Biomedical subjects
Publications and source records attributed to D Wheatley.
Dose comparison trials were undertaken with trazodone given once, twice and thrice daily. Therapeutic effects were the same but once daily dosage produced drowsiness whilst thrice daily dosage did not. In a double-blind comparison to imipramine, anti-depressant effects were similar, except at 6 weeks when imipramine was significantly better. There were no significant differences in relief of anxiety symptoms.
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1 The causes of insomnia are considered, including those amenable to improvement of the sleep environment and medical treatment. 2 The use of hypnotics is discussed and the investigation of new drugs in general practice reviewed.
A group of 85 patients suffering from non-articular rheumatic disorders was studied in an open trial of naproxen sodium in general practice. Patients were assessed and then treated for 7 days with naproxen sodium at a dosage of 275 mg 3 or 4-times daily depending on the severity of pain. Patients were asked to keep a daily record of symptoms and were re-assessed by the doctor after 7 days and, in some cases, after 14 days. Pain and limitation of movement were the predominant symptoms at admission. Patients' daily records showed statistically significant reductions in pain from Day 1 and significant reductions of limitation of movement from Day 2 of the study. At the 7-day follow-up, 27 were cured, 35 improved, 19 not changed or worse, and 4 were not assessed. Thirty patients were given a second weeks' therapy and at the end of this period 24 were cured or improved. Indigestion was the most common side-effect, but only 1 patient withdrew from the trial because of this. One patient developed a rash and was withdrawn from the trial. Both patients were taking the lower dose.
The beta-adrenergic blocking drug, timolol, was combined with bendrofluazide in a comparative trial between once and twice daily dosage, conducted on 51 patients suffering from hypertension seen in general practice. During the initial control period seven of these patients became normotensive, leaving 44 who entered the trial. Using a crossover design, treatment was continued for a total period of up to 16 weeks. With both dose regimes, systolic and diastolic pressures were rendered normotensive in over three-quarters of the patients, significant reductions occurring within the first two to four weeks of treatment.
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A double-blind comparison was undertaken between Debendox with 10mg of extra pyridoxine and placebo with 10mg of pyridoxine, in 56 women suffering from nausea and/or vomiting during the first 10 weeks of pregnancy. The results of treatment were assessed on the patient's own dialy records of:the time of nausea, the frequency of nausea, and the severity of nausea, retching and vomiting. There were statistically significant differences in favour of Debendox with extra pyridoxine in respect of the days of nausea all day (P les than 0-02), the severity of nausea (P less than 0-05) and the severity of retching (P less than 0.05).
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The hypotensive effects of acebutolol and bendrofluazide were studied comparatively, used alone or in association, using a permutation method over three consecutive six week periods, in 47 patients aged over 21 whose diastolic pressure prior to treatment was in excess of 100 mm Hg. Whether used alone or associated, the drugs were prescribed at the following daily doses: acebutolol 500 mg, bendrofluazide 5-15 mg. After six weeks and at the end of the trials (18 weeks), acebutolol proved to have an hypotensive effect, less marked when given alone than in association. It provided significant relief from anxiety, especially when prescribed alone during the latter part of the test. Side effects were unfrequent on the whole and without marked predominance for any type of treatment.
It has been suggested that depression is a disease of cholinergic dominance and since the beta-adrenergic blocking drug propranolol hydrochloride can cause depression, there arises the possibility that a beta-adrenergic stimulant could benefit the condition. For ethical reasons, the adrenergic drug metaproterenol sulfate was combined with chlordiazepoxide hydrochloride and compared to placebo and chlordiazepoxide in a formal double-blind trial. However, the results did not show any advantage for the addition of metaproterenol either in respect of enhanced antidepressant effect or a reduced incidence, nature, or severity of side-effects.
Three children are described with a right coronary artery fistula communicating with a right heart chamber. Each had a continuous murmur like that of a patent ductus arteriosus but situated at a lower level. Aortography established the diagnosis and excluded any accompanying malformation. It is concluded that to prevent complications surgical treatment should be recommended.
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