EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 28, 2004
To contact Jeff Wiese, M.D., call Fran Simon at 504/588-5221.

DIETARY SUPPLEMENT CONTAINING PLANT EXTRACT APPEARS TO REDUCE SOME HANGOVER SYMPTOMS

CHICAGO—Individuals who took a dietary supplement containing extracts of Opuntia ficus indica, a type of prickly pear cactus, before consuming alcohol, had reduced symptoms of alcohol hangover compared to individuals who drank but took placebo, according to an article in the June 28 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

Alcohol hangovers cause substantial economic and health consequences, the article states. The severity of alcohol hangovers may be related to inflammation caused by impurities in alcoholic beverages and byproducts of alcohol metabolism. C-reactive protein, a protein produced by the liver, becomes elevated after injury or trauma and is thought to be involved in inflammation and alcohol hangovers. An extract from the skin of the prickly pear fruit, Opuntia ficus indica (OFI) has been shown to reduce inflammation, the article states.

Jeff Wiese, M.D., of Tulane University, New Orleans, and colleagues investigated the effect of OFI on the symptoms of alcohol hangover.

The researchers randomly assigned 55 young adult volunteers (aged 21 to 35 years) to receive either OFI or placebo five hours before alcohol consumption. The study participants were given dinner (cheeseburger, fries and soda) four hours before alcohol consumption started, and were able to choose a single type of alcohol to drink for the study: vodka, gin, rum, bourbon, scotch, or tequila.

Over four hours of drinking, volunteers consumed up to 1.75 grams of alcohol per kilogram of body weight, a quantity that has produced hangovers in previous studies. One hour after alcohol consumption ended, the researchers measured blood alcohol levels, and the volunteers were driven home.

The next morning, volunteers returned to the study site and had their vital signs measured, and blood and urine samples were taken. Hangover severity (based on nine symptoms) and overall well-being were assessed on a scale (zero to six points, with six points indicating the worst well-being). Two weeks later, the study was repeated with the same volunteers except those that were previously given OFI were given placebo and vice versa.

The researchers found that three of the nine symptoms of hangover - nausea, dry mouth, and loss of appetite - were significantly reduced after taking OFI. The average score for well-being the next morning was 2.75 for volunteers who took OFI and 3.10 for volunteers who took placebo. The researchers also found that levels of C-reactive protein were strongly associated with hangover severity, and C-reactive protein levels were 40 percent higher in volunteers who took placebo compared with OFI.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 28, 2004
To contact Susan M. Frayne, M.D., M.P.H., call Kerri Childress at 650/858-3925

POSTTRAUMATIC STRESS DISORDER LINKED WITH POOR HEALTH

CHICAGO—Women with posttraumatic stress disorder (PTSD) report having more illnesses and poorer health than women with depression alone, according to an article in the June 28 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

According to the article, posttraumatic stress disorder (PTSD) is a psychiatric disorder characterized by avoidance behaviors and interpersonal difficulties that can occur following experiencing or witnessing a life-threatening or particularly traumatic event, such as terrorism, rape or physical assault. Patients with depression and posttraumatic stress disorder make up about 12 percent of primary care patients, and depression has been linked with poor health, the article states. However, the association between PTSD and physical illness in women is poorly understood.

Susan M. Frayne, M.D., M.P.H., from the Veterans Affairs Palo Alto Health Care System, Menlo Park, Calif., and colleagues compared the number of medical symptoms and health status of women with PTSD (n=4,348; average age, 45.7 years), women with depression alone (n=7,580; average age, 50.2 years), and women without depression or PTSD (n=18,937; average age, 53.2 years).

The researchers found that among women younger than 45 years, 17 percent had a reported history of PTSD, and 25 percent had a reported history of depression. Among women aged 45 to 64 years, 17 percent had PTSD, and 28 percent had depression; and among women 65 years or older, 4 percent had PTSD, and 20 percent had depression.

Across all ages, women with PTSD had more medical conditions and worse physical health status (poor physical functioning, role limitations due to physical problems, pain, low energy) than women with depression alone, or neither depression nor PTSD, report the researchers.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, June 28, 2004
To contact Liana Fraenkel, M.D., M.P.H., call Karen Peart at 203/432-1326.

KNEE OSTEOARTHRITIS PATIENTS MAY BE WILLING TO ACCEPT LESS EFFECTIVE DRUG TREATMENTS FOR LOWER RISK OF SIDE EFFECTS

CHICAGO—Many older patients with knee osteoarthritis prefer treatments with lower risks of adverse side effects, even if those treatments were not the most effective, according to an article in the June 28 issue of the Archives of Internal Medicine, one of the JAMA/Archives journals.

Knee osteoarthritis (OA) is a leading cause of disability in the elderly, according to information in the article. Treatment for knee OA, which includes surgery, weight loss, muscle-strengthening exercise, and joint protection techniques, is aimed at improving or maintaining knee function, and targeting symptoms. Medication options provide modest effectiveness for decreasing pain associated with knee OA, and vary greatly with respect to their cost and risk of toxicity.

Liana Fraenkel, M.D., M.P.H., from Yale University, New Haven, Conn., and colleagues interviewed 100 consecutive patients with symptomatic knee osteoarthritis (79 percent female; 92 percent white; average age, 70 years) about their OA medication preferences. The researchers surveyed the importance of specific medication characteristics-including type of drug (prescription or over-the-counter), administration (dose and method), time to benefit, response rate, common adverse effects, risk of ulcer, and monthly copayments-and then measured the impact of these characteristics on the percentage of patients preferring the following treatments: non-selective non-steroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 inhibitors (cox-2 inhibitors), glucosamine and/or chondroitin sulfate, opioid derivatives, and/or capsaicin.

Despite being described as less effective than the other drug treatments, capsaicin-a topical agent that has been used in treating pain-was preferred by 44 percent of participants, assuming the patient was responsible for full cost of the medication. Of the medication traits studied, risk of common adverse side effects and gastrointestinal ulcer had the greatest impact on patients' choice, each accounting for approximately 19 percent of total relative importance. Non-selective NSAIDs, the most widely prescribed medication for arthritis patients, was found to be the least-preferred option across almost all circumstances.