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October 1958

Meprobamate Idiosyncrasy: Report of a Case and Review of the Literature

Author Affiliations

U. S. Army

Dr. Charkes now Assistant Resident in Medicine, University Hospital, Baltimore.

AMA Arch Intern Med. 1958;102(4):584-593. doi:10.1001/archinte.1958.00260210070012

Meprobamate (Miltown, Equanil) was synthesized in 1950 by Ludwig and Piech in an effort to find a muscle relaxant with longer duration of action and fewer side-effects than mephenesin.1 In the initial pharmacological evaluation, Berger discovered three unusual attributes of meprobamate which account in some part for its effectiveness as a tranquilizing agent, namely: (1) muscle relaxation due to selective blockage of interneuronal synapses but without effect on monosynaptic reflexes, impulse transmission in peripheral nerves, or activity at the neuromuscular junction; (2) peculiar "taming" effect on monkeys in that aggression disappears, and (3) thalamic stimulation.2 Although the drug has been in clinical use since 1954, reports of toxicity have been scattered, and only one review of adverse responses has appeared.3 One death has been reported.4 The purpose of this communication is to present a case of meprobamate idiosyncrasy with skin biopsy and skin testing, to review

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