The relationship between mental health and drug use.

The aim was to examine the relationship between mental health and use of different kinds of drugs. The study was a cross-sectional survey of a total population aged 45-69 years, conducted in 2 municipalities in southwestern Finland. Altogether 1821 people (80% of those invited), 815 men and 1006 women, took part in the screening. The subjects were examined by a questionnaire mailed beforehand and checked in a personal interview. The questionnaire contained questions about the currently used drugs and Goldberg's questionnaire on mental health. Half of the people examined used prescribed drugs currently, more women used drugs than men, and the use of drugs increased with age. Mental symptoms measured with the Goldberg Index appeared in one fifth of the subjects, showing a slight increase with age. Men with mental symptoms showed a fourfold psychotropic drug use compared with the men without mental symptoms. The women with mental symptoms showed a threefold use of psychotropic drugs compared with the women without mental symptoms. Similar differences were found also in other drug groups, for example cardiac glycosides, other cardiovascular drugs, analgesics and drugs for respiratory and digestive organs. Persons with mental disorders showed a high tendency to drug use, also when those drugs had no direct attachment to the mental problem. Men seemed more liable to somatization of mental problems than women.

The use of prescription drugs among elderly Finnish men.

The extent and factors that influence drug use were studied in two rural cohorts of Finnish men. The men aged between 65 and 84 years belonged to the Finnish study population of the 25-year follow-up of the 'Seven Countries Study'. Of the original 1,711 men in 1959, 766 were still alive in 1984. The participation rate in the follow-up was 93%. Of the non-institutionalized men (n = 675), 66% had used prescription drugs, and 36% non-prescription drugs, while 25% had not used any drugs during the week preceding the study. The number of drugs in use was highly dependent on the time period covered in the assessment. The number of prescribed drugs was associated with the number of symptoms experienced (P less than 0.001) and the use of OTC-drugs (P less than 0.05). Drug use was not associated with socio-economic variables. Standardized measurement methods are needed in the assessment of drug use to obtain more reliable and comparable results in different populations.

Trade names and generic names. Problems for prescribing physicians.

Drugs are marketed with generic and trade names. Our purpose was to study whether this dual name system causes problems to physicians. We interviewed 102 Finnish physicians to find out how well they recalled the composition of combination drugs, and connected the corresponding generic and trade names. The generic name of the given trade-names were known on average by 83% of the physicians who had recently prescribed them, but knowledge of the combination drugs was poor. When generic names were given, on average 9% of the physicians who had prescribed them could mention the corresponding trade names. A multitude of names causes information problems, with possible clinical consequences. From the information point of view, one naming system would be desirable.

Patient report validated against prescription records for measuring use of and compliance with antihypertensive drugs.

Drug use and patient compliance in antihypertensive treatment were studied by interview and validated with prescription records in a Finnish population. The original study population consisted of 675 hypertensives identified in a 6.6% random survey of the 25-59-year-old population in 1972. At re-examination in 1977, 310 of the 570 participants had then used antihypertensive drugs during the preceding year. Two thirds renewed prescriptions appropriately within 70% of the correct time (considered as good compliance). Prescription filling patterns of the re-examination non-participants did not differ from those of the participants. Eight per cent of the participants reported not having followed prescription instructions. There was 94% agreement between the re-examination and prescription records; 5% reported taking fewer drugs than the records showed and 1% reported taking more. Drug history given by the patient gave accurate information about the number and type of drugs in use. However, patient interview gave an overestimation of compliance.

Combination therapy in hypertension. A population-based study in eastern Finland.

In a cross-sectional study, antihypertensive drug treatment was studied in a representative population sample of people aged 30-64 years, using a combination of postal survey, personal interview, clinical assessment and drug prescriptions. 11% of the men and 16% of the women were currently taking antihypertensives; 54% of patients used one, 38% used two, and 8% used three or more preparations. Men used slightly more drugs than women. Diuretics were used by 62% and betablockers by 49% of the sample population. Fixed combinations of thiazides and potassium-sparing agents formed 70% of all diuretic preparations used. Only 12% of the patients used fixed antihypertensive combinations, of which over half were diuretic-reserpine-vasodilator combinations; women and older patients used them most often. The most common freely combined preparations were diuretics and betablockers, which formed almost half of all two-drug combinations, and were also present in 70% of all triple combinations. Adequate control of blood pressure (DBP less than 100 mmHg) was achieved by slightly under 50% of the patients, the BP of women being more adequately controlled than that of men. Differences in BP control were found between the different drugs and combinations. Antihypertensive combination therapy is important in successful treatment, but we still cannot be sure whether fixed combination preparations or, as in this study, free combinations of marketed preparations are better alternatives for treatment.

Protective effect of tryptophan and 5-hydroxytryptophan on experimental phenylketonuria induced with phenylalanine+ p-cholorophenylalanine in rats.

An experimental phenylketonuria-like syndrome was produced in rats by oral administration of 1-phenylalanine (Phe, 500 mg/kg) and dl-p-chloro-phenylalanine (pCPA, 100-125 mg/kg) daily from the 2nd-3rd day of life to the age of 42 days. The effects of added dl-5-hydroxytryptohan (5HTP, 5 mg/kg) or 1-tryptophan (Trp, 100-125 mg/kg) were also studied. The groups receiving Phe+pCPA gained less weight than normal and less than the Phe controls. When tested during the last week of treatment the Phe+pCPA rats made more errors in the swim maze without changes in swimming times, and they showed significantly poorer learning of conditioned shock avoidance. These effects were partly antagonized by 5HTP or Trp. One to three weeks after the end of the treatments similar differences still remained in conditioned shock avoidance (and Trp and 5HTP prevented the effect of pCPA), but no more in maze learning, motor activity, or exploration on open field. Brain 5HT and 5-hydroxyindoleacetic acid (5HIAA) were lowered in all the pCPA treated rats during the treatment but returned to normal after it. Trp and 5HTP in the doses used only partly corrected the decrease of 5HT and 5HIAA. Brain noradrenaline did not change much.