Prescribing of selective serotonin reuptake inhibitors, anxiolytics, and sedative-hypnotics by general practitioners in The Netherlands: a multivariate analysis.

A study of the prescribing of anxiolytics and sedative-hypnotics and the occurrence of anxiety or sleep disorders before and after the initiation of selective serotonin reuptake inhibitor (SSRI) therapy may provide insight into differences in individual SSRIs. The purpose of our study was to evaluate whether and in what way the likelihood of being prescribed an anxiolytic or sedative-hypnotic or receiving a diagnosis of an anxiety or sleep disorder differed in patients prescribed either fluoxetine or paroxetine by a general practitioner (GP) in the Netherlands, where these two agents are the most commonly prescribed SSRIs. Episodes of SSRI treatment were constructed from a recently available GP database in the Netherlands. Logistic regression analysis was used to determine whether, after controlling for other observable factors, the receipt of paroxetine or fluoxetine was a statistically significant determinant for receipt of an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder. We found that patients who were prescribed fluoxetine as their index drug were less likely to receive a concomitant sedative-hypnotic on their index date compared with patients receiving paroxetine. After controlling for other observable factors, such as use of anxiolytics and sedative-hypnotics before SSRI therapy or on the index date or the existence of comorbid anxiety or sleep disorders, patients starting fluoxetine therapy were no more likely than patients starting paroxetine therapy to receive an anxiolytic or sedative-hypnotic or a diagnosis of an anxiety or sleep disorder during the 60-day post period. The likelihood of a patient's being diagnosed with or receiving a prescription for an anxiety or sleep disorder does not appear to be a differentiating factor between the prescribing of fluoxetine or paroxetine by GPs in the Netherlands.

[Metabolism of arachidonic acid in the thrombocytes of patients with periodic disease]. / Metabolizm arakhidonovoi kisloty v trombotsitakh bol'nykh periodicheskoi bolezn'iu.

Washed platelets of patients with familial Mediterranean fever (FMF) were incubated with I-14C arachidonic acid (AA). Only 10% of AA were transformed into thromboxane A2, 12(S)-12-hydroxy-5Z,8Z,10E,14Z-eicosatetraenoic acid (12-HETE) and 12(S)-12-hydroxy-5Z,8Z,10E-heptadecatrienoic acid (HHT), which strongly indicates the suppression of platelet lipoxygenase and cyclooxygenase or the deficit in these enzymes in FMF. However, there were no noticeable alterations in AA platelet metabolism during attacks of fever and immediately after hyperbaric oxygenation used to relieve pain and fever. The data obtained suggest that arachidonic acid metabolism plays an important role in the pathogenesis of FMF.

[Level of leukotrienes B4 and C4 in the blood of patients with periodic disease]. / Uroven' leikotrienov B4 i C4 v plazme krovi bol'nykh periodicheskoi bolezn'iu.

The level of LTB4 and LTC4 in blood plasma of patients with familial mediterranean fever is significantly higher than in healthy donors: 53 + 10 pg/ml for LTB4 (normal - 25 + 5 pg/ml) and 175 + 22 pg/ml for LTC4 (normal 67 + 19 pg/ml). The more increase of the LTB4 and LTC4 content in plasma is observed during attacks of fever - 107 + 21 pg/ml (LTB4) and 249 + 34 pg/ml (LTC4). Hyperbaric oxygenation of patients, used to relieve pain and fever, reduces the level of leukotrienes.