[New drugs for substitution treatment of opioid dependence. Buprenorphine and 1-alpha-acetylmethadol (LAAM) ]. / Nye medikamenter til substitutionsbehandling af opioidafhaengige. Buprenorphin og 1-alpha-acetylmethadol (LAAM).

Two new long-acting opioid agonists have recently been introduced for the substitutional treatment of opioid-dependent patients: Orlaam (LAAM) and Subutex (buprenorphine). Both have a dose-related duration of action two to three times that of methadone, and can be given only three times a week instead of daily, thus reducing the need for take-home doses. Further, the longer duration of action provides a smoother blood level with fewer fluctuations between doses. With the availability of buprenorphine and LAAM as alternatives to methadone, agonist treatment can be more differentiated, and one can hope that this will increase the quality of the treatment.

Morning fluoxetine plus evening mianserin versus morning fluoxetine plus evening placebo in the acute treatment of major depression.

In a randomized clinical study the combination of fluoxetine 20 mg daily and mianserin 30 mg daily was compared to fluoxetine 20 mg daily and a mianserin placebo. In total, 34 patients with major depression were randomized, of whom 16 received fluoxetine plus mianserin; 18 patients received fluoxetine plus placebo. Of these patients, 69% completed the planned trial of six weeks in the fluoxetine plus mianserin group while 61% completed in the fluoxetine plus placebo group. In the efficacy analysis (excluding dropouts from the first two weeks of treatment) the combination of fluoxetine and mianserin was superior to fluoxetine and placebo both in observer ratings of depression and in quality of life ratings. However, in the intention-to-treat analysis this difference was not statistically significant. No major side effects were reported. After four weeks of treatment headache was most often seen in the fluoxetine and mianserin combination, while sweating was most often seen in the fluoxetine plus placebo group. No pharmacokinetic interaction in terms of fluoxetine plasma levels was found in the mianserin-treated patients.

[Sterilization of women using laparoscopy. A 3-year cohort]. / Sterilisation af kvinder ved laparoskopi. Et 3 års materiale.

PIP: Retrospective review of 294 women who were sterilized by laparoscopy employing the falope ring during a 3-year period revealed complications in 2.7% of the cases. 2.5% became pregnant after the intervention. In more than 1/2 of the cases, this was due to incorrect placement of the ring. 21% experienced low abdominal pain postoperatively and 58% experienced menstrual changes. On the average, the patients felt well after 12 days; work was re-commenced after 3. Sexual activity was resumed after 14 days. Dyspareunia occurred in 6.5% of the cases and persisted, on an average, for 18 weeks. 14% experienced increased libido and 16% said they found greater sexual satisfaction. Nearly every 10th women (8.6%) regretted the procedure and 7% were dissatisfied with the cosmetic results. The frequency and predictability of complications, postoperative lower abdominal pain, and menstrual disturbances were similar in both a department of general surgery and a specialized gynecological unit. The duration of hospitalization, time spent convalescing, and duration of sick leave were considerably shorter than following sterilization by laparotomy and, in addition, sexual activity was resumed earlier. On the basis of this investigation, laparoscopic sterilization is recommended as a means of sterilization for women in departments of general surgery. (author's modified)^ieng