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Biomedical subjects

Helena Vorma

Publications and source records attributed to Helena Vorma.

7 recordsLinked to original sources
PubMed2007

A comparison of aripiprazole, methylphenidate, and placebo for amphetamine dependence.

OBJECTIVE: Problems related to illegal amphetamine use have become a major public health issue in many developed countries. To date, evidence on the effectiveness of psychosocial treatments has remained modest, and no pharmacotherapy has proven effective for amphetamine dependence. METHOD: Individuals meeting DSM-IV criteria for intravenous amphetamine dependence (N=53) were randomly assigned to receive aripiprazole (15 mg/day), slow-release methylphenidate (54 mg/day), or placebo for 20 weeks. The study was terminated prematurely due to unexpected results of interim analysis. An intention-to-treat analysis was used. The primary outcome measure was the proportion of amphetamine-positive urine samples. RESULTS: Patients allocated to aripiprazole had significantly more amphetamine-positive urine samples than patients in the placebo group (odds ratio=3.77, 95% CI=1.55-9.18), whereas patients who received methylphenidate had significantly fewer amphetamine-positive urine samples than patients who had received placebo (odds ratio=0.46, 95% CI=0.26-0.81). CONCLUSIONS: Methylphenidate is an effective treatment for reducing intravenous drug use in patients with severe amphetamine dependence.

Adult↗
PubMed2006

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Journal Article↗
PubMed2005

Predictors of benzodiazepine discontinuation in subjects manifesting complicated dependence.

We described characteristics of subjects with benzodiazepine dependence that was typically complicated by harmful and hazardous alcohol use or high benzodiazepine doses, and assessed predictors of successful discontinuation of benzodiazepines for this group. Seventy-six patients who participated in a randomized clinical trial of two different gradual withdrawal treatment approaches were assessed. The trial was conducted between February 1995 and July 1999. The mean age +/- SD of subjects was 40.0 +/- 9.6 years, 55% were male, 38% were married or cohabiting, and 70% had received more than nine years of education. The median benzodiazepine dose was 35 mg/day (range 2.5-180) in diazepam equivalents. The median duration of benzodiazepine use was 84 (range 8-360) months. Subjects with lower benzodiazepine doses and no previous withdrawal attempts were more successful at benzodiazepine discontinuation. Cluster B personality/borderline personality disorder was associated with an inability to stop benzodiazepine use and with "dropping out" of treatment. Alcohol use-related disorders or other psychiatric diagnoses were not associated with outcome. Further studies on predictors of successful benzodiazepine discontinuation in different populations are required. Patients manifesting cluster B personality/borderline personality disorder and benzodiazepine dependence may need concomitant treatment for their personality disorders to benefit from benzodiazepine discontinuation treatment.

Adult↗
PubMed2004

Symptom severity and quality of life after benzodiazepine withdrawal treatment in participants with complicated dependence.

The aims of the present study were to assess changes in psychopathology and quality of life after withdrawal treatment in participants with benzodiazepine dependence that was in most cases complicated by harmful and hazardous alcohol use or high benzodiazepine doses. Seventy-six participants with benzodiazepine dependence (DSM-III-R) who participated in a randomized clinical trial of two different gradual withdrawal treatment approaches were initially assessed by Symptom Checklist-90 (SCL-90), visual analogue scales (VASs), and the Health-Related Quality of Life battery (HRQOL). The assessments were repeated after treatment ended and again after a follow-up averaging 11 months. During the study, all measurements for the participants with clinically significant (over 50%) benzodiazepine-dose decreases improved more than those for the participants with smaller decreases, and differences in the HRQOL energy/vitality, home management, and life satisfaction scores were significant. Our data indicate that in participants with complicated benzodiazepine dependence, clinically significant dose decreases are associated with improvements in their self-rated quality of life.

Adult↗
PubMed2003

Long-term outcome after benzodiazepine withdrawal treatment in subjects with complicated dependence.

BACKGROUND: The study aimed to monitor subjects with benzodiazepine (BZ) dependence after withdrawal treatment in order to evaluate long-term outcome and predictors of remaining BZ-free. Subjects with high-dose dependence or co-occurring alcohol problems were not excluded. METHOD: Seventy-six participants in an earlier, randomized, controlled trial of outpatient BZ discontinuation were interviewed, and documents from their treatment settings obtained, along with urine and serum samples for BZ use. Long-term outcomes for a cognitive-behavioral treatment group and a treatment-as-usual group were measured. RESULTS: BZ discontinuation treatment outcomes were maintained in both treatment groups. No between-group differences were found. At the end of the study 25% of the subjects were BZ-free, and the median dose decrease from pre-treatment levels was 16.1 mg in diazepam equivalents. Subjects with pre-treatment doses exceeding 40 mg were able to maintain their doses at therapeutic levels through the follow-up. Pre-treatment low BZ dose, no previous withdrawal attempts, and high life satisfaction predicted success in staying BZ-free. CONCLUSIONS: In subjects with complicated BZ dependence, the benefits of BZ discontinuation treatment may persist, but more studies are needed.

Adult↗
PubMed2002

Treatment of out-patients with complicated benzodiazepine dependence: comparison of two approaches.

AIMS: To evaluate whether gradual benzodiazepine taper combined with cognitive-behavioural treatment is more effective than standard treatment for patients with dependence in out-patient clinics. DESIGN: A randomized, controlled clinical trial, using standard questionnaires and serum and urine tests. SETTINGS: Four public-sector out-patient clinics for alcohol and drug abusers in Helsinki. PARTICIPANTS: Seventy-six patients with benzodiazepine dependence (DSM-III-R). Patients taking high doses of the drug or with alcohol use disorders were included to obtain a subject group representative of usual clinical practice. INTERVENTION: Subjects received gradual benzodiazepine taper combined with cognitive-behavioural therapy (experimental group) or standard withdrawal treatment not scheduled by the researchers (control group). MEASUREMENTS: The outcome was measured in terms of attaining a state of abstinence or by a decrease in the dosage during the study period of up to 12 months' duration. FINDINGS: No statistically significant differences in the outcomes were observed between the groups. A total of 13% of the experimental group and 27% of the control group were able to discontinue drug use. In addition 67% of the experimental group and 57% of the control group were able to decrease the dose. CONCLUSIONS: The search continues for improved methods of helping patients with complicated benzodiazepine dependence.

Adult↗