Lars Tanum

Lars Tanum
Akershus universitetssykehus | Ahus · Department of Research & Development in Mental Health

MD, DMSci

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80
Publications
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Introduction
Addiction medicine

Publications

Publications (80)
Article
Introduction Life satisfaction (LS) in opioid-dependent individuals is lower than in the general population. This study aimed to explore changes in LS during short- and long-term treatment with extended-release naltrexone (XR-NTX). Methods This open-label 12-week clinical trial randomized 159 participants to either monthly XR-NTX or daily buprenor...
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The level of impulsivity, hyperactivity, and inattention (IHI) is higher among patients with substance use disorder (SUD) than in the general population. However, the prevalence of such symptoms in patients seeking treatment with an opioid antagonist, such as extended-release naltrexone (XR-NTX), is unknown. We screened 162 patients with opioid use...
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Background: Extended-release naltrexone (XR-NTX) is effective for illicit opioid abstinence as an opioid maintenance treatment. To improve treatment outcomes, patient's preference for the modality of treatment is an important factor. Objectives: We aimed to test the relationship between baseline preference for XR-NTX and adherence to treatment,...
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Background and Objectives Compare the risk of relapse to heroin and other illicit opioids among opioid-dependent patients receiving treatment with extended-release naltrexone (XR-NTX) or buprenorphine-naloxone (BP-NLX). Methods Re-analyzed data from a 12-week multicenter, open-label, randomized treatment study with a subsequent 36-week open-label...
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Background and Objectives Chronic pain is not well understood in opioid‐dependent populations. We report the prevalence of chronic pain and pain characteristics in an opioid‐dependent population by treatment type and gender. Methods This cross‐sectional study opportunistically recruited 569 patients (32% women) receiving treatment for opioid use d...
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Opioid-dependence is a comprehensive, relapsing disorder with negative individual, - family, - and societal consequences. Recovery is difficult to achieve. Research has shown reduced substance use and improved health- and psychosocial factors with extended-release naltrexone (XR-NTX) treatment. Pharmacological treatment should include psychosocial...
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Background and aim Extended‐release naltrexone (XR‐NTX) is an underused treatment option for opioid dependence, today only available in a few countries in the world. Although effective, safe and feasible in short‐term treatment, long‐term data are scarce and there is no recommendation for required treatment length. The aims of the study were to det...
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The paper describes the Antipsychotic Medication Management Fidelity Scale and its psychometric properties, including interrater reliability, frequency distribution, sensitivity to change and feasibility. Fidelity assessors conducted fidelity reviews four times over 18 months at eight sites receiving implementation support for evidence-based antips...
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Background: Scaled-up direct-acting antiviral (DAA) treatment of hepatitis C virus (HCV) infection among people who inject drugs (PWID) is crucial to reach the World Health Organization HCV elimination targets within 2030. One of the critical obstacles to HCV care in this population is the lack of treatment models within specialist healthcare adap...
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Background: A defined goal in mental health care is to increase the opportunities for patients to more actively participate in their treatment. This goal includes integrating aspects of user empowerment and shared decision-making (SDM) into treatment courses. To achieve this goal, more knowledge is needed about how patients and therapists perceive...
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This cross sectional study examined patients' perceptions of professional support regarding use of psychotropic medication in a specialist mental health care setting. The aims were to evaluate reliability and validity of the MedSupport inventory, and investigate possible associations between MedSupport scores and patient characteristics.A cross-sec...
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Objective: Neuropathic pain and fibromyalgia are two common and poorly understood chronic pain conditions that lack satisfactory treatments, cause substantial suffering and societal costs. Today, there are no biological markers on which to base chronic pain diagnoses, treatment choices or to understand the pathophysiology of pain for the individua...
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Rationale and aims: There is a growing expectation of implementing shared decision making (SDM) in today's health care service, including mental health care. Traditional understanding of SDM may be too narrow to capture the complexity of treatments of mental health problems. Although the patients' contribution to SDM is well described, the contrib...
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Background and objective: Opioid maintenance treatment (OMT) is highly available in Norway, but only 50% of opioid-dependent individuals are enrolled in such programs. This study was aimed at examining if availability of extended-release naltrexone (XR-NTX) could attract individuals who for different reasons were not enrolled in an OMT program. M...
