Kazuo Yamada

Impairment of theory of mind in patients in remission following first episode of schizophrenia

AbstractThe aim of this study was to investigatentheory of mind (ToM) ability in patients in remission afternthe first episode of schizophrenia. A ToM task whichncontained four pictures was given to 30 patients withnschizophrenia in remission and 30 matched healthy controls.nPatients with schizophrenia in remission showednstatistically significant impairment in the ToM tasks.nToM impairment was not correlated with psychiatricnsymptoms. Thus, ToM deficit in schizophrenia may be antrait marker.

Use of herbal medicine for treating psychiatric disorders in Japan

Alongside the Western pharmacotherapy that is now the major medical modality in Japan, we continue to offer a number of traditional remedies. We prefer to allow patients to choose between these two approaches, after explaining the advantages and potential adverse effects of each. Research into the traditional treatments continues, and we now have a number of studies available concerning the efficacy of oriental herbal medicine (Kampo medicine) in Japan. There are about 120 different prescriptions available for treatment. Herbs are believed to affect both the psyche and soma, and Kampo medicine does not differentiate between them. Improvement brought about by herbal medicine is usually mild and slow, but sometimes very drastic. Side effects are rare. Those that do occur are mostly allergic reactions to natural substances. Therefore, herbal medicine is especially useful for elderly patients and patients with physical complications. Prescription is traditionally selected by judging Sho of a patient. Sho is equivalent to a syndrome, but comprises psycho and somatic symptoms and signs obtained by traditional physical examination that focuses constitution, general physical condition, pulse, abdominal signs, and examination of the tang. However, currently modern diagnoses are also applied to deciding upon the prescription. Western physicians can select the appropriate preparation without having a special knowledge of Oriental medicine.

Low superoxide dismutase activity in schizophrenic patients with tardive dyskinesia

BACKGROUNDnTardive dyskinesia (TD) is a therapy-resistant adverse effect of neuroleptics. Although the exact pathophysiology of TD is unknown, oxygen radicals have been speculated to play a role in TD based on several lines of evidence. Superoxide dismutase (SOD) is a key enzyme which scavenges oxygen radicals. The authors investigated the association between erythrocyte SOD activity and TD.nnnMETHODSnErythrocyte SOD activities were measured, blinded as to the presence or absence of TD. In 30 patients with schizophrenia who had been on typical neuroleptics for more than 10 years. TD severity was independently assessed, using the abnormal involuntary movement scale (AIMS), by two raters.nnnRESULTSnThere was a significant decrease in erythrocyte SOD activity in the definite TD group (N = 10) as compared with the no TD (N = 8) and questionable TD (N = 12) groups. Erythrocyte Cu,Zn-SOD activities correlated with AIMS scores.nnnCONCLUSIONSnPatients with TD had low SOD activities as compared to those without TD. As a causal link between SOD activity and TD was not established in this study, larger prospective studies are warranted to determine whether patients with low SOD activity are susceptible to neuroleptic-induced TD.

Ginseng enhances contextual fear conditioning and neurogenesis in rats

Panax Ginseng is a commonly used galenical known to have an enhancing effect on learning. Neurogenesis in the hippocampus has been shown to be necessary for hippocampus/amygdala-dependent learning tasks. To investigate the role of Ginseng in neurogenesis and learning of rats, we administered both Ginseng and BrdU for five consecutive days. As a result, Ginseng increased the number of BrdU-positive cells in the dentate gyrus in a dose-dependent manner. Further, we administered one dose of BrdU after Ginseng treatment for five consecutive days, and the number of BrdU-positive cells did not increase significantly. However, when one dose of BrdU was given 1 day before the following five consecutive days of Ginseng treatment, the number of BrdU-positive cells markedly increased in the hippocampus. Therefore, it is likely that Ginseng enhances not proliferation but survival of newly generated neurons in the hippocampus. Second, we administered both Ginseng and BrdU to rats for five consecutive days. One day after the last Ginseng and BrdU co-administration, contextual fear conditioning (CFC) was conducted. Ginseng in a dose-dependent manner increased the % freezing time and the number of BrdU-positive cells in the dentate gyrus of rats that received CFC. Thus, an increase in CFC-related neurogenesis may be one mechanism of Ginsengs properties to enhance learning ability.

Effectiveness of Shakuyaku‐kanzo‐to in neuroleptio induced hyperprolactinemia: A preliminary report

Abstract We investigated the efficacy of Shakuyaku‐kanzo‐to (TJ‐68) in neuroleptic‐induced hyperprolactinemia in 11 treated schizophrenic patients. The mean plasma prolactin level decreased significantly from 28.9 ± 14.5 ng/mL at baseline to 22.0 ± 15.2 ng/mL at 4 weeks. Potassium levels did not change significantly. Neither the exacerbation of psychosis nor other adverse effects occurred.

Clinical efficacy of tandospirone augmentation in patients with major depressive disorder: a randomized controlled trial.

Abstract The purpose of the present paper was to investigate the efficacy of augmentation of clomipramine (CMI) by tandospirone in 36 untreated outpatients with major depressive disorder. Twelve patients were treated with CMI and tandospirone (T group), 12 with CMI and diazepam (D group) and 12 with CMI alone (C group) for 6u2003weeks. No statistically significant differences in the percentage improvement of the Hamilton Depression Rating Scale (17 items; HDRS‐17) and the Hamilton Anxiety Rating Scale (14 items; HARS‐14) scores were shown among the three treatment groups. However, at 2u2003weeks, the percentage improvement of HDRS‐17 score in the T group tended to be higher than that in the D and C groups, although there was no statistically significant difference among the three treatment groups. No change in plasma prolactin level or adverse events was induced by the addition of tandospirone. These results suggest that 6u2003weeks of treatment with tandospirone or diazepam was not effective for augmentation of CMI in major depressive disorder patients. However, augmentation of antidepressants by tandospirone administration for a few weeks might induce early expression of antidepressive effects.

Improvement of schizophrenic symptoms and changes in plasma HVA concentrations, plasma anti-D2 and anti-5-HT2 receptor activities with clozapine

Abstract In order to investigate the biological mechanisms underlying the clinical efficacy of clozapine, 200 mg/day of clozapine was added to the drug regimens of 19 patients with chronic, anti‐psychotic‐resistant schixophrenia, and the plasma homovanillic acid (HVA), clozapine concentrations, anti‐dopamine D2 and anti‐serotonin 5‐HT2 receptor activities were measured. After 28 days, six patients showed an improvement of more than 20% over baseline Brief Psychiatric Rating Scale (BPRS) scores. Mean plasma HVA concentrations and anti‐D2 receptor activities did not change significantly in the entire group or in the six patients showing improvement. However, anti‐5‐HT2 receptor activities increased significantly in all 19 patients. Changes in BPRS scores did not correlate significantly with changes in plasma HVA or with changes in clozapine concentrations, or with anti‐D2 and anti‐5‐HT2 receptor activities.