Summary A double‐blind, cross‐over comparison of flunisolide nasal spray and its inactive aqueous vehicle has been carried out in fifty patients suffering from perennial allergic rhinitis. Patients were randomly allocated to two groups; the first group (group I) received flunisolide for 3 weeks and then placebo for 3 weeks while the regimes were given in the reverse order to the second group (group II). Patients used two insufflations of 0.1 ml in each nostril twice daily. As the active spray was presented as a 0.025% solution of flunisolide, the total daily dosage was 200 μg. Patients were assessed on admission and at the end of each 3 week period. The results show flunisolide to be significantly superior to placebo in relieving sneezing, nasal obstruction and postnasal drip, as well as improving the quality of sleep and everyday life. At the end of the trial the preferences for treatment recorded by both doctors and patients were significantly in favour of the flunisolide spray. Side effects were minor and occurred during both placebo and active phases of the trial. A short Synacthen test performed at each visit showed no evidence of adrenal suppression.

SUMMARY A double-blind cross-over trial between pheneturide and phenytoin in ninety-four outpatients with epilepsy is described. There was no significant difference between the frequency of seizures in the two groups. The difficulties in comparing two anticonvulsants of similar efficacy are discussed particularly in relation to ethical problems, the selection of patients and trial design.Recent research in anticonvulsant drugs has concentrated on their mode of action, their absorption, metabolism and elimination. Thus while the pharmacokinetics of these drugs are well understood, there are few adequate trials to test their efficacy in the management of epilepsy,' 2 possibly because ethical and design difficulties frequently

Summary An open, parallel comparison of flunisolide and beclomethasone dipropionate nasal sprays is described. Sixty patients entered the study of whom fifty‐six completed the full 4 weeks' therapy. The dosage of flunisolide was two actuations (25 μg/actuation) into each nostril twice a day (total 200 μg). The dosage of beclomethasone dipropionate was one actuation (50 μg) in each nostril four times a day (total 400 μg). Both drugs produced statistically significant improvements compared with admission values in sneezing, stuffiness, runny nose, nose blowing and post‐nasal drip. Both drugs significantly decreased the interference by symptoms with routine life and sleep. At the end of the trial both treatment groups showed total or good control of symptoms in the majority of patients. No statistically significant difference was shown between the effects of the two drugs. Side‐effects did not cause withdrawal from the trial in any patient and were mostly confined to minor headache and nose and throat complaints, in neither treatment group was there any evidence of adrenal suppression or growths of Candida from nasal swabs.