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An Evaluation of Meprobamate in Opiate Withdrawal

An Evaluation of Meprobamate in Opiate Withdrawal Abstract Meprobamate has been reported to relieve muscular spasm, insomnia, and anxiety symptoms.1 Since these findings are prominent in the opiate-withdrawal syndrome, it was hypothesized that meprobamate might be a useful adjunct in the treatment of this illness. To date, only a few isolated observations have been reported. Collomb and Miletto2 reported that several cases of drug addiction responded favorably. In an evaluation of 65 hospitalized alcoholics and 6 drug addicts, Thimann and Gauthier3 found that three patients addicted to diacetylmorphine (heroin) showed a "good" response and the other addicts were unaffected. Meprobamate has been found useful in the treatment of alcoholism by several investigators. Thimann and Gauthier3 reported that more than 58% of their series showed "marked to moderate" improvement, as manifested by relief of severe anxiety symptoms, subsiding of tremors, and better sleeping and eating. Selling4 noted that meprobamate helped prevent serious alcoholwithdrawal symptoms. References 1. A patient, for example, enters the hospital one morning, stating that he is addicted to morphine, that he had his last medication the morning of the previous day. At the time of admission he manifests no definite withdrawal signs. Several hours later, however, he is noted to display withdrawal signs, such as goose flesh, lacrimation, rhinorrhea, and dilated pupils. At this time he is given 15 mg. methadone hydrochloride syrup. After observation one hour later it is found that withdrawal signs still persist. The patient is then given an additional 15 mg. of methadone hydrochloride syrup. On subsequent hourly observations throughout the day and night the patient manifests no definite withdrawal signs. The following morning he is observed by the physician to have moderate withdrawal signs. He is then placed on a stabilization dosage of 20 mg. of methadone hydrochloride twice daily. Stabilization doses of methadone hydrochloride ranged from 20 to 70 mg. daily. The average dose was 45 mg. daily, equivalent to approximately 140 mg. of morphine. 2. Berger, F. M.: Meprobamate: Its Pharmacologic Properties and Clinical Uses , Internat. Rec. Med. 169:184 ( (April) ) 1956. 3. Collomb, H., and Miletto, G.: Place of Meprobamate in Neuropsychiatric Therapeutics , Presse méd. 65:1550 ( (Sept. 28) ) 1957. 4. Thimann, J., and Gauthier, J.: Miltown as a Tranquilizer in the Treatment of Alcohol Addicts , Quart. J. Stud. Alcohol 17:19 ( (March) ) 1956. 5. Selling, L. J.: A Clinical Study of Miltown, a New Tranquilizing Agent , J. Clin. & Exper. Psychopath. 17:7 ( (Jan.-March) ) 1956. 6. Greenberg, L. A., and others: An Evaluation of Meprobamate in the Treatment of Alcoholism , Ann. New York Acad. Sc. 67:816 ( (May) ) 1957. 7. Himmelsbach, C. K., and Mertes, O. T.: The Nursing Care of Drug Addicts , Trained Nurse & Hosp. Rev. 99:495 ( (Nov.) ) 1937. 8. Siegel, S.: Nonparametric Statistics for the Behavioral Sciences , New York, McGraw-Hill Book Company, Inc., 1956. 9. Felix, R. H.: An Appraisal of the Personality Types of the Addict , Am. J. Psychiat. 100:462 ( (Jan.) ) 1944. 10. Unna, K., in discussion on Pfeiffer, C., and others: Comparative Study of the Effect of Meprobamate on the Conditioned Response, on Strychnine and Pentylenetetrazol Thresholds, on the Normal Electroencephalogram, and on Polysynaptic Reflexes , Ann. New York Acad. Sc. 67: 734 ( (May) ) 1957, p. 744. 11. Wikler, A.: Addiction Research Center, National Institute of Mental Health, Lexington, Ky., personal communication, March, 1958. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1958 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1958.02340120124020
Publisher site
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Abstract

Abstract Meprobamate has been reported to relieve muscular spasm, insomnia, and anxiety symptoms.1 Since these findings are prominent in the opiate-withdrawal syndrome, it was hypothesized that meprobamate might be a useful adjunct in the treatment of this illness. To date, only a few isolated observations have been reported. Collomb and Miletto2 reported that several cases of drug addiction responded favorably. In an evaluation of 65 hospitalized alcoholics and 6 drug addicts, Thimann and Gauthier3 found that three patients addicted to diacetylmorphine (heroin) showed a "good" response and the other addicts were unaffected. Meprobamate has been found useful in the treatment of alcoholism by several investigators. Thimann and Gauthier3 reported that more than 58% of their series showed "marked to moderate" improvement, as manifested by relief of severe anxiety symptoms, subsiding of tremors, and better sleeping and eating. Selling4 noted that meprobamate helped prevent serious alcoholwithdrawal symptoms. References 1. A patient, for example, enters the hospital one morning, stating that he is addicted to morphine, that he had his last medication the morning of the previous day. At the time of admission he manifests no definite withdrawal signs. Several hours later, however, he is noted to display withdrawal signs, such as goose flesh, lacrimation, rhinorrhea, and dilated pupils. At this time he is given 15 mg. methadone hydrochloride syrup. After observation one hour later it is found that withdrawal signs still persist. The patient is then given an additional 15 mg. of methadone hydrochloride syrup. On subsequent hourly observations throughout the day and night the patient manifests no definite withdrawal signs. The following morning he is observed by the physician to have moderate withdrawal signs. He is then placed on a stabilization dosage of 20 mg. of methadone hydrochloride twice daily. Stabilization doses of methadone hydrochloride ranged from 20 to 70 mg. daily. The average dose was 45 mg. daily, equivalent to approximately 140 mg. of morphine. 2. Berger, F. M.: Meprobamate: Its Pharmacologic Properties and Clinical Uses , Internat. Rec. Med. 169:184 ( (April) ) 1956. 3. Collomb, H., and Miletto, G.: Place of Meprobamate in Neuropsychiatric Therapeutics , Presse méd. 65:1550 ( (Sept. 28) ) 1957. 4. Thimann, J., and Gauthier, J.: Miltown as a Tranquilizer in the Treatment of Alcohol Addicts , Quart. J. Stud. Alcohol 17:19 ( (March) ) 1956. 5. Selling, L. J.: A Clinical Study of Miltown, a New Tranquilizing Agent , J. Clin. & Exper. Psychopath. 17:7 ( (Jan.-March) ) 1956. 6. Greenberg, L. A., and others: An Evaluation of Meprobamate in the Treatment of Alcoholism , Ann. New York Acad. Sc. 67:816 ( (May) ) 1957. 7. Himmelsbach, C. K., and Mertes, O. T.: The Nursing Care of Drug Addicts , Trained Nurse & Hosp. Rev. 99:495 ( (Nov.) ) 1937. 8. Siegel, S.: Nonparametric Statistics for the Behavioral Sciences , New York, McGraw-Hill Book Company, Inc., 1956. 9. Felix, R. H.: An Appraisal of the Personality Types of the Addict , Am. J. Psychiat. 100:462 ( (Jan.) ) 1944. 10. Unna, K., in discussion on Pfeiffer, C., and others: Comparative Study of the Effect of Meprobamate on the Conditioned Response, on Strychnine and Pentylenetetrazol Thresholds, on the Normal Electroencephalogram, and on Polysynaptic Reflexes , Ann. New York Acad. Sc. 67: 734 ( (May) ) 1957, p. 744. 11. Wikler, A.: Addiction Research Center, National Institute of Mental Health, Lexington, Ky., personal communication, March, 1958.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Dec 1, 1958

References

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