Anxio-depressive symptomatology was not found in a small group of thirteen myotonic dystrophy ("Steinert's disease") patients. This contradicts previously published reports which document a moderately severe affective disorder in this disease as well as showing a beneficial clinical response to "imipramine" and "lithium carbonate". Methodologic and interpretative difference may explain the discordance between the studies.

Nineteen cancer patients with chronic pain of moderate to severe intensity were randomized in a double-blind manner to 5 days of either 8-hourly or 12-hourly administration of controlled-release morphine (MS Contin, MSC), followed by the alternate schedule for 5 days. The control of pain, using an average dose of 303.4 +/- 254.4 mg/day of MSC, was good during both the 8-hourly and 12-hourly phases, and the mean daily pain intensity measured by visual analogue scale (VAS), pain relief (VAS), and global efficacy scores did not differ when compared by treatment schedule. The need for supplemental "rescue" morphine was infrequent and did not differ between treatment phases (8-hourly, 0.7 +/- 0.7 and 12-hourly, 0.6 +/- 0.6 doses per day, p = 0.6232). The overall frequency and severity of adverse events did not differ between the two dosing schedules. A majority of patients (67%) reported that they believed that 12-hourly dosing was a moderate or great advantage over 8-hourly dosing.

The purpose of this open, uncontrolled study in a group of confirmed heroin addicts of both sexes was to determine whether clonidine by itself suppresses opiate withdrawal reactions, its maximal effective dosage range, the time of maximal effect, duration of its effectiveness and the extent of cardiovascular side effects. After a washout phase of opium residues, clonidine was administered for eight days and its effects were closely monitored and recorded. Even during the first 24 hour period, when clonidine was administered alone in a high dosage, it suppressed the signs and symptoms of opiate withdrawal reactions. The maximum effect was attained within three days. Thereafter, it maintained improvement until natural resolution of the reactions. Side effects were limited to some small but statistically significant cardiovascular changes. Illicit drug use during the treatment period indicated that drug related behaviour is only slightly affected by clonidine. The drug is thus effective in the acute withdrawal phase but does not replace the important psychosocial management needed to achieve long term drug abstinence.

No abstract

Twelve patients of both sexes (5 women, 7 men; mean age = 39,9) suffering from marked anxiety as defined by DSM III for generalised anxiety (score greater than 20 on the Hamilton-A scale) but in good physical health, were given 15 mg of clorazepate daily at 8 p.m. for a period of 28 days. Desmethyldiazepam, the active metabolite of clorazepate was measured in blood samples on day 1, 14 and 28 of the experiment as well as the level of anxiety on the Hamilton scale. Anxiety decreased significantly between day 1 and day 14 (mean score declining from 33,9 to 18,4) and from day 14 to day 28 (mean score 18,4 to 14,7). Desmethyldiazepam reached its maximum blood concentration 2 hours after the first intake of clorazepate. A plateau had been reached at day 14 and remained stable up until day 28, indicating the absence of cumulating effects. The dosage remained the same for all patients during the 28 days of the experiment. There were no drop outs and no undesirable effects.