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Not chocolate as we know it.

Last post 01 Feb 2019, 1:22 PM by Mark Davies. 0 replies.
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  •  01 Feb 2019, 1:22 PM 2727

    Not chocolate as we know it.

    In times of stress many - including those in healthcare - turn to chocolate. Chocolatiers have over the years managed successfully to blend the cocoa bean to overcome its inherent bitterness (still evident in dark chocolate with 70% cocoa solids). People young & old love it: a bar once broken is rarely left half-eaten. On the face of it therefore, the concept of using a chocolate-flavoured ‘sweet’ to disguise the bitter taste of an anxiolytic medicine given to reduce anxiety in anxious patients, is an excellent one. Unfortunately however, in this study [1] although we see a statistically significant improvement in palatability as compared with other mixtures containing midazolam, the new tablet fails to deliver the chocolate experience. For many it’s simply better than something that tastes awful. Perhaps with the advice and help of master chocolatiers it might be possible to formulate a better preparation of midazolam, one that is not only acceptable but is also enjoyable. We might also want to revisit our ‘red line’ on sugar: the small amount in one tablet can hardly be concerning from a health perspective, but might significantly help with formulation and anxiety reduction. We hope the authors will be encouraged to continue refining their product. 


    M. Cullinane

    M. Davies

    Royal Liverpool & Broadgreen University Hospitals NHS Trust,

    Liverpool, UK

    Email: mwd@mac.com


    No external funding and no conflicts of interest declared.



    1. Salman S, Tang EKY, Cheung LC, et al. A novel, palatable paediatric formulation of midazolam: pharmacokinetics, tolerability, efficacy and safety. Anaesthesia 2018; 73: 1469-77.
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