Orthoptic status before and immediately after heroin detoxification.

Aim: To determine whether changes in orthoptic status take place during withdrawal from heroin and/or methadone.

Method: A prospective study of patients, using a repeated measures design, attending a 5 day naltrexone compressed opiate detoxification programme.

Results: 83 patients were seen before detoxification (mean age 27.

A compressed opiate detoxification regime with naltrexone maintenance: patient tolerance, risk assessment and abstinence rates.

Opiate detoxification using methadone programmes are inefficient and expensive. Rapid and ultra-rapid detoxification using precipitated withdrawal under heavy sedation or anaesthesia provide increased efficiency and speed, but are limited by the requirement for high-dependency facilities and are perceived as high-risk procedures. Procedures using precipitated withdrawal over longer periods with lower sedation are safer, but 20% of patients fail to tolerate these.

The prognosis of primary depressive illness. Its relationship to the dexamethasone suppression test.

We followed up 30 recovered depressives for an average of 2 years. At 18 months, despite prophylactic medication, 30% had relapsed. Persistent DST suppression during the index illness was found to be a predictor of good prognosis.