[Tizanidine in the treatment of acute withdrawal symptoms in heroin dependent patients]. / A tizanidin hatékonysága heroinfüggó betegek akut megvonási tüneteinek kezelésében.

One of the treatment alternative of withdrawal symptoms of patients suffering from opiate dependence is to apply the clonidine in combination or itself. This remedy is not in commercial trade in our country. It is expectable according to the recent data analysing the effects of the alfa2 adreneregic agonist tizanidine that tizanidine has the similar protective effect as clonidine with the resembling target point. Based on this theory a research was done, in the course of which the i.v. heroin users who presented themselves at the Drug Outpatient Department of Buda between 1.10.1998-8.01.1999. were divided into two groups. The groups had got the usual detoxification treatment, but in the experimental group tizanidine were given in 3 x 8 mg/day dose too. Sixteen patients were in the tizanidine group, 10 patients were in the control group. The patients estimated the intensity of 7 symptoms of withdrawal (sweating, nervousness, insomnia, tremor, diarrhoea, muscle pain, drug craving) on a subjective scale day by day. The analysis showed that the tizanidine treatment decreased the intensity of the withdrawal symptoms in every symptom type examined. The ten days long acute withdrawal period were accomplished by all of the patients, but in the short course of the following (mean 9 and 11 weeks in the treated and the control groups respectively) there were three relapses in each group (3/16 in the treated and 3/10 in the control).

[Prevalence of chronic viral hepatitis in drug abusers]. / Idült hepatitisvírus-fertózések elófordulása drogfogyasztókban.

Authors examined the prevalence of hepatitis B, C and D viral infections in Hungarian drug users. Between January 1995 and October 1998 256 examinations were made (58% intravenous, 42% non intravenous drug user). Hepatitis C virus infection in 27 patients, hepatitis C and B virus infection in 4 patients, hepatitis B virus infection in 17 patients was detected. Every hepatitis B virus positive case was past infection. Hepatitis D virus infection was not detected. Clinically overt liver disease was proved in more than half of the hepatitis C virus infected patients. Because of insufficient collaboration only 11 were followed up. Liver biopsy was made in 5 cases. Interferon therapy was indicated in 3 cases. The 24% of intravenous drug users was anti-HCV seropositive contrary to 1.4% of non intravenous group. Anti-HCV seropositivity was proved in 38% in common needle users, while in disposable needle users only 3%. The prevalence of hepatitis C virus infection in intravenous drug users is rather frequent in Hungary too. The exact diagnosis of liver diseases is very difficult as for insufficient collaboration. The prevalence of hepatitis B virus infection in i.v. and non i.v. drug users is the same as in the normal population. The importance of information, especially to avoid common needle use is stressed.

Protective and risk predictors in the development of drug use.

The authors examined the relationship of two dimensions of the theory of social development--vulnerability (predictors, risk factors) and protectivity--in two samples, schoolchildren aged ten to fifteen years and addictive drug users. On the basis of the Hirschi model of protective factors, they found that the most important protective factors (attachment, commitment, involvement, belief) act against substance use. A surprising finding was that among the predictors of the addicts some forms of escape from the family act against the development of drug use, that is, they can be regarded as a protective predictor. The findings of the study draw attention to the complexity of the vulnerability-protectivity relationship and to the need for further research.

Drug use in Hungary: an overview.

Based on surveys and clinical data, it is concluded that the use of illegal drugs is spreading in Hungary. The social composition of drug users is changing and new forms of drugs and uses have appeared, such as heroin use and cocaine snorting. The legal regulation of access to drugs changed in 1993: stricter sentences can be imposed on drug traffickers, while the possibility has been created for drug users to undertake therapy in place of punishment. The Interministerial Committee on Drug Affairs and the Hungarian Association on Drug Use and Addiction have been set up. There are a few scientifically-based prevention programs. A number of clear paradigms have emerged in prevention policy and therapy, although it is not yet possible to see which of these will be confirmed by time and practice.

[The concept and diagnosis of addiction. New trends in the terminology of addictive syndromes]. / Az addikció fogalomköre és diagnózisa. Uj tendenciåk az addiktív kórképek terminológiájában.

The terms addiction, dependence, tolerance and abuse are not interchangeable and cannot be used as synonyms. Two types of addictions, chemical and behaviour addictions, have similar cycles, but the "pull" type mechanisms are more characteristic of the chemical addictions and the "push" type mechanisms of the behaviour addictions. Among the integrative, complex conceptual models, the definitions of the WHO model are most in harmony with the latest research findings, although this model too is in need of revision on several points. The modern diagnostic systems are polythetic; they advance beyond the principle of "all or nothing" and despite their shortcomings they can be used effectively in clinical practice. Aspirations in the direction of both expanding and restricting the concept addiction can be observed.

Clinical notes on the possible anticholinergic reversal of depressive syndromes.

The authors report on the effects of acute confusional states and deliria (pharmacogenic confusional syndromes - PCS), occurring under the influence of psychotropic drugs on the depressive syndrome of three patients. The favourable influence of PCS on the depressive syndrome is considered to be largely linked to the anticholinergic effect of the drugs. The observations made in these three patients may give support to the hypothesis that cholinergic activity has pathogenic significance in depressive syndromes.

Further data on the diagnostic value of spontaneous drawing.

In discussing 2 patients, the authors point out that a study of spontaneous drawings by psychotics can be of considerable diagnostic importance in clinical practice. The clear structure of the drawings threw doubt on the diagnosis of schizophrenia in the case of the first patient who could be classified in the schizophenia spectrum on the basis of the formal symptoms. In the case of the second patient, where th clinical picture suggested different diagnosis, the drawings represent the 'ossified' essence of the experience and behavior symptoms and thus provided an objective basis for nosological classification. In addition, a characteristic feature of the difference between the creativity of the schizophrenic and the creative artist could be seen from a comparison with medieval Gothic art.