1
|
Blumenthal SR, Mohan LS, Knabel DR, Mori W, Demer A, Farah R, Fiessinger L, Mattox A, Maher I. Periosteal flaps allow for single stage reconstruction of larger full thickness eyelid defects: a retrospective study. Arch Dermatol Res 2023; 315:2833-2839. [PMID: 37603088 DOI: 10.1007/s00403-023-02689-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 06/25/2023] [Accepted: 07/27/2023] [Indexed: 08/22/2023]
Abstract
Full-thickness lower eyelid defects after Mohs micrographic surgery are frequently referred out to oculoplastic surgery for reconstruction. Reconstructive options include wedge closure with or without canthotomy/cantholysis and tarsoconjunctival sliding flaps. Defects > 50% of the eyelid margin have traditionally required the two-stage Hughes flap, leaving the patient with monocular vision for 3-6 weeks until pedicle division. To demonstrate single-stage periosteal flaps performed by dermatologic surgeons can result in safe, functional, and cosmetically acceptable repairs for large full thickness eyelid defects, an institutional review board-approved retrospective study of repairs performed by two dermatologic surgeons between January 2017 and July 2021 at the University of Minnesota. Patient demographics, operative notes, and follow-up notes were reviewed. Defect and follow-up photographs were scored using a visual analogue scale to assess aesthetic results. Ten cases were included in the analysis. Six patients were male and the average age was 62 years old. 8/10 were basal cell carcinoma and 2/10 were melanoma. The mean defect was 9.5 cm2, with a range of 1-24 cm2. The median cosmetic score was 85.8 ± 10.7. There were no serious complications reported. Mohs micrographic surgeons can safely and successfully reconstruct large, full thickness eyelid defects by periosteal flap.
Collapse
Affiliation(s)
- Shoshana R Blumenthal
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Lauren S Mohan
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA.
| | - Daniel R Knabel
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Westley Mori
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Addison Demer
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Ronda Farah
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Lori Fiessinger
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Adam Mattox
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| | - Ian Maher
- Department of Dermatology, University of Minnesota, Phillips-Wangsteen Building, 516 Delaware Street SE Suite 4-240, Minneapolis, MN, 55455, USA
| |
Collapse
|
2
|
Veerabagu SA, Perz AM, Lukowiak TM, Lee MP, Neal D, Aizman L, Miller CJ, Golda N, Albertini JG, Chen D, Bar A, Leitenberger J, Maher IA, Sobanko JF, Hollmig T, Aasi S, Sutton A, Higgins Ii HW, Shin TM, Weinberger C, Mattox A, Wysong A, Nugent ST, Etzkorn JR. Patient-Reported Nasal Function and Appearance After Interpolation Flap Repair Following Skin Cancer Resection: A Multicenter Prospective Cohort Study. Facial Plast Surg Aesthet Med 2023; 25:113-118. [PMID: 35950993 DOI: 10.1089/fpsam.2021.0271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: Among patients undergoing two-stage interpolated flap repair of nasal defects, nasal function, and appearance before surgery and at 16 weeks after flap takedown were compared using the Nasal Appearance and Function Evaluation Questionnaire (NAFEQ). Design: Multicenter prospective cohort study. Methods: Adult patients with a nasal skin cancer anticipated to require two-stage interpolation flap repair completed the NAFEQ before surgery, at 1 week after flap placement, 4 weeks after flap takedown, and 16 weeks after flap takedown. Results: One hundred sixty-nine patients were enrolled, with 138 patients completing both presurgical and 16-week post-takedown NAFEQs. Overall NAFEQ score increased by 1.09 points (1.91% improvement, confidence interval [95% CI -0.34 to 2.53]). NAFEQ functional subscale increased by 0.72 points (2.58% increase; 95% CI [0.10-1.35]) and appearance subscale increased by 0.37 points (1.28% improvement, 95% CI [-0.65 to 1.39]). Conclusion: At 16 weeks after flap takedown, patients' perceptions of their nasal function and appearance are similar to or slightly improved when compared with their presurgical assessments.
