A double-blind crossover study comparing betahistine and cinnarizine in the treatment of recurrent vertigo in patients in general practice.

A double-blind crossover study was carried out in general practice in 88 patients with peripheral vertigo of unknown origin to compare the efficacy and tolerance of 12 mg betahistine dihydrochloride and 15 mg cinnarizine. Patients were allocated at random to receive 2 tablets 3-times daily of one or other drug for 3 consecutive months before being crossed over to the alternative medication for a further 3 months. Severity of symptoms was assessed at 4-week intervals using the Clinical Global Impression scale and patients kept a record in a daily diary of the frequency and duration of attacks. Details were also recorded of any side-effects reported. The results were analyzed for 46 patients who completed the 6-month study period. Both drugs were shown to be equally effective in reducing the duration and severity of symptoms. Significantly fewer attacks of vertigo, however, occurred during betahistine therapy. Side-effects were the most common reason for dropping out whilst on cinnarizine (9 patients) and were complained of by 38 patients during the study (16 only when on betahistine, 19 only on cinnarizine, 3 whilst on both drugs). The most frequently reported were drowsiness or lethargy affecting 16 patients on cinnarizine and 7 on betahistine.

Efficacy and tolerability of sustained-release clomipramine (Anafranil SR) in the treatment of phobias: a comparison with the conventional formulation of clomipramine (Anafranil).

This multicentre double-blind trial in general practice compared the efficacy and tolerability of the sustained-release formulation of clomipramine (Anafranil SR) with its conventional formulation (Anafranil) in the treatment of phobias. Patients were allocated at random to receive clomipramine 75 mg once daily as either the sustained-release or conventional formulation for 11 weeks following a 1-week dosage build-up period. Analysis of results from forty-six patients showed that the sustained release formulation of clomipramine 75 mg was as effective as the conventional formulation of clomipramine 75 mg in improving symptoms of phobia as assessed by a phobia inventory and global evaluation. Unwanted effects attributable to therapy were similar in both treatment groups but there were fewer withdrawals due to unwanted effects of the sustained release formulation of clomipramine 75 mg. It was concluded that the sustained-release formulation of clomipramine does offer advantages for patients requiring 75 mg clomipramine daily.

The management vf essential hypertension with once daily administration of timolol maleate and bendrofluazide.

A placebo controlled-blind study performed on new patients presenting with mild to moderate essential hypertension. A once daily combined dose of timolol maleate and bendrofluazide in a 4:1 ratio was administered ot each patient after a four week placebo period. The starting dose was timolol 10 mg and bendrofluazide 2-5 mg and this dose was increased in steps of timolol 10 mg and bendrofluazide 2-5 mg until blood pressure was controlled. Eleven out of twelve patients achieved normotension, the falls in diastolic and systolic blood pressure being highly significant on active treatment compared with placebo. The once daily regimen of timolol and bendrofluazide resulted in good control of blood pressure with no more side-effects than occurred on the placebo. A combination of these two drugs in one tablet would appear to be both practical and advantageous and should increase patient compliance in taking medication.