ABSTRACT
Comparing the efficacy of different treatments in psychiatry is difficult for many reasons, even when they are investigated in "head-to-head" studies. A consensus meeting was, therefore, held to produce best practice guidelines for such studies. This article presents the conclusions of this consensus and illustrates it using published data in the field of antidepressant treatment of generalized anxiety disorder.
Subject(s)
Antidepressive Agents/therapeutic use , Anxiety Disorders/drug therapy , Cyclohexanols/therapeutic use , Evidence-Based Medicine , Practice Guidelines as Topic , Selective Serotonin Reuptake Inhibitors/therapeutic use , Thiophenes/therapeutic use , Antidepressive Agents/adverse effects , Anxiety Disorders/diagnosis , Consensus Development Conferences as Topic , Cyclohexanols/adverse effects , Duloxetine Hydrochloride , Humans , Randomized Controlled Trials as Topic , Selective Serotonin Reuptake Inhibitors/adverse effects , Thiophenes/adverse effects , Venlafaxine HydrochlorideABSTRACT
BACKGROUND: Some recent studies have suggested a lower risk of fatal intoxications in drug-dependent patients under buprenorphine compared to methadone treatment. METHODS: Epidemiological reference data for the Munich region suggest that in 2003 approximately 10 % of all substitution patients were treated with buprenorphine, and 87 % with methadone. We studied the proportion of patients under methadone and buprenorphine substitution among drug-related deaths. Data from forensic post-mortem and toxicological analysis were analyzed. RESULTS: Data indicate that in 96 (35 %) of all 272 so-called drug deaths, methadone was involved compared to a single case of buprenorphine, possibly indicating a relatively better risk profile of buprenorphine. DISCUSSION: More prospective studies are necessary to assess the risk of fatal intoxications under different substitution regimens.
