A Case report of suicide in a teenager with long-term use of fluoxetine associated with CYP2D6 Polymorphism

Abstract

August 2015 e95 Company, Jupiter, FL, USA; Reckitt Benckiser, Slough, Berkshire, UK; and Reckitt Benckiser, Parsippany, NJ, USA Background: Beyond the evaluative complaint of a “sore” throat, patients with pharyngitis frequently report different qualities of throat pain such as “burning” and “difficulty swallowing” (Schachtel et al. Arch Intern Med 1984). Optimally, treatments should not only relieve throat soreness, but also reduce these other dimensions of pain. We investigated the effects of a lozenge containing 8.75 mg of the nonsteroidal anti-inflammatory drug, flurbiprofen, on 11 qualities of throat pain. Material and Methods: This randomised, double-blind, placebo-controlled, single-dose trial enrolled adults with recent onset moderateto-severe sore throat and pharyngitis (≥ 5 on the Tonsillo-Pharyngitis Assessment; TPA). Patients were randomised to one flurbiprofen or one identically-flavoured vehicle lozenge (placebo). At baseline and hourly for 3 hours post dose, patients used Likert scales to rate throat soreness and 10 other qualities of throat pain: sensory symptoms (burning, raw, dry, irritated/scratchy, tight, like a lump in the throat, swollen), functional symptoms (difficulty swallowing, husky/hoarse voice) and an affective descriptor (agonising). These 11 scales comprise the Qualities of Sore Throat Index (QuaSTI). Mean changes in the QuaSTI scores for both treatment groups were compared from baseline to 3 hours after treatment. Results: A total of 122 patients with moderate/severe sore throat were randomised to flurbiprofen or placebo treatment. Mean age was 19.5 years, mean TPA score was 9.9. Compared with placebo, flurbiprofen-treated patients reported significantly greater reductions in sensory, evaluative, affective and functional QuaSTI symptoms (all P < 0.05). Conclusions: In adults with sore throat, a single dose of flurbiprofen 8.75 mg lozenge reduced sensory, functional and affective qualities of throat pain as well as throat soreness. The QuaSTI appears to be a sensitive instrument for the measurement of different qualities of throat pain and response to treatment.