Collapse
Affiliation(s)
| | - Allison M Perz
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Tess M Lukowiak
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael P Lee
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Donald Neal
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Leora Aizman
- George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicholas Golda
- Department of Dermatology, University of Missouri, Columbia, Missouri, USA
| | | | - David Chen
- Division of Dermatology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Anna Bar
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Justin Leitenberger
- Department of Dermatology, Oregon Health & Science University, Portland, Oregon, USA
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tyler Hollmig
- Division of Dermatology, University of Texas Dell Medical Center, Austin, Texas, USA
| | - Sumaira Aasi
- Department of Dermatology, Stanford University, Stanford, California, USA
| | - Adam Sutton
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - H William Higgins Ii
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christine Weinberger
- Division of Dermatology, University of Vermont Medical Center, Burlington, Vermont, USA
| | - Adam Mattox
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Shannon T Nugent
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
3
|
Lukowiak TM, Perz AM, Veerabagu SA, Lee MP, Neal D, Aizman L, Miller CJ, Golda N, Albertini JG, Holmes T, Bar A, Leitenberger J, Maher IA, Sobanko JF, Chen D, Aasi S, Sutton A, Higgins HW, Shin TM, Weinberger C, Mattox A, Wysong A, Etzkorn JR. Patient Quality of Life After Interpolated Flap Repair of Nasal Mohs Surgery Defects: A Multicenter Prospective Cohort Study. JAMA Dermatol 2021; 157:1213-1216. [PMID: 34431977 DOI: 10.1001/jamadermatol.2021.3161] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Single-center studies have shown that patients report better skin cancer-specific quality of life (QOL) after Mohs micrographic surgery (MMS), but it is unclear whether this improved QOL applies to patients after MMS and complex reconstruction in cosmetically sensitive areas. Objective To evaluate patient QOL after MMS and interpolation flap reconstruction for patients with nasal skin cancers. Design, Setting and Participants This multicenter prospective survey study used the Skin Cancer Index (SCI), a validated, 15-question QOL questionnaire administered at 4 time points: before MMS, 1 week after flap placement, 4 weeks after flap takedown, and 16 weeks after flap takedown. Patients age 18 years or older with a nasal skin cancer who presented for MMS and were anticipated to undergo 2-stage interpolated flap repair by a Mohs surgeon were recruited from August 9, 2018, to February 2, 2020, at 8 outpatient MMS locations across the United States, including both academic centers and private practices. Main Outcomes and Measures Mean difference in overall SCI score before MMS vs 16 weeks after flap takedown. Results A total of 169 patients (92 men [54.4%]; mean [SD] age, 67.7 [11.4] years) were enrolled, with 147 patients (75 men [51.0%]; mean [SD] age, 67.8 [11.7] years) completing SCI surveys both before MMS and 16 weeks after flap takedown. Total SCI scores improved significantly 16 weeks after flap takedown compared with pre-MMS scores, increasing by a mean of 13% (increase of 7.11 points; 95% CI, 5.48-8.76; P < .001). All 3 SCI subscale scores (emotion, appearance, and social) improved significantly (emotion subscale, increase of 3.27 points; 95% CI, 2.35-4.18; P < .001; appearance subscale, increase of 1.65 points; 95% CI, 1.12-2.18; P < .001; and social subscale, increase of 2.10 points; 95% CI, 1.55-2.84; P < .001) 16 weeks after flap takedown compared with pre-MMS. Conclusions and Relevance Removal of a nasal skin cancer and repair of the resulting defect can be distressing for patients. However, this cohort study suggests that physicians referring patients for MMS can be reassured that their patient's QOL will improve on average after surgery, even when a complex reconstruction is required.
Collapse
Affiliation(s)
- Tess M Lukowiak
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Allison M Perz
- Cooper Medical School of Rowan University, Camden, New Jersey
| | | | | | - Donald Neal
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Leora Aizman
- George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Christopher J Miller
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
| | - Nicholas Golda
- Department of Dermatology, University of Missouri, Columbia
| | | | - Todd Holmes
- Division of Dermatology, University of Vermont Medical Center, Burlington
| | - Anna Bar
- Department of Dermatology, Oregon Health & Science University, Portland
| | | | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Joseph F Sobanko
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
| | - David Chen
- Division of Dermatology, University of Vermont Medical Center, Burlington
| | - Sumaira Aasi
- Department of Dermatology, Stanford University, Stanford, California
| | - Adam Sutton
- Department of Dermatology, University of Nebraska Medical Center, Omaha
| | - H William Higgins
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
| | - Thuzar M Shin
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
| | | | - Adam Mattox
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Ashley Wysong
- Department of Dermatology, University of Nebraska Medical Center, Omaha
| | - Jeremy R Etzkorn
- Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia.,Associate Editor, JAMA Dermatology
| |
Collapse
|
4
|
