Opioid response different in men and women with acute pain

  

Researchers Penny Miller and Amy Ernst from the University of California Davis Medical Center found that among 94 patients (49 men, 45 women) enrolled in a double-blind trial for acute pain management, women respond better to a kappa agonist (such as butorphanol) versus a mu agonist (such as morphine sulfate). The authors conclude by writing, “Females had better pain scores with butorphanol than morphine at 60 minutes. Kappa receptor agonists should be chosen preferentially for female patients with acute
traumatic injury pain."

  

Southern Medical Journal 2004, 97, 35-41

  

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Death of a child increases multiple sclerosis risk in parents

  

Dr. Jiong Li from the University of Aarhus in Denmark reports that parents who lose a child to death are at risk for developing Multiple Sclerosis. Dr. Li, in a prospective longitudinal study, compared the rate of MS in 21,062 parents who lost a child to 293,745 parents who did not. The subjects were followed for 17 years. Two hundred and fifty eight people in both groups were
diagnosed with multiple sclerosis with bereaved parents being 56% more likely to develop the disease compared to controls. Statistical significance was reached at year eight. Dr. Li concludes, “This is more evidence that stress plays a role in the disease, because losing a child unexpectedly is considered to be even more stressful for parents.”

  

Neurology 2004,62, 726-729

  

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PTSD Patients benefit from transcranial magnetic stimulation (TMS)

  

Hagit Cohen, Ph.D. and colleagues of Ben-Gurion University report that among 24 patients who fulfilled the diagnostic criteria for Post Traumatic Stress Disorder (PTSD) who either underwent low frequency TMS (1hz), or high frequency TMS (10hz), or sham treatment, those who underwent the high frequency treatment showed the greatest response with a decrease of 39% from baseline scores on the Treatment Outcome PTSD Scale. With the most noticeable side effect being headache, Dr. Cohen concludes by writing, “The effect of 10-Hz rTMS was significant and stable for at least 14 days after the last treatment. It is suggested that in further studies the stimulation could be repeated as maintenance therapy, as in [electroconvulsive
therapy] procedures," Dr. Cohen and colleagues add, "However, given the small number of patients, our study must be considered preliminary."

  

American Journal of Psychiatry 2004,161, 515-524

  

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Bipolar children benefit from special cognitive-behavioral therapy (CBT)

  

Dr. Mani Pavuluri from the University of Illinois at Chicago states that in a study of 34 Pediatric Bipolar Disorder (PBD) patients who were treated with a modified CBT called “Child and Family Focused Cognitive Behavioral Therapy (CFF-CBT),” combining interpersonal therapy with traditional CBT, along with medication, patients demonstrated significant reductions in severity of symptoms indicating improvement in mania, depression, aggression, attention-deficithyperactivity disorder and sleep disorder. High medication adherence and patient satisfaction with the treatment were also demonstrated. One of the CFF-CBT tools is mnemonic called
“RAINBOW,” standing for: Routine Affect Regulation, I can do it, No negative thoughts, Be a good friend, Oh how can we solve it, and Ways to get support. Dr. Pavuluri partly concludes by saying, “We want beautiful colors of mood like the rainbow, but not the extreme blue of depression or the extreme red of mania.”

  

Journal of the American Academy of Child and Adolescent Psychiatry (in press)

  

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Osteoarthritis and Herbal Therapy

  

Little, Parsons and Logan write that after reviewing five studies and combining the results of two of those, they were able to determine that the sue of avocado and soybean unsaponifiable extracts produced beneficial effects on functional index, pain, use of non-steroidal antiinflammatory
drugs as well as over-all global evaluation of condition. The authors conclude, “The evidence for avocado-soybean unsaponifiables in the treatment of osteoarthritis is convincing but evidence for [the] other herbal interventions is insufficient to either recommend or discourage
their use.”

  

Cochrane Review Abstracts 2003, 2

  

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Botanicals for women’s health

  

Jodi Godfrey Meisler, M.S., R.D. interviews Stacie E. Geller, Ph.D., an assistant professor and director of the National Center of Excellence in Women's Health at the University of Illinois and Fredi Kronenberg, Ph.D., a professor of clinical physiology and director of the Richard and Linda
Rosenthal Center for Alternative/Complementary Medicine at Columbia University.

Geller and Kronenberg state that botanicals (vitamin, mineral, herb, or nutritional element which enhance the dietary intake) are becoming incresingly popular among women for relief of menopausal symptoms (e.g., black cohosh or soy), lessening joint pain, improving sleep, combating symptoms of PMS (e.g., chasteberry) and improving memory (e.g., Ginkgo biloba). The use of botanicals is especially significant in light of the potential harmful effects of the traditional Hormone Replacement Theory now evidenced in the recently conducted Women’s Health Initiative.

  

Dr. Geller says, “Because of the increasingly difficult challenge of staying healthy and managing chronic disease, many women are looking for alternatives to drugs, a goal that is complicated because there is very little scientific information on the safety and efficacy of botanicals and dietary supplements currently on the market.” Dr. Kronenberg adds, “Many of the multiherb products contain 10 or 20 mg/day of black cohosh, which is a subtherapeutic dose. If several subtherapeutic doses are combined, say black cohosh, soy, and red clover, will these add up to an effective dose? We do not know. It is likely that these small doses are not harmful, but will they help? Or are people just wasting their money? These questions should be raised with patients who are considering herbal therapy.”

  

Journal of Women’s Health 2003, 12(9), 847-852

Larry Lachman, PsyD is a Licensed Clinical Psychologist with Inner Dimensions Group in Monterey, California, who specializes in Psycho-Oncology, Cardiac Psychology, Pain Management and Grief and Loss. Dr. Lachman is the co-author with Carmel Poet/Philosopher Ric Masten of a book on coping with cancer entitled, “Parallel Journeys.” Dr. Lachman can be reached through his web site at: http://www.paralleljourneys-cancer.com/

  

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