The Experts below are selected from a list of 165 Experts worldwide ranked by ideXlab platform
Kevin V Thomas - One of the best experts on this subject based on the ideXlab platform.
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determination of selected human pharmaceutical compounds in effluent and surface water samples by high performance liquid chromatography electrospray tandem mass spectrometry
Journal of Chromatography A, 2003Co-Authors: Martin J Hilton, Kevin V ThomasAbstract:Abstract A simple method is presented for the analysis of 13 pharmaceutical and pharmaceutical metabolite compounds in sewage effluents and surface waters. The pharmaceutical compounds were extracted using a generic solid-phase extraction (SPE) procedure using Phenomenex Strata X as a stationary phase. Extracts were quantitatively analysed by four separate reversed-phase high-performance liquid chromatography–electrospray tandem mass spectrometry (HPLC–ESI-MS/MS) techniques and quantified by comparison with an internal standard ([ 13 C ]-phenacetin). Recoveries and limits of detection (LOD) for sulfamethoxazole (120%, 50 ng l −1 ), acetyl-sulfamethoxazole (56%, 50 ng l −1 ), trimethoprim (123%, 10 ng l −1 ), erythromycin (73%, 10 ng l −1 ), paracetamol (75%, 50 ng l −1 ), ibuprofen (117%, 20 ng l −1 ), clofibric acid (83%, 50 ng l −1 ), mefenamic acid (24%, 50 ng l −1 ), diclofenac (62%, 20 ng l −1 ), propranolol (45%, 10 ng l −1 ), dextropropoxyphene (63%, 20 ng l −1 ) and tamoxifen (42%, 10 ng l −1 ) were all acceptable. The recovery of Lofepramine (4%) was too low to be of use in a monitoring programme. Application of the method to samples collected from UK sewage effluents and surface waters showed detectable concentrations of mefenamic acid, diclofenac, propranolol, erythromycin, trimethoprim and acetyl-sulfamethoxazole in both matrices. Ibuprofen and dextropropoxyphene were detected in sewage effluents alone. All other pharmaceutical compounds were below the methods limits of detection.
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determination of selected human pharmaceutical compounds in effluent and surface water samples by high performance liquid chromatography electrospray tandem mass spectrometry
Journal of Chromatography A, 2003Co-Authors: Martin J Hilton, Kevin V ThomasAbstract:Abstract A simple method is presented for the analysis of 13 pharmaceutical and pharmaceutical metabolite compounds in sewage effluents and surface waters. The pharmaceutical compounds were extracted using a generic solid-phase extraction (SPE) procedure using Phenomenex Strata X as a stationary phase. Extracts were quantitatively analysed by four separate reversed-phase high-performance liquid chromatography–electrospray tandem mass spectrometry (HPLC–ESI-MS/MS) techniques and quantified by comparison with an internal standard ([ 13 C ]-phenacetin). Recoveries and limits of detection (LOD) for sulfamethoxazole (120%, 50 ng l −1 ), acetyl-sulfamethoxazole (56%, 50 ng l −1 ), trimethoprim (123%, 10 ng l −1 ), erythromycin (73%, 10 ng l −1 ), paracetamol (75%, 50 ng l −1 ), ibuprofen (117%, 20 ng l −1 ), clofibric acid (83%, 50 ng l −1 ), mefenamic acid (24%, 50 ng l −1 ), diclofenac (62%, 20 ng l −1 ), propranolol (45%, 10 ng l −1 ), dextropropoxyphene (63%, 20 ng l −1 ) and tamoxifen (42%, 10 ng l −1 ) were all acceptable. The recovery of Lofepramine (4%) was too low to be of use in a monitoring programme. Application of the method to samples collected from UK sewage effluents and surface waters showed detectable concentrations of mefenamic acid, diclofenac, propranolol, erythromycin, trimethoprim and acetyl-sulfamethoxazole in both matrices. Ibuprofen and dextropropoxyphene were detected in sewage effluents alone. All other pharmaceutical compounds were below the methods limits of detection.
Martin J Hilton - One of the best experts on this subject based on the ideXlab platform.
