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Author: Admin | 2025-04-28
Are psychosomatie, few, if any, workers have attempted specifically to measure simultaneously and to correlate physiological and psychological responses in these or related conditions. 5) It is suggested that, in the future, a multidisciplinary and simultaneous approach, involving psychiatric, psychological, and physiological parameters will provide better and more valid methods of studying the etiological interrelationships between various "psychological factors" and disordered potency.Although opiate addicts often equate the drug experience with sexual orgasm, diminished libido and impaired sexual performance are common sequelae of chronic use. Early clinical studies suggested that opiates may interfere with sex hormone secretion. The authors carried out three sequential studies which demonstrated that heroin use in man results in acute suppression of luteinizing hormone (LH) release from the pituitary followed by a secondary drop in plasma testosterone levels. The time course of these neuroendocrine events correlates well with the tension-reducing effects of heroin and suggests that drive reduction is an important component of opiate reinforcement.The unique pharmacological properties of buprenorphine may make it a useful maintenance therapy for opiate addiction. This meta-analysis considers the effectiveness of buprenorphine relative to methadone.A systematic literature search identified five randomized clinical trials comparing buprenorphine to methadone. Data from these trials were obtained. Retention in treatment was analyzed with a Cox proportional hazards regression. Urinalyses for opiates were studied with analysis of variance and a common method of handling missing values. A meta-analysis was used to combine these results.Subjects who received 8-12 mg/day buprenorphine had 1.26 times the relative risk of discontinuing treatment (95% confidence interval 1.01-1.57) and 8.3% more positive urinalyses (95% confidence interval 2.7-14%) than subjects receiving 50-80 mg/day methadone. Buprenophrine was more effective than 20-35 mg/day methadone. There was substantial variation in outcomes in the different trials.The variation between trials may be due to differences in dose levels, patient exclusion criteria and provision of psychosocial treatment. The difference in the effectiveness of buprenorphine and methadone may be statistically significant, but the differences are small compared to the wide variance in outcomes achieved in different methadone treatment programs. Further research is needed to determine if buprenorphine treatment is more effective than methadone in particular settings or in particular subgroups of patients.Physicians and frontline sex counsellingRenshawRenshaw DC. Physicians and frontline sex counselling. CME. 1998;16:824-829.Evaluation of the pituitarygonadal axis in women with amenorrhoea associated with narcotic addiction, abstract, 55th meeting of the endocrine societyR J SantenN BilicSanten RJ, Bilic N. Evaluation of the pituitarygonadal axis in women with amenorrhoea associated with narcotic addiction, abstract, 55th meeting of the endocrine society, Illinois, June 1972; 22-24.Sexual Effects and Side Effects of Heroin and MethadoneW E WielandM YungerWieland WE, Yunger M. Sexual Effects and Side Effects of Heroin and Methadone. Proceedings of the Third National Conference on Methadone Treatment. Washington, DC: US Government Printing Office; 1970:50-53.World Health Organisation. The ICD-10 Classification of Mental and Behavioural DisordersWorld Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO; 1992.Sexual dysfunction and psychological distress in methadone maintenanceW D SpringM L WillenbringT L MaddoxSpring WD Jr, Willenbring
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