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Background and objectives: It is presently unclear whether extended-release naltrexone hydrochloride treatment induces pain or aggravates existing pain among individuals with opioid use disorders. We assessed changes in pain among individuals receiving treatment with either extended-release naltrexone hydrochloride or buprenorphine-naloxone hydroc...
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Importance Extended-release naltrexone (XR-NTX) is a promising alternative treatment of opioid addiction but has never been compared with opioid agonist treatment for effects on symptoms of anxiety, depression, and insomnia. Objective To investigate whether XR-NTX unmasks or reinforces current comorbid symptoms of anxiety, depression, or insomnia...
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Background and aim: This is a follow-up study of a previously published randomized clinical trial conducted in Norway that compared extended-release naltrexone (XR-NTX) to buprenorphine-naloxone (BP-NLX) over 3 months. At the conclusion of the trial, participants were offered their choice of study medication for an additional 9 months. While BP-NL...
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Significance: Fibromyalgia is present in as much as 2% of the population, causing pain, stiffness, and tenderness of the muscles. Upon accurate diagnostic, nonpharmacological and pharmacological therapies can be used to alleviate pain and manage other symptoms. However, lack of objective, universal applicable diagnostic criteria as well as vague a...
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Importance To date, extended-release naltrexone hydrochloride has not previously been compared directly with opioid medication treatment (OMT), currently the most commonly prescribed treatment for opioid dependence. Objective To determine whether treatment with extended-release naltrexone will be as effective as daily buprenorphine hydrochloride w...
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There is increasing evidence of clinically relevant anti-inflammatory effects of monoaminergic antidepressants. PubMed and Ovid databases were searched systematically for the use and efficacy of antidepressants in association with 5 common inflammatory skin disorders: chronic urticaria, psoriasis, atopic dermatitis, other eczema, and alopecia areat...
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In addition to central hyperexcitability and impaired top–down modulation, chronic inflammation probably plays a role in the pathophysiology of fibromyalgia (FM). Indeed, on the basis of both animal experiments and human studies involving the analysis of cytokines and other inflammation-related proteins in different body fluids, neuroinflammatory m...
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Background/aims: Treatment for addiction to illicit opioids has, thus far, been limited to 2 main approaches: maintaining physical dependence by administering opioids medically and medication-free abstinence with psychosocial support. Assisted abstinence by taking daily tablets with the opioid antagonist naltrexone is rarely practiced, but it is u...
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Background Current guidelines for opioid dependence recommend daily maintenance of physical dependence with methadone or buprenorphine, and discourage abstinence due to the high risk of relapse and overdose. Extended-release formulations of the opioid antagonist naltrexone (XR-NTX) block heroin and other opioid agonists competitively for around 4 w...
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There is increasing evidence of platelet activation and systemic inflammation in chronic spontaneous urticaria and delayed pressure urticaria (DPU). Inflammation may be central to understanding the high comorbidity of depression and anxiety in patients with chronic urticaria (CU). We report a case of DPU and depression in a patient, which responded...
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Objectives: Bifrontal (BF) electrode placement has been explored to refine the electroconvulsive therapy (ECT) technique. No previous study has compared the cognitive effects of BF versus right unilateral (RUL) ECT by only including the subgroup that is most likely to receive it: elderly patients with major depression. Methods: Nondemented patie...
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Background: No study has previously investigated whether the speed of recovery from disorientation in the post-ictal period may predict the short-term treatment outcome of electroconvulsive therapy (ECT). Methods: This longitudinal cohort study included 57 elderly patients with unipolar or bipolar major depression, aged 60-85 years, treated with...
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No prior study has investigated whether impairment of specific cognitive functions at baseline may predict the short-term treatment outcome of electroconvulsive therapy (ECT) in elderly non-demented patients with major depression (MD). This longitudinal cohort study included 65 elderly patients with unipolar or bipolar MD, aged 60-85 years, treated...
