a total of 40 isolates of carbapenem-resistant A. baumannii, obtained from 103 tracheal tubes in hospitalized ICU patients. Antimicrobial susceptibility testing was performed according to CLSI guidelines. The blaOXA-51, blaOXA-23, blaOXA-24, blaOXA-58, and ISAba1 genes were detected by PCR.Results: All of the A. baumanniiisolates were resistant to imipenem and meropenem, and 100% of the isolates were MDR. The blaOXA-51 and ISAba1 genes were detected in 100% of the isolates. blaOXA-23 and blaOXA-24 were detected in 90% and 40% of the isolates, respectively, but blaOXA-58 was absent in the A. baumannii isolates. In addition, 32.5% of carbapenem-resistant strains contained at least three genes encoding blaOXA-type carbapenemase. Colistin and polymyxin B were the most effective antibiotics. The sole risk factor for infection of hospitalized patients with carbapenem-resistant Acinetobacter strains was age over 40 years (P = 0.042). The mortality rate was 27.5%.Conclusions: These findings signify the alarming spread of OXA genes in A. baumannii strains in our intensive care unit. The spread of carbapenem-resistantAcinetobacter strains has serious health implications and requires the application of strict infection-control measures.