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determination of selected human pharmaceutical compounds in effluent and surface water samples by high performance liquid chromatography electrospray tandem mass spectrometry
Journal of Chromatography A, 2003Co-Authors: Martin J Hilton, Kevin V ThomasAbstract:Abstract A simple method is presented for the analysis of 13 pharmaceutical and pharmaceutical metabolite compounds in sewage effluents and surface waters. The pharmaceutical compounds were extracted using a generic solid-phase extraction (SPE) procedure using Phenomenex Strata X as a stationary phase. Extracts were quantitatively analysed by four separate reversed-phase high-performance liquid chromatography–electrospray tandem mass spectrometry (HPLC–ESI-MS/MS) techniques and quantified by comparison with an internal standard ([ 13 C ]-phenacetin). Recoveries and limits of detection (LOD) for sulfamethoxazole (120%, 50 ng l −1 ), acetyl-sulfamethoxazole (56%, 50 ng l −1 ), trimethoprim (123%, 10 ng l −1 ), erythromycin (73%, 10 ng l −1 ), paracetamol (75%, 50 ng l −1 ), ibuprofen (117%, 20 ng l −1 ), clofibric acid (83%, 50 ng l −1 ), mefenamic acid (24%, 50 ng l −1 ), diclofenac (62%, 20 ng l −1 ), propranolol (45%, 10 ng l −1 ), dextropropoxyphene (63%, 20 ng l −1 ) and tamoxifen (42%, 10 ng l −1 ) were all acceptable. The recovery of Lofepramine (4%) was too low to be of use in a monitoring programme. Application of the method to samples collected from UK sewage effluents and surface waters showed detectable concentrations of mefenamic acid, diclofenac, propranolol, erythromycin, trimethoprim and acetyl-sulfamethoxazole in both matrices. Ibuprofen and dextropropoxyphene were detected in sewage effluents alone. All other pharmaceutical compounds were below the methods limits of detection.
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determination of selected human pharmaceutical compounds in effluent and surface water samples by high performance liquid chromatography electrospray tandem mass spectrometry
Journal of Chromatography A, 2003Co-Authors: Martin J Hilton, Kevin V ThomasAbstract:Abstract A simple method is presented for the analysis of 13 pharmaceutical and pharmaceutical metabolite compounds in sewage effluents and surface waters. The pharmaceutical compounds were extracted using a generic solid-phase extraction (SPE) procedure using Phenomenex Strata X as a stationary phase. Extracts were quantitatively analysed by four separate reversed-phase high-performance liquid chromatography–electrospray tandem mass spectrometry (HPLC–ESI-MS/MS) techniques and quantified by comparison with an internal standard ([ 13 C ]-phenacetin). Recoveries and limits of detection (LOD) for sulfamethoxazole (120%, 50 ng l −1 ), acetyl-sulfamethoxazole (56%, 50 ng l −1 ), trimethoprim (123%, 10 ng l −1 ), erythromycin (73%, 10 ng l −1 ), paracetamol (75%, 50 ng l −1 ), ibuprofen (117%, 20 ng l −1 ), clofibric acid (83%, 50 ng l −1 ), mefenamic acid (24%, 50 ng l −1 ), diclofenac (62%, 20 ng l −1 ), propranolol (45%, 10 ng l −1 ), dextropropoxyphene (63%, 20 ng l −1 ) and tamoxifen (42%, 10 ng l −1 ) were all acceptable. The recovery of Lofepramine (4%) was too low to be of use in a monitoring programme. Application of the method to samples collected from UK sewage effluents and surface waters showed detectable concentrations of mefenamic acid, diclofenac, propranolol, erythromycin, trimethoprim and acetyl-sulfamethoxazole in both matrices. Ibuprofen and dextropropoxyphene were detected in sewage effluents alone. All other pharmaceutical compounds were below the methods limits of detection.
Cornelius Katona - One of the best experts on this subject based on the ideXlab platform.
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placebo controlled trial of lithium augmentation of fluoxetine and Lofepramine
British Journal of Psychiatry, 1995Co-Authors: Cornelius Katona, M T Abousaleh, D A Harrison, D R L Edwards, Toni Lock, Bertrand A Nairac, Robert A Burns, Mary M RobertsonAbstract:BACKGROUND This study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial. METHOD Lithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or Lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10. RESULTS Response was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P or = 0.4 mmol/l). No differences in the efficacy of LA were apparent between fluoxetine and Lofepramine. CONCLUSIONS Our results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.
