[Individualising the evidence--single case randomized trial].
A 64-year old patient with well controlled essential hypertension reported convincingly that oral yohimbine had beneficial acute effects in treating his erectile dysfunction. However, when asking for a prescription of the compound his physician was not very responsive because acute effects of this treatment are uncommon and a2-adrenoceptor antagonism was known to increase blood pressure. They decided to convince each other and to objectively document yohimbine's efficacy or failure using a single case randomized trial design, i.e. an experimental approach to perform a controlled study in a single individual and to collect data in a double-blind fashion. The results of 10 comparisons between placebo and oral yohimbine revealed no difference and prevented exposure of the patient with a potentially harmful drug combination.
Haefeli
W E
WE
Universität Heidelberg.
D000317:Adrenergic alpha-Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018660:Blood Pressure Monitoring, Ambulatory; D004311:Double-Blind Method; D007172:Erectile Dysfunction / Q000188:drug therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D010147:Pain Measurement; D012307:Risk Factors; D015016:Yohimbine / Q000009:adverse effects / Q000627:therapeutic use*
D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D015016:Yohimbine; D009543:Nifedipine