せん妄に対するSerotonin-Dopamine Antagonist（SDA）の有用性

The Usefulness of Serotonin-Dopamine Antagonist (SDA) in the Medication of Delirium

抄録

　せん妄の薬物療法において，近年では薬剤の有効性だけでなく，副作用をはじめとする安全性の問題が考慮されるようになっている。今回我々は，serotonin-dopamine antagonist（SDA）に分類されるrisperidoneおよびperospironeのせん妄の薬物療法における有用性について，入院治療を行った自験例30例（risperidone群23例/perospirone群7例）を対象に検討を行った。

　risperidone，perospironeともにせん妄患者に対する有効率は高く，両薬剤間でも統計学的有意差は認められなかった。risperidoneは1日投与量1～3mg程度という低用量でせん妄改善に効果が認められ，最大血中濃度時間（T^max）が約4時間と比較的長いため夕食後投与が有効だった。perospironeは1日投与量4～10mg程度でせん妄改善に効果が認められ，T^maxが約1.4時間と比較的短いため眠前投与が有効だった。

Summary

　In medication for delirium, not only the validity of the medicine but the problem of safety including side effects is being taken into consideration in recent years. We examined the usefulness of risperidone and perospirone which are classified among serotonin-dopamine antagonists (SDA) for the treatment of delirium in 30 cases (23 cases：risperidone group/7cases：perospirone group).

　The results showed that the rate of effectiveness was high in the treatment of delirium by both risperidone and perospirone, and no statistically significant difference was found between either of the drugs. Medication using risperidone was relatively effective with a low dosage (1-3mg), and since the Tmax was comparatively as long as about 4 hours, this medication after dinner was judged as effective. Medication using perospirone was also effective with a low dosage (4-10mg), but since the Tmax was comparatively short (about 1.4 hours), it was judged that its administration befor sleep was effective.