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platelet 5 ht uptake sites labelled with 3h paroxetine in controls and depressed patients before and after treatment with fluoxetine or Lofepramine
Psychopharmacology, 1994Co-Authors: Kevin M Lawrence, Mary M Robertson, M T Abousaleh, D A Harrison, D R L Edwards, Cornelius Katona, Toni Lock, Bertrand L Nairac, Roger A Burns, Roger W HortonAbstract:Platelet [3H] paroxetine binding was measured in 73 depressed patients and in 64 healthy volunteers. No differences were found in Bmax or Kd either overall, or when the 61 depressed subjects who had never received psychotropic drugs were analysed separately. Within the depressed group, no differences in Bmax or Kd were found between subgroups divided on the basis of endogenicity, suicidal thoughts or severity of depression. None of the subgroups differed significantly from controls. Forty of the depressed subjects were retested after 6 weeks' treatment with fluoxetine (n=22) or Lofepramine (n=18). Treatment was not associated with any change in Bmax but a similar and significant increase in Kd was noted following treatment with either antidepressant. Neither pre- nor post-treatment platelet binding parameters appeared to relate to clinical response to treatment.
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a double blind controlled comparison of fluoxetine and Lofepramine in major depressive illness
Journal of Psychopharmacology, 1994Co-Authors: Mary M Robertson, M T Abousaleh, D A Harrison, B L Nairac, D R L Edwards, T Lock, R A Burns, Cornelius KatonaAbstract:One hundred and eighty three patients with DSM-III-R major depressive illness were allocated randomly to treatment with one of two new generation antidepressants, fluoxetine and Lofepramine. Both patient groups had significantly lower mean scores on the Hamilton Depression Rating Scale (HDRS) 6 weeks after entry to the trial (p < 0.001), but there were no differences between the groups, either at baseline or after 6 weeks, in total HRDS score or in subscores for anxiety or suicidality. Anticholinergic side effects were commoner with Lofepramine; adverse effects were on the whole mild and few patients dropped out because of them. This study does not support previous claims of specific adverse effects of fluoxetine on anxiety and suicidality.
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a double blind placebo controlled trial of lithium augmentation in patients showing absent or partial responses to fluoxetine or Lofepramine
European Neuropsychopharmacology, 1992Co-Authors: Cornelius Katona, Mary M Robertson, M T Abousaleh, B L Nairac, D R L Edwards, Toni Lock, B BurnsAbstract:Abstract A double-blind controlled trial of lithium augmentation was performed in 62 depressed patients not responding adequately to a six week trial of fluoxetine or Lofepramine. 58% of subjects made clinically useful responses, with no significant differences detected between the four treatment groups.
Helen Smith - One of the best experts on this subject based on the ideXlab platform.
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cost effectiveness and cost utility of tricyclic antidepressants selective serotonin reuptake inhibitors and Lofepramine randomised controlled trial
British Journal of Psychiatry, 2006Co-Authors: Tony Kendrick, David S. Baldwin, Judy Chatwin, Andrew Thornett, Jonathan Goddard, Michael J. Campbell, Robert Peveler, Louise Longworth, Michael Moore, Helen SmithAbstract:Background The cost-effectiveness of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) has not been compared in a prospective study in primary care. Aims To determine the relative cost-effectiveness of TCAs, SSRIs and Lofepramine in UKprimary care. Method An open-label, three-arm randomised trial with a preference arm. Practitioners referred 327 patients with incident depression. Results No significant differences were found in effectiveness or cost-effectiveness. The numbers of depression-free weeks over12 months (on the Hospital Anxiety and Depression Scale) were 25.3 (95% CI 21.3–29.0) for TCAs, 28.3 (95% CI 24.3–32.2) for SSRIs and 24.6 (95% CI 20.6–28.9) for Lofepramine. Mean health service costs per patient were £ 762 (95% CI 553–1059) for TCAs, £875 (95% CI 675–1355) for SSRIs and £867 (95% CI 634–1521) for Lofepramine.Cost-effectiveness acceptability curves suggested SSRIs were mostcost-effective (with a probability of up to 0.6). Conclusions The findings support a policy of recommending SSRIs as first-choice antidepressants in primary care.
