Abstract: Skilled clinical decision making in the diagnosis and treatment of chronic pain can create unique clinical and ethical challenges, particularly when opioid medications are involved. This report presents the case of a pregnant woman who sought treatment for an illicit opioid dependence, initiated by opioid analgesic treatment of chronic pain. While recognizing opioids’ high level of effectiveness for pain relief, the case demonstrates the potential harms of opioid medications for particular patients
Clinical trials with positive findings are more likely to be submitted and published than those with negative findings, but negative findings can provide invaluable information, particularly when based on sound methodology. The study by Somoza and colleagues in this issue provides a powerful illustration of the potential value of a negative finding.
Abstract: Granulocyte colony-stimulating factor agents such as filgrastim can be administered in order to reduce the duration of clozapine-induced agranulocytosis. Successful long-term combination treatment with filgrastim and clozapine in patients with previous clozapine-induced agranulocytosis has been described in several cases. We describe a patient with schizophrenia who developed agranulocytosis during treatment with clozapine and who did not respond to other antipsychotics