Months Of Drug Treatment Research Articles

The variation in serum triiodothyronine (T3) achieved during suppression testing in thyrotoxicosis.

SUMMARYRegular measurement of thyroidal radioiodine uptake has been widely used as a means of monitoring continued extrapituitary stimulation of the thyroid during the treatment of thyrotoxicosis with carbimazole and triiodothyronine (T3). However, it is unclear to what extent the serum T3 level may vary at the time of testing, nor what effect this might have on the uptake of radioiodine. Two studies have been undertaken. In the first, serum T3 levels in twenty‐four thyrotoxic patients were measured at intervals during an 18‐month course of carbimazole combined with T3, 20 μg qid. Considerable variations in the highest and lowest levels of serum T3 were found both between and within individuals. The second study was on twenty‐three thyrotoxic patients thought to be entering remission because the iodine uptake after 5 months of drug treatment had fallen to less than 50% of the pretreatment value (suppressors). The changes in uptake of radioiodine after 5 and then 6 months of treatment were compared in seven patients, who received carbimazole and T3 throughout, with the corresponding changes in the remaining sixteen patients, whose T3 alone was withdrawn prior to the uptake test at month 6. The mean degree of suppression remained unchanged by month 6 in the first group. In the second group, however, the mean uptake rose significantly, and nine of the sixteen patients would have been classified as non‐suppressors at the sixth month (i.e. uptake greater than 50% the pretreatment value) had their failure to maintain high serum levels of T3 gone undetected. The first study indicated this could well happen in routine circumstances, and it is suggested that the reliability of suppression tests be checked with simultaneous measurement of serum T3.

Effect of a new niacin derivative (nicotinic hexaester of d-glucitol) on type IIA, IIB and IV hyperlipoproteinemia in man

The hypolipemic effects of a new niacin, derivative (nicotinic hexaester of D-glucitol) were studied in 127 patients with hyperlipoproteinemia. The patients were put on a restricted diet for 2 months and were then given Nicosterolo* 4 tablets daily, each tablet providing 363,5 mg nicotinic acid, for 2 months. 30 patients continued with the treatment for one year. Diet failed to normalise the serum cholesterol in any of the 37 type IIA cases whereas the drug treatment achieved this in 19% of cases after 2 months (and in 45% as from the 6th month in group continuing with treatment). Of the 40 type IIB cases 22% presented a normal cholesterol value and 35% a normal triglyceride value after diet whilst after drug treatment for 2 months 30% showed a normalized cholesterol and the same 35% a normal triglyceride level. In the six type IIB patients continued treatment up to 12 months did not improve results obtained after the first two months of drug treatment. Of the type IV cases 20% presented normal triglycerides after dietary and 40% after drug treatment. 75% of patients pursuing treatment showed normal triglycerides after 12 months.

Withdrawal Reaction to Diazepam

To the Editor.— Major withdrawal reactions were evoked experimentally in patients taking larger than usual therapeutic doses of benzodiazepines for several weeks and who suddenly had the drug withdrawn. 1 Covi et al 2 studied the effects of abrupt withdrawal of chlordiazepoxide, 15 mg three times per day, when given for 20 weeks or longer. They found only minor abstinence symptoms. We wish to report a severe withdrawal reaction on a therapeutic dose of diazepam. Report of a Case.— The patient was a healthy, 23-year-old man who suffered from moderate anticipatory anxiety mainly related to fear of poor performance at work. Treatment with diazepam, 10 mg three times per day, brought considerable relief. After three months of drug treatment he went to an army base to fulfill his reserve duty obligation. At this time, he abruptly discontinued use of diazepam. Five days later he had two grand mal convulsions within

Effect of dimethylaminoethanol on the life span of senile male A/J mice

Dimethylaminoethanol p-acetamidobenzoate was found to increase median, mean and maximum survival time from the start of drug administration of senile male A/J mice by 30·8, 49·5 ( P= 0·018) and 10·9 per cent respectively. Three months of drug treatment did not cause weight loss. Dimethylaminoethanol is a natural substance, found in minute concentrations in animal tissues. As the immediate precursor of choline, dimethylaminoethanol is involved in the biosynthesis of cellular membranes. Cellular (especially lysosomal) membrane breakdown has previously been postulated to be a mechanism underlying aging in animals.