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a randomised controlled trial to compare the cost effectiveness of tricyclic antidepressants selective serotonin reuptake inhibitors and Lofepramine
Health Technology Assessment, 2005Co-Authors: Robert Peveler, David S. Baldwin, Martin Buxton, Judy Chatwin, Andrew Thornett, Jonathan Goddard, Louise Longworth, Michael Moore, Tony Kendrick, Helen SmithAbstract:Aim/ Principal Research Question - The main aim of the “AHEAD” study was to determine the relative cost-effectiveness of three classes of antidepressants: tricyclics (TCAs), selective serotonin reuptake inhibitors (SSRIs), and the tricyclic-related antidepressant Lofepramine, as first choice treatments for depression in UK primary care. Factors of interest - This is the first randomised prospective study in UK primary care to address this question. Most previous work on this topic has relied upon modelling and/or post hoc analysis of data collected for other purposes. The only other published trial of this type was conducted in HMOs in the United States. Methods - The study was an open label, pragmatic controlled trial with three randomised arms and one preference arm. Patients were followed up for a total of 12 months. Patients were randomised to receive a tricyclic antidepressant (amitriptyline, dothiepin, or imipramine), a selective serotonin reuptake inhibitor (fluoxetine, sertraline, or paroxetine), or Lofepramine. Standardised recommendations about dose and dose escalation based on the BNF were issued to GPs. Cost effectiveness was based upon an analysis of direct costs from an NHS perspective. Sample groups - The study was carried out in UK primary care: 73 practices in urban and rural areas in Hampshire, Wiltshire, Dorset, Sussex, and Surrey agreed initially to take part. Patients with a new episode of depressive illness according to GP diagnosis were recruited. A total of 388 patients were referred to the study team by 87 GPs from 55 practices. Incremental cost-effectiveness ratios and cost-effectiveness acceptability curves (CEACs) were computed. Estimates were bootstrapped with 5000 replications. Outcome measures - At baseline the Clinical Interview Schedule, Revised (CIS-R PROQSY computerised version) was administered to establish symptom profiles. Outcome measures over 12 month follow-up included the Hospital Anxiety and Depression Scale self-rating of depression (HAD-D), CIS-R, EuroQol (EQ-5D) for quality of life, Short Form (SF-36) Health Survey for generic health status, and patient and practice records of use of health and social services (UHSS). The primary effectiveness outcome was the number of depression-free weeks (HAD-D less than 8, with interpolation of intervening values), and the primary cost outcome total direct NHS costs. Quality adjusted life years (QALYs) were used as the outcome measure in a secondary analysis. Findings - 327 patients were randomised. Follow-up rates were 68% at 3 months and 52% at 1 year. Linear regression analysis revealed no significant differences between groups in number of depression-free weeks when adjusted for baseline HAD-D. A higher proportion of patients randomised to TCAs entered the preference arm than those allocated to the other choices. Switching to another class of antidepressant in the first few weeks of treatment occurred significantly more often in the Lofepramine arm and less in the preference arm. There were no significant differences between arms in mean cost per depression-free week. For values placed on an additional QALY of over £5,000, treatment with SSRIs was likely to be the most cost-effective strategy. Tricyclics were the least likely to be cost-effective as first choice of antidepressant for most values of a depression free week or QALY respectively, but these differences were relatively modest. Conclusion - Given the low probability of significant differences in cost-effectiveness, it is appropriate to base the first choice between these three classes of antidepressant in primary care on doctor and patient preferences. Adopting this policy may lead to less switching of medication subsequently. Choosing Lofepramine is likely to lead to a greater proportion of patients switching treatment in the first few weeks. Implications for further research - It is difficult to see how a better study of this topic could be conducted in the primary care setting. The research agenda concerning the management of depression in primary care should move on to address important questions such as the most appropriate threshold of severity at which to commence antidepressant medication, the effectiveness of strategies to improve recognition of depression and quality of management of identified patients, and the efficacy of interventions to improve persistence in treatment taking by patients.