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Published ahead of print. Abstract: Objective: Electroconvulsive therapy (ECT) is an effective biological treatment option for severely depressed elderly patients; however, it can cause cognitive side effects, including anterograde and retrograde amnesia. Elderly patients with “cognitive impairment no dementia” (CIND) are reported as being more vu...
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The tapering of methadone or buprenorphine during pregnancy is an understudied and controversial issue. The aim of this study was to determine to what extent women tapered their opioid medication dose during pregnancy and what the neonatal outcomes were for those who tapered compared to the women who did not. The study was a mixed prospective/retro...
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Antipsychotic agents have serious metabolic adverse effects, among them dyslipidemia, which may necessitate secondary prophylaxis with cholesterol-lowering drugs. Second-generation antipsychotics (SGAs), particularly clozapine and olanzapine, are known to confer a higher risk of metabolic adverse effects than first-generation antipsychotics (FGAs)....
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Background: No prior study has compared the efficacy of bifrontal (BF) vs right unilateral (RUL) electroconvulsive therapy (ECT) by including the subgroup that is most likely to receive it: only elderly patients with major depression (MD). Methods: This single-site, randomized, assessor-blinded, controlled trial was conducted from 2009 to 2013....
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Knowledge about cognitive side-effects induced by electroconvulsive therapy (ECT) in depressed elderly patients is sparse. In this study we investigated changes in the cognitive functioning of non-demented elderly depressed patients receiving ECT (n = 62) compared with healthy elderly people (n = 17). Neuropsychological tests were administered at t...
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Introduction: The aim of this study was to investigate cognitive functions after admission to a geriatric psychiatric hospital, and to study the short-term effects of cessation of benzodiazepine use on cognitive functions. Methods: Details of benzodiazepine use and serum concentration measurements were recorded on admission. The Hopkins verbal l...
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Introduction: Previous studies have shown cognitive impairment in long-term benzodiazepine users compared to non-users. However, little is known about such effects in a population of geriatric psychiatry patients. The aim of this study was to identify differences between benzodiazepine users and non-users on standardized tests of the cognitive fiel...
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Background: The literature describing neurocognitive function in patients with late-life depression (LLD) show inconsistent findings in regard to incidence and main deficits. Reduced information processing speed is in some studies found to explain deficits in higher order cognitive function, while other studies report specific deficits in memory a...
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Objective: Exact information on drug use is important information at admittance to hospital departments. The aim of this study was to validate the information given in the referral regarding benzodiazepine use by analysis of serum samples. Methods: A total of 241 patients were included at admittance to a geriatric psychiatry department. Informat...
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Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorde...
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The dose recommendations in the Norwegian Pharmaceutical Product Compendium (Felleskatalogen) are not gender-specific, despite evidence of gender-dependent differences in the metabolism of a number of drugs. The purpose of this study was to investigate the extent to which age and gender influence the prescription and serum concentration of psychotr...
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Introduction: This article is concerned with the optimal treatment of behavioral and psychological symptoms present in patients with dementia. This pilot study compares the benefits of an ambulant treatment intervention in nursing homes to hospital admission. Material and Methods: Patients referred for hospital admission were randomized to either h...
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Although not recommended in treatment guidelines, previous studies have shown a frequent use of more than one antipsychotic agent among patients with schizophrenia. The main aims of the present study were to explore the antipsychotic treatment regimen among patients with schizophrenia in a catchment area-based sample and to investigate clinical cha...
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An important objective of many health care systems is to ensure equal access to health care services. One way of achieving this is by having universal coverage (low or absent out-of-pockets payments) combined with tax-financed transfers (block grants) to providers with a catchment area responsibility. However, a precondition for equal access in suc...
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To investigate possible differences in MMSE scores due to the time of testing at admission to the hospital, we randomly stratified eligible patients into two groups, and tested on the first day ( n = 28) or the third day ( n = 26) of admission, respectively. Both groups were retested on day seven, and there was no significant difference in delta va...
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Depression is a highly prevalent condition throughout the world. Ethnicity is reported to influence treatment outcome with antidepressants in a number of ways, including both cultural and genetic factors. Non-genetic factors such as the type of diet, beliefs about depression and attitudes towards treatment with antidepressants are proposed to direc...
