Two-year outcomes of methadone maintenance therapy at a clinic in Malaysia.

BACKGROUND: The commencement of methadone maintenance therapy (MMT) in 2005 represents a quantum leap in the management of heroin dependence in Malaysia. OBJECTIVE: To examine the 2-year outcomes of this modality in the treatment of heroin dependence with respect to the quality of life (QOL), heroin abstinence, and rate of employment among heroin dependants attending the Tengku Ampuan Afzan Hospital (HTAA) MMT clinic. METHOD: This was an experimental study in which the second QOL assessment was conducted 2 years after treatment initiation. RESULTS: A total of 172 patients enrolled at the point of entry to the MMT program. The authors examined 107 patients who remained in the program 2 years later (62.6% retention rate). A paired t test demonstrated significant improvements in all 4 domains of QOL (physical, psychological, social relationships, and environment; P < .001). The most marked improvement was noted in the psychological domain. CONCLUSION: The MMT program at HTAA is effective in improving the QOL among heroin dependants.

Information for assistants of repeated transcranial magnetic stimulation.

Repeated transcranial magnetic stimulation (rTMS) is an exciting new technology being used in psychiatric and neurological research in many centres around the world. rTMS has been accepted as a routine treatment of depression in Canada and Israel. To this point, it has been exclusively conducted by medical officers. As knowledge and experience grows, it is probable that professionals with other backgrounds will have the opportunity to play a role. The aim of this paper is to provide information that will be valuable to assistants. Electromagnetic principles are harnessed to deliver electric currents to localized regions of the cortex. rTMS does not involve anaesthesia or seizure. Side-effects appear to be few. Much remains uncertain, however, even including the most appropriate treatment parameters.