Reflex sympathetic dystrophy syndrome and barbiturates. A study of 25 cases treated with barbiturates compared with 124 cases treated without barbiturates.

Amongst 149 cases of reflex sympathetic dystrophy syndrome (RSDS), 25 (16.8%) were being treated with barbiturates at the time the RSDS symptoms began. This group is unusual by the frequent absence of provocative events (32%), a high number of diseased joints, bilaterality (76%), involvement of upper limbs (76%) and Dupuytren's disease (52%). Swift and complete recovery depends mostly on barbiturate withdrawal. These data support the idea that barbiturates may be the principal initiating event in some RSDS. Since unfavorable progress is seen with persistent use of barbiturates, this medication should be recognised early in the course of the disease in order to prevent severe sequels.