Keisuke Sarai

A preliminary double-blind study on the efficacy of carbamazepine in prophylaxis of manic-depressive illness

A preliminary double-blind controlled study on the prophylactic effect of carbamazepine on recurrent manic-depressive psychotics was conducted with 22 patients using an inert placebo in ten subjects as a control drug. Carbamazepine in the dosage of 200–600 mg was administered for 1 year. Among the 22 carbamazepine subjects, carbamazepine was found to be effective in 60% of the cases and inert placebo in 22.2% (U-test, P<0.10). It is suggested that carbamazepine is a useful drug for the prophylaxis of manic-depressive illness.

Comparison of the antimanic efficacy of carbamazepine and chlorpromazine: A double-blind controlled study

A multiinstitutional cooperative study comparing carbamazepine (Tegretol) with chlorpromazine was performed using a controlled, double-blind trial design. In a series of 63 cases of endogenous manic psychosis, carbamazepines clinical utility and efficacy, characteristics of therapeutic effect, and side effects were evaluated. Carbamazepine and chlorpromazine were given by a fixed, but flexible, method at an equipotent ratio of 2∶1, starting from the initial dosages of 300 and 150 mg, respectively. The overall improvement rate, based on the number of cases showing moderate to marked amelioration of manic symptoms, was 70% in the carbamazepine group and 60% in the chlorpromazine group. No significant differences were found between the two groups. Improvements in basic mood, insomnia, headache and lassitude, and diurnal fluctuations of mood tended to be characteristic of carbamazepine efficacy for mania compared with the effects of chlorpromazine. The onset of therapeutic effect was within 10 days of treatment in 65.7% of the patients receiving carbamazepine and 50% receiving chlorpromazine. The incidence of side effects was significantly lower in the carbamazepine group than in the chlorpromazine group. It was suggested that carbamazepine is potentially useful drug for the treatment of the manic state.

A double-blind study of adjunctive carbamazepine versus placebo on excited states of schizophrenic and schizoaffective disorders

A multi‐institutional double‐blind study comparing the therapeutic effect of adjunctive carbamazepine and placebo with standard neuroleptic treatment was performed on 162 patients with DSM‐UI diagnosis of schizophrenic (n = 127) or schizoaffective disorders (n = 35) who had excited states or aggressive /violent behavior that responded unsatisfactorily to neuroleptic treatment. The patients participated in a 4‐week trial of carbamazepine plus neuroleptics (n = 82) or placebo plus neurolep‐tics (n = 80). The sum of patients with marked and moderate improvement was modestly larger in the carbamazepine group (48 vs. 30%, P <0.05). There was no significant, difference between the carbamazepine and placebo groups in the changes of total BPRS scores, although the carbamazepine group showed more improvement on the items suspiciousness, uncooperativeness and excitement. The results suggest that carbamazepine, when used in combination with neuroleptics, is a useful drug for the treatment of excited states of patients with schizophrenic and schizoaffective disorders.

Comparison of Efficacy of a New Butyrophenone Derivative, Timiperone and Perphenazine in Schizophrenia by a Multicentre Controlled Study

The efficacy of timiperone in schizophrenia as compared with perphenazine was assessed in a double-blind fashion in 205 patients throughout a 12-week treatment period. More than half of the subjects were chronic schizophrenics. Global improvement in the timiperone treatment group was superior to that in the perphenazine group in view of a lower rate of aggravation. With regard to overall safety and general usefulness rating, there were no significant differences between the two drug treatments. However, timiperone showed less frequency of excitability, irritability, anxiety and anorexia than perphenazine on occasions during the 12 week treatment period. From these results it may be concluded that the efficacy of timiperone could be superior or equivalent to that of perphenazine which has been confirmed to be of use as an antipsychotic.

Effects of chronic sultopride treatment on endocrine systems in psychotic women

The effects of chronic sultopride treatment on endocrine systems were studied using five schizophrenic women. Sultopride, an antipsychotic drug, was administered orally three times daily for 5 weeks in a daily dose of 300–600 mg. The serum prolactin levels increased significantly after 1 day of treatment, reaching a maximum at 1 week and remaining elevated during treatment. The serum GH levels declined temporarily after 1 week of treatment and then returned to normal values after 3–5 weeks of treatment. Sultopride had no significant effects on LH, FSH, TSH, insulin, estradiol-17β and cortisol basal levels. Serum sultopride levels measured by radioimmunoassay remained steady during treatment. These results showed that sultopride stimulates prolactin secretion in schizophrenic women, probably by blocking pituitary dopamine receptors.

Hypoproteinemia related with chronic lithium therapy in two patients

Abstract: We present here two cases of reversible hypoproteinemia which could have occurred as an adverse effect of chronic lithium administration. In the present cases, protein losing a renal dysfunction, liver dysfunction and malabsorption syndrome were not observed, and the relationship between their dietary volume and serum protein levels was poor. The mechanism of hypoproteinemia in these cases was not identified from previously obtained data. We suggested that this type of hypoproteinemia might be a new adverse effect of lithium

CT scan and EEG findings in 10 epileptic patients.

A wealth of information can be obtained safely and within a short period by computerized tomography (CT) scan in the field of clinical neurology. CT scan and EEG findings of 10 patients with epileptic seizures who were recently examined in our clinic were presented. The patients consisted of six males and four females ranging in age from 13 to 69. The most frequent type of seizure was grand ma1 seizure, followed by psychomotor seizure. Eight cases had two or more types of seizure. Abnormal CT findings were observed in four cases (Cases 7, 8 ,9 and 10) all of whom were elderly.

Chronic necrotizing encephalitis involving mainly the grey matter of the temporo-rhinencephalic and insular regions.

The authors reported an autopsy case of chronic necrotizing encephalitis.