These results indicate a clinically and statistically significant effect of bupropion in improving ADHD in adults. The results suggest a therapeutic role for bupropion in the armamentarium of agents for ADHD in adults, while further validating the continuity of pharmacological responsivity of ADHD across the lifespan.
We developed an interactive, customizable, Web-based program focused on the prevention of HIV, sexually transmitted infections, and hepatitis among youth. Results from a randomized, controlled trial with youth in treatment for substance use demonstrated that this Web-based tool, when provided as an adjunct to an educator-delivered prevention intervention, increased accurate prevention knowledge, increased intentions to carefully choose partners, and was perceived as significantly more useful relative to the educator-delivered intervention when provided alone. Results suggest this Web-based program may be effective and engaging and may increase the adoption of effective HIV and disease prevention science for youth. Limitations are discussed.
Background and Aims
Few randomized controlled trials have evaluated buprenorphine treatment interventions for opioid-dependent youth. Consequently, optimal administration strategies for this cohort are unclear. Our aim was to evaluate the relative efficacy of two different buprenorphine taper lengths in promoting abstinence from illicit opioids and treatment retention among opioid-dependent youth.
Design
A double blind, placebo controlled, multicenter randomized controlled trial.
Setting
Two hospital-based research clinics (Manhattan and Brooklyn) in New York City, USA from 2005 to 2010.
Participants
Volunteer sample of 53 primarily Caucasian participants between the ages of 16 and 24 (n=11 under age 18) who met DSM-IV opioid dependence criteria.
Intervention
Participants were randomly assigned to either a 28-day buprenorphine taper (n=28) or 56-day buprenorphine taper (n=25) via a parallel groups design over a 63-day period. Both groups received behavioral counseling and opioid abstinence incentives. Both taper conditions had a minimum of one week of placebo dosing at the end of the taper.
Measurements
The primary outcome was opioid abstinence measured as percent of scheduled urine toxicology tests documented to be negative for opioids. The secondary outcome was treatment retention, measured as number of days attended scheduled visits.
Findings
Intent-to-treat analyses revealed that participants who received a 56-day buprenorphine taper had a significantly higher percentage of opioid negative scheduled urine tests compared with participants who received a 28-day buprenorphine taper (35% vs 17%, p=.039; Cohen's d=0.57, 95% CI: 0.02,1.13). Participants who received a 56-day buprenorphine taper were retained in treatment significantly longer than participants who received a 28-day buprenorphine taper (37.5 vs 26.4 days, p=.027; Cohen's d=0.63, 95% CI: 0.06, 1.19). Daily attendance requirement was associated with decreased abstinence and shorter retention compared with a 2-3 times weekly attendance requirement, independent of taper duration. Follow-up data were insufficient to report.
Conclusion
Longer (56-day) buprenorphine taper produces better opioid abstinence and retention outcomes than shorter (28-day) buprenorphine taper for opioid-dependent youth.
Background
Depression appears to be a common complication in patients during and post–COVID-19 infection. Understanding the mechanism of action of cytokines such as interleukin-6, interleukin-10 and others in depression and in cytokine storm syndrome, the core component of COVID- 19, could shine a new light on future treatment options for both disorders.
Objective
This review demonstrates the role of interleukins in COVID-19 pathogenesis and their role in depression.
Results
We described cases we have treated as an example for the dual role interleukins have in COVID-19 infection and depression and reviewed approximately 70 articles focusing on the role of interleukins in cytokine storm syndrome and depression.
Conclusion
This review highlights the key features of cytokines in both diseases. As the scientific community has more time to recover and process the effect of the current pandemic, we believe that additional research will pave the way to diverse pathways to treat depression in these patient and others.
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