A fatal toxicity index (deaths per million National Health Service prescriptions) was calculated for antidepressant drugs on sale during the years 1975-84 in England, Wales, and Scotland. The tricyclic drugs introduced before 1970 had a higher index than the mean for all the drugs studied (p<0-001). In this group the toxicity of amitriptyline, dibenzepin, desipramine, and dothiepin was significantly higher, while that ofclomipramine, imipramine, iprindole, protriptyline, and trimipramine was lower. The monoamine oxidase inhibitors had intermediate toxicity, and the antidepressants introduced since 1973, considered as a group, had significantly lower toxicity than the mean (p<0-001). Ofthese newer drugs, maprotiline had a fatal toxicity index similar to that of the older tricyclic antidepressants, while the other newly introduced drugs had lower toxicity indices, with those for mianserin, nomifensine, trazodone, and viloxazine reaching significance. Provided that these drugs are equally effective clinically, serious consideration should be given to prescribing antidepressants with a lower fatal toxicity.

Summary:A questionnaire on the pattern of drug taking was completed by 185 patients with chronic airflow obstruction. Of these, 49% admitted to taking their prescribed therapy regularly and 33% could be regarded as being fully compliant. The use ofincreasing numbers ofdrugs was not accompanied by a fall in compliance. Regular drug taking was better in patients (particularly females) with asthma than in patients with chronic bronchitis and emphysema. During acute exacerbations of airflow obstruction, excessive use of bronchodilators beyond the recommended increase in medication was rare; indeed, underuse of therapy in this situation was commoner. These conclusions must be regarded as tentative since the questionnaire was not validated by repeat interviewing or measurement of drug usage.

The authors explore the usefulness of orientation programs for students aged 27 and older who delayed entry to graduate school and whether differences in personal importance of orientation programs, willingness to participate in them, and preferences in matters of scheduling and topics. The results indicated that several demographic variables affected the interest level in some topics, suggesting that a cafeteria-workshop style format, which would allow students to select just those sessions that were of interest to them, may be the best for this group.

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The effects of acute and chronic administration of a slow-release preparation of pinacidil have been studied in eight normotensive volunteers aged 40-57 years. Continuous administration of 20 mg b.i.d. pinacidil had no effect on serum pinacidil concentrations measured as AUC (0-9 h), but accumulation of the principal metabolite, pinacidil pyridine-N-oxide was found to occur. There were no significant changes in erect and supine blood pressure and heart rate from the pretreatment levels on days 1,15 or 29. Chronic administration of pinacidil caused a significant increase in weight over the total period of study. There were also significant changes in mean sodium (+2.38 mmol/l) and alkaline phosphatase (+15.75 iU/l) from the start to the end of pinacidil therapy but values were within the normal ranges, except for one alkaline phosphatase. There were significant changes in the following haematological parameters over the period of pinacidil therapy; leukocytes (-1.49 x 10(9)/l), haemoglobin (-0.56 g/dl), MCH (-1.1 pg), MCHC (-1.22 g/dl), platelet MCV (-0.90 fl).