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The antidepressive effect of racemic citalopram (CIT) is exerted by S-CIT, while R-CIT is a partial antagonist to S-CIT. Since R-and S-CIT are metabolized by different pathways, we investigated whether the ratio of S- and R-CIT may differ between individuals on the same dose of racemic CIT, and if a possible variability in the R/S-ratio could be do...
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Mianserin is a tetracyclic antidepressant that has gained popularity in Europe owing to lack of anticholinergic side effects and good tolerability. Being a histamine-1 and -2 receptor antagonist and an alpha-2 receptor blocker suggests that it should be of particular value in somatoform gastrointestinal disorders. In an open trial mianserin was giv...
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Cigarette smoking has been shown in several studies to induce the metabolism of the cytochrome P4501A2 (CYP1A2) substrates clozapine and olanzapine. The aim of the present study was to investigate the dose-dependent effect of cigarette smoking on serum concentrations of these drugs in a naturalistic setting. In 73 schizophrenic patients recruited f...
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To compare serum concentrations of risperidone, 9-hydroxy (OH) risperidone and risperidone plus 9-OH risperidone, as well as the 9-OH risperidone/risperidone ratio in patients receiving depot and oral risperidone. Serum concentrations from 78 patients receiving three different doses of risperidone depot were measured and compared with serum concent...
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The aim of the present work was to study correlations between self-assessment of symptoms of depression, anxiety, rheumatic pain and functional disability. One hundred patients admitted to a university rheumatology clinic were tested in a consecutive manner, applying the Hospital Anxiety and Depression Scale (HADS). In addition, the patients were a...
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Risperidone depot is the first long-acting atypical antipsychotic to be registered in Norway. The combination of antipsychotic efficacy for negative symptoms, reduction of adverse effects and assured delivery of medication is expected to improve patient compliance and thus reduce the rate of hospitalization. Nevertheless, clinicians have reported t...
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A chiral capillary electrophoresis (CE) system allowing simultaneous enantiomer determination of citalopram (CIT) and its pharmacologically active metabolite desmethylcitalopram (DCIT) was developed. Excellent chiral separation was obtained using 1% sulfated-beta-cyclodextrin (S-beta-CD) as chiral selector in combination with 12% ACN in 25 mM phosp...
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We investigated the relationship between personality and reported pain and somatic distress in patients with functional gastrointestinal disorder (FGD) without psychopathology. Fifty-six patients and 55 controls completed Buss-Durkee Hostility Inventory (BDHI), NEO Personality Inventory (NEO-PI), Eysenck Personality Questionnaire (EPQ: N+L scales),...
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We investigated the relationship between personality traits and response to treatment with the tetracyclic antidepressant mianserin or placebo in patients with functional gastrointestinal disorder (FGD) without psychopathology. Forty-eight patients completed the Buss-Durkee Hostility Inventory, Neuroticism Extroversion Openness -Personality Invento...
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Since reboxetine acts selectively on the reuptake of noradrenaline, it has a different side-effects profile than drugs acting predominantly on the serotonin reuptake mechanism. Data from patients treated with reboxetine (n = 1503) or placebo/comparator drugs (n = 1027) show that reboxetine has no significant cardiovascular effects, a low potential...
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We investigated if response to the fenfluramine challenge test could predict outcome in 47 nonpsychiatric patients with chronic functional gastrointestinal disorder (FGD) treated with mianserin, a drug closely related to mirtazepine, or placebo. Sixty milligrams of fenfluramine was given orally in the morning on nonfasting basis. Serum cortisol (CO...
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We investigated prolactin and cortisol response to fenfluramine in non-psychiatric patients with chronic functional gastrointestinal disorder (FGD). Sixty milligrams fenfluramine was given orally to 55 subjects without any DSM-III axis-1 psychopathology and 29 healthy control subjects matched for sex and age. Serum cortisol and prolactin levels wer...
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The efficacy of unselected monoamine reuptake inhibitors (tricyclic antidepressants) in the treatment of patients with functional gastrointestinal disorders (FGD) has not been convincingly demonstrated. We investigated the efficacy of an antidepressant (mianserin) with a different receptor profile (combined 5-hydroxytryptamine-2 + 3 and alpha-2 ant...