Intended for healthcare professionals

Minerva Minerva


BMJ 1999; 319 doi: (Published 27 November 1999) Cite this as: BMJ 1999;319:1446

Minerva is always looking for new ways to avoid wrinkles but will take care not to use skin creams containing tretinoin after reading a warning in Prescrire (1999;8:139-40) that it barely works and can cause serious side effects. The journal reports that in trials, the drug caused desquamation, dry skin, or stinging in more than half the subjects using it. More than a quarter had itching and irritation, and 40% had erythema. Worse, there are persistent fears that tretinoin might be teratogenic. Don't use it to combat ageing caused by exposure to sunlight; it's safer to wear a wide brimmed hat.

Many elderly people take benzodiazepines to help them sleep, but it can be difficult to give them up. Melatonin may help, according to a randomised trial in Archives of Internal Medicine (1999;159:2456-60). Significantly more subjects in the melatonin arm of the trial managed to quit their benzodiazepines than controls given placebo. They also reported better quality sleep than controls. Melatonin is produced by the pineal gland, but when used therapeutically it is still a drug. Patients should be warned that its long term effects are unknown.

Minerva ran into trouble last month for being too British to …

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