The place of long-acting beta 2 agonists in primary care.
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Biomedical subjects
Publications and source records attributed to P C Stott.
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A double-blind, parallel-group study was carried out to compare the efficacy and tolerability of a controlled-release tablet formulation of trazodone with the standard trazodone tablet. Three hundred and forty-seven general practice patients with depressive symptoms were recruited into the trial. Patients were randomly allocated to receive either 1 controlled-release trazodone (150 mg) tablet at night or 1 standard trazodone (150 mg) tablet at night for a period of 6 weeks. Assessments of efficacy, tolerability and compliance were made at study entry and after 1, 2, 4 and 6 weeks of study medication. Seventy-seven patients withdrew from the study of whom 44 were in the standard trazodone tablet group and 33 were in the controlled-release trazodone tablet group. There were no statistically significant differences between treatment groups in any of the measures of efficacy (global severity, global improvement and Hamilton Depression Rating Scales 17- and 21-item). Major improvements in patients' condition were shown in all efficacy measures by the end of the study in comparison with study entry. Treatment differences were small but were numerically in favour of the controlled-release tablet formulation. As expected, a greater proportion of side-effects were reported during the first 2 weeks of treatment in both groups. Treatment differences, revealed in a five symptom adverse event checklist used throughout the study, were small, although in favour of the controlled-release tablet in the majority of cases, but not statistically significant.
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One hundred and three women who were known to have complained of menorrhagia at some time in their lives were compared with a control group drawn from the practice's age-sex index.The results indicated that the women in the menorrhagia group were more likely to have had antidepressant medication prescribed for them at some time in their lives than the women in the control group. Furthermore, their case folders were thicker than those of the controls. The age at which menorrhagia was first reported was the only factor studied which was associated with increased likelihood of hysterectomy.
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I report my experiences in learning general practice as a vocational trainee with 12 months divided between two general practices at the end of a three-year course. A parallel between developmental milestones and a trainee's educational development is drawn and the reasons which brought patients to me as a trainee are analysed.I suggest the trainee year should be a dynamic time of learning and that trainees should be in an educational environment including progressively less authority. The trainer/trainee relationship, like the doctor/patient relationship, is all important.