Mary M Robertson - One of the best experts on this subject based on the ideXlab platform.
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placebo controlled trial of lithium augmentation of fluoxetine and Lofepramine
British Journal of Psychiatry, 1995Co-Authors: Cornelius Katona, M T Abousaleh, D A Harrison, D R L Edwards, Toni Lock, Bertrand A Nairac, Robert A Burns, Mary M RobertsonAbstract:BACKGROUND This study was designed to establish whether (as suggested in a number of open and relatively small controlled trials) lithium augmentation is more effective than continued antidepressant alone, where response to a standard course of antidepressant treatment has been absent or partial. METHOD Lithium or placebo was added on a double-blind basis for six weeks to the drug regime of 62 patients with major depressive illness (in both hospital and primary care settings) who had failed to respond to a controlled trial of fluoxetine or Lofepramine. Response was defined as a final Hamilton Depression Rating Scale (HDRS) score of < 10. RESULTS Response was seen more frequently in patients taking lithium (15/29) than in those remaining on antidepressant alone (8/32; P or = 0.4 mmol/l). No differences in the efficacy of LA were apparent between fluoxetine and Lofepramine. CONCLUSIONS Our results confirm that LA is a useful strategy in the treatment of antidepressant-resistant depression. Partial response was, however, frequently observed with continued antidepressant treatment alone, and the superiority of LA appears to depend on achieving adequate serum lithium levels.
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platelet 5 ht uptake sites labelled with 3h paroxetine in controls and depressed patients before and after treatment with fluoxetine or Lofepramine
Psychopharmacology, 1994Co-Authors: Kevin M Lawrence, Mary M Robertson, M T Abousaleh, D A Harrison, D R L Edwards, Cornelius Katona, Toni Lock, Bertrand L Nairac, Roger A Burns, Roger W HortonAbstract:Platelet [3H] paroxetine binding was measured in 73 depressed patients and in 64 healthy volunteers. No differences were found in Bmax or Kd either overall, or when the 61 depressed subjects who had never received psychotropic drugs were analysed separately. Within the depressed group, no differences in Bmax or Kd were found between subgroups divided on the basis of endogenicity, suicidal thoughts or severity of depression. None of the subgroups differed significantly from controls. Forty of the depressed subjects were retested after 6 weeks' treatment with fluoxetine (n=22) or Lofepramine (n=18). Treatment was not associated with any change in Bmax but a similar and significant increase in Kd was noted following treatment with either antidepressant. Neither pre- nor post-treatment platelet binding parameters appeared to relate to clinical response to treatment.
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a double blind controlled comparison of fluoxetine and Lofepramine in major depressive illness
Journal of Psychopharmacology, 1994Co-Authors: Mary M Robertson, M T Abousaleh, D A Harrison, B L Nairac, D R L Edwards, T Lock, R A Burns, Cornelius KatonaAbstract:One hundred and eighty three patients with DSM-III-R major depressive illness were allocated randomly to treatment with one of two new generation antidepressants, fluoxetine and Lofepramine. Both patient groups had significantly lower mean scores on the Hamilton Depression Rating Scale (HDRS) 6 weeks after entry to the trial (p < 0.001), but there were no differences between the groups, either at baseline or after 6 weeks, in total HRDS score or in subscores for anxiety or suicidality. Anticholinergic side effects were commoner with Lofepramine; adverse effects were on the whole mild and few patients dropped out because of them. This study does not support previous claims of specific adverse effects of fluoxetine on anxiety and suicidality.
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a double blind placebo controlled trial of lithium augmentation in patients showing absent or partial responses to fluoxetine or Lofepramine
European Neuropsychopharmacology, 1992Co-Authors: Cornelius Katona, Mary M Robertson, M T Abousaleh, B L Nairac, D R L Edwards, Toni Lock, B BurnsAbstract:Abstract A double-blind controlled trial of lithium augmentation was performed in 62 depressed patients not responding adequately to a six week trial of fluoxetine or Lofepramine. 58% of subjects made clinically useful responses, with no significant differences detected between the four treatment groups.