Reynolds KA, Schlessinger DI, Vasic J, Iyengar S, Qaseem Y, Behshad R, DeHoratius DM, Denes P, Drucker AM, Dzubow LM, Etzkorn JR, Harwood C, Kim JYS, Lee EH, Lissner GS, Marghoob AA, Matin RN, Mattox A, Mittal BB, Thomas JR, Zhou XA, Zloty D, Schmitt J, Kirkham J, Poon E, Sobanko JF, Cartee TV, Maher IA, Alam M. Core Outcome Set for Actinic Keratosis Clinical Trials. JAMA Dermatol 2020; 156:326-333. [PMID: 31939999 DOI: 10.1001/jamadermatol.2019.4212] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Although various treatments have been found in clinical trials to be effective in treating actinic keratosis (AK), researchers often report different outcomes. Heterogeneous outcome reporting precludes the comparison of results across studies and impedes the synthesis of treatment effectiveness in systematic reviews. Objective To establish an international core outcome set for all clinical studies on AK treatment using systematic literature review and a Delphi consensus process. Evidence Review Survey study with a formal consensus process. The keywords actinic keratosis and treatment were searched in PubMed, Embase, CINAHL, and the Cochrane Library to identify English-language studies investigating AK treatments published between January 1, 1980, and July 13, 2015. Physician and patient stakeholders were nominated to participate in Delphi surveys by the Measurement of Priority Outcome Variables in Dermatologic Surgery Steering Committee members. All participants from the first round were invited to participate in the second round. Outcomes reported in randomized controlled clinical trials on AK treatment were rated via web-based e-Delphi consensus surveys. Stakeholders were asked to assess the relative importance of each outcome in 2 Delphi survey rounds. Outcomes were provisionally included, pending the final consensus conference, if at least 70% of patient or physician stakeholders rated the outcome as critically important in 1 or both Delphi rounds and the outcome received a mean score of 7.5 from either stakeholder group. Data analysis was performed from November 5, 2018, to February 27, 2019. Findings A total of 516 outcomes were identified by reviewing the literature and surveying key stakeholder groups. After deduplication and combination of similar outcomes, 137 of the 516 outcomes were included in the Delphi surveys. Twenty-one physicians and 12 patients participated in round 1 of the eDelphi survey, with 17 physicians (81%) retained and 12 patients (100%) retained in round 2. Of the 137 candidate outcomes, 9 met a priori Delphi consensus criteria, and 6 were included in the final outcomes set after a consensus meeting: complete clearance of AKs, percentage of AKs cleared, severity of adverse events, patient perspective on effectiveness, patient-reported future treatment preference, and recurrence rate. It was recommended that treatment response be assessed at 2 to 4 months and recurrence at 6 to 12 months, with the AK rate of progression to cutaneous squamous cell carcinoma reported whenever long-term follow-up was possible. Conclusions and Relevance Consensus was reached regarding a core outcome set for AK trials. Further research may help determine the specific outcome measures used to assess each of these outcomes.
Collapse
Affiliation(s)
- Kelly A Reynolds
- University of Cincinnati College of Medicine, Cincinnati, Ohio.,Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Daniel I Schlessinger
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jelena Vasic
- Division of Dermatology, College of Medicine Tucson, University of Arizona, Tucson, Arizona
| | - Sanjana Iyengar
- Department of Dermatology, West Virginia University, Morgantown
| | - Yaqoob Qaseem
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ramona Behshad
- Department of Dermatology, St Louis University, St Louis, Missouri
| | - Danielle M DeHoratius
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Pablo Denes
- Division of Cardiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Aaron M Drucker
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Dermatology, Department of Medicine, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | | | - Jeremy R Etzkorn
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Catherine Harwood
- Department of Dermatology, Royal London Hospital, Barts Health National Health Service Trust, London, United Kingdom.,Blizard Institute, Barts and the London School of Medicine and Dentistry, Centre for Cutaneous Research and Cell Biology, Queen Mary University of London, London, United Kingdom
| | - John Y S Kim
- Division of Plastic and Reconstructive Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Erica H Lee
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Gary S Lissner
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ashfaq A Marghoob
- Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, New York
| | - Rubeta N Matin
- Department of Dermatology, Churchill Hospital, Oxford, United Kingdom
| | - Adam Mattox
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Bharat B Mittal
- Department of Radiation Oncology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - J Regan Thomas
- Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Xiaolong Alan Zhou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - David Zloty
- Department of Dermatology & Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jochen Schmitt
- Center for Evidence-Based Healthcare, Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Jamie Kirkham
- Department of Biostatistics, University of Liverpool, Liverpool, United Kingdom
| | - Emily Poon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joseph F Sobanko
- Department of Dermatology, Perelman Center for Advanced Medicine, Hospital of the University of Pennsylvania, Philadelphia.,Division of Dermatologic Surgery, Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia
| | - Todd V Cartee
- Department of Dermatology, Penn State Health, Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis
| | - Murad Alam
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| |
Collapse
|
5
|
Abstract
Pityriasis rosea is a dermatological disease with a well-documented clinical appearance, but less is known about causes and treatment. Bell's palsy is a neurological condition leading to acute idiopathic hemifacial paralysis. Recent studies indicate that human herpesvirus (HHV) 6-7 reactivation may be a contributing factor to both conditions. We report a case of the 2 concurrent diagnoses that supports a common contributing factor and suggests further awareness and research into the role HHV 6-7 may play in the aetiology of both conditions.
