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To the Editor.—
Wasserman and Yahr reported choreic movements under methadone hydrochloride maintenance treatment (Archives 1980; 37:327-328). We recently saw a 71year-old addict who suffered from ballism associated with methadone withdrawal. Since World War II he had continuously taken about 25 mg of methadone hydrochloride daily and for nearly half a year carbromal (2,400 mg daily) and diphenhydramine hydrochloride (100 mg daily) additionally. By reducing the drug dose because of nausea and vomiting, typical withdrawal symptoms and involuntary movements appeared, which increased by further reduction of the drugs. He showed the striking feature of ballism with involuntary flashlike or hurling movements of all limbs and the trunk, which were triggered by sensory stimuli, emotion, and intention. Further examination revealed slight leukocytosis (11,100/μL) and some moderate abnormalities including hypochromic anemia (hemoglobin level, 10.7 g/dL) with iron deficit (serum level, 7.3 μmole/L) and increase of γ-glutamyl transferase (44 units/L) and alkaline phosphatase