The Effects of Mephenesin in Neurotic Anxiety

In 1946 Berger and Bradley showed that mephenesin caused muscular relaxation and, in the same year, Stephen and Chandy (1947) reported that the intravenous administration of mephenesin to human subjects was usually accompanied by a feeling of euphoria and relaxation. The clinical trial of mephenesin in neurotic states associated with tension and anxiety was a natural corollary of these findings. Reports of its efficacy have been conflicting, but this is hardly surprising when a new drug is introduced for the treatment of a common disorder whose natural course may be either chronic or self-limiting, which is subject in a marked degree to apparently spontaneous fluctuations in intensity and on which the effects of suggestion are notorious. The assessment of therapy is made more difficult by the fact that there is no satisfactory objective method of measuring changes in the degree of anxiety; the investigator must either use tests the relevance of which many people will dispute or he must rely on clinical assessment, a subjective judgment very dependent on the skill and experience of the clinician. As Bradford Hill (1951) has stressed, clinical assessment can only be given full weight in a therapeutic trial when the possibility of enthusiasm or scepticism on the part of the clinician is eliminated. Such elimination of bias is best achieved by treating one group of patients with the drug and another group with a placebo, the clinician, nursing staff and patients not knowing to which group any particular patient has been assigned.

A Controlled Study of the Effect of Mephenesin on Psychiatric Out-Patients

The chemical compound 3-ortho-toloxy-1,2-propanediol, known as mephenesin, Myanesin or Tolserol, was shown by Berger and Bradley in 1946 to depress reflex excitability of the spinal cord and to have a depressant action at higher levels of the central nervous system in higher dosage. Other investigators confirmed this and the drug has been found effective for the spasticity and tremor of some neurological conditions.

Clinical manifestations of essential tremor

A clinical study of 42 patients with essential tremor is presented. In the case of 12 patients the family history strongly suggested an autosomal dominant mode of transmission, in four the mode of inheritance was indeterminate, and the remaining 26 patients were sporadic cases without an established genetic basis. The tremor involved the upper extremities in 41 patients, the head in 25, lower limbs in 15, and trunk in two. Seven patients showed involvement of speech. Variations were found in the speed and regularity of the tremor. Leg involvement took a variety of forms: (1) direct involvement by tremor; (2) a painful limp associated with forearm tremor; (3) associated dyskinetic movements; (4) ataxia; (5) foot clubbing; and (6) evidence of peroneal muscular atrophy. Several minor symptoms-hyperhidrosis, cramps, dyskinetic movements, and ataxia-were associated with essential tremor. Other features were linked phenotypically to the ataxias and system degenerations. Apart from minor alterations in tone, expression, and arm swing, features of Parkinsonism were notably absent.