Collapse
Affiliation(s)
- Vanessa Voss
- Saint Louis University, Saint Louis, Missouri, USA
| | - Adam Mattox
- Department of Dermatology, Saint Louis University, Saint Louis, Missouri, USA
| | - Mary Guo
- Department of Dermatology, Saint Louis University, Saint Louis, Missouri, USA
| |
Collapse
|
6
|
Abstract
The ability of a placebo drug capsule to serve as a conditioned reinforcer as a function of being paired with money reinforcement was evaluated. Volunteers were administered two differently colored capsules that presumably contained two different drugs. Although the volunteers were told they might contain a stimulant, sedative, or placebo, both capsules contained only a placebo. During sessions, volunteers participated in performance tasks. The tasks were programmed so that following one capsule, the amount of money obtained contingent upon responding was greater (high frequency of reinforcement) than following the other capsule (low frequency of reinforcement). During experiment 1, participants were exposed twice each to the two reinforcement conditions (sampling). During these choice sessions, 9 of 12 participants chose the capsule associated with the high frequency of reinforcement 2 or 3 times. Experiment 2 was designed to explore further whether the differential mood effects observed during sampling sessions could be conditioned. Although this could not be demonstrated, the self-administration results demonstrating the control of choice behavior even in the absence of pharmacological effects suggest that drugs may function as conditioned reinforcers. This finding has implications for broadening our understanding of the determinants of initiation and continued drug use.
Collapse
Affiliation(s)
- C E Johanson
- Etiology Branch, National Institute on Drug Abuse, Baltimore, MD 21224, USA
| | | | | |
Collapse
|
7
|
Negus SS, Henriksen SJ, Mattox A, Pasternak GW, Portoghese PS, Takemori AE, Weinger MB, Koob GF. Effect of antagonists selective for mu, delta and kappa opioid receptors on the reinforcing effects of heroin in rats. J Pharmacol Exp Ther 1993; 265:1245-52. [PMID: 8389859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Antagonists selective for mu, delta and kappa-opioid receptors were evaluated for their effects on responding maintained by i.v. injections of heroin (60.0 micrograms/kg/injection) in rats during daily 3-hr sessions. Under base-line conditions, rats self-administered 10 to 20 heroin injections during each session, and injections were separated by relatively constant interinjection intervals of about 10 to 20 min. The mu-selective antagonist beta-funaltrexamine (beta-FNA; 5.0-20.0 mg/kg, s.c.) produced a dose-dependent increase in responding for heroin, with some doses of beta-FNA producing an extinction-like pattern of responding. These results were qualitatively similar to the effect obtained by lowering the unit dose per injection of heroin. The mu 1-selective antagonist naloxonazine (NXZ; 7.5-30.0 mg/kg, i.v.) and the delta-selective antagonist naltrindole (1.0-17.0 mg/kg) also produced dose-dependent increases in heroin self-administration, but neither naloxonazine nor naltrindole produced extinction-like patterns of responding. The kappa-selective antagonist nor-binaltorphimine (nor-BNI; 5.0-10.0 mg/kg, s.c.) had no effect on heroin self-administration. These results indicate that mu receptors play an important role in mediating the reinforcing effects of heroin in the rat. Delta and mu 1 receptors, but not kappa receptors, may also be involved.
Collapse
Affiliation(s)
- S S Negus
- Department of Neuropharmacology, Scripps Research Institute, La Jolla, California
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Raft D, Davidson J, Wasik J, Mattox A. Relationship between response to phenelzine and MAO inhibition in a clinical trial of phenelzine, amitriptyline and placebo. Neuropsychobiology 1981; 7:122-6. [PMID: 7231652 DOI: 10.1159/000117841] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
This report examines the hypothesis that for phenelzine to be more effective than placebo it is necessary to achieve at least 80% inhibition of platelet MAO activity. This hypothesis was examined in the context of a double-blind comparison of phenelzine, amitriptyline and placebo in depressed patients. When phenelzine became significantly more effective than placebo at 4 weeks, the average MAO inhibition was 85%. By the 5th week, with MAO inhibition greater than 90%, phenelzine was significantly more effective than amitriptyline. A highly significant correlation was noted between improvement and MAO inhibition within the phenelzine group.
Collapse
|