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Seishin Igaku Volume 25, Issue 6 （June 1983）

精神医学 25巻6号（1983年6月発行）

Japanese English

研究と報告

向精神薬治療中に心電図異常を呈する患者と呈しない患者に対するβ-受容体遮断剤Carteololの効果の比較 Effects of a New β-receptor Blocking Agent, Carteolol, on the Patients with or without ECG Abnormalities during Antipsychotic Drug Therapy 高柴哲次郎 ¹ , 有田真 ² , 佐々木勇之進 ¹ Tetsujiro Takashiba ¹ , Makoto Arita ² , Yuno shin Sasaki ¹ ¹恵愛会福間病院 ²大分医科大学生理学教室 ¹Department of Psychiatry, Fukuma Hospital ²Department of Physiology, Medical College of Oita キーワード： Antipsychotic drug , ECG abnormality , Sinus tachycardia , β-blockers , Carteolol Keyword: Antipsychotic drug , ECG abnormality , Sinus tachycardia , β-blockers , Carteolol pp.617-625

発行日 1983年6月15日 Published Date 1983/6/15

DOI https://doi.org/10.11477/mf.1405203600

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Abstract 文献概要
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　抄録　向精神薬服用中の患者で，ECG正常者15名（男8，女7，平均年齢31.0歳）と異常者22名（男13，女9，平均年齢39.5歳）を選び，各群に対しβ-受容体遮断剤Carteololを1日10mg（分2）7日間投与し，その前後における心拍数，血圧，心電図変化を検討した。

　結果1）心拍数は，ECG正常群では有意な変化がなかったが，異常群では21％の減少を示した。2）T波高（V₅）は，正常群でも異常群でも有意な変化がなかったが，異常群のうち（T波高／R波高）≦0.2以下の患者6例についてみると，T波高は有意に増高（改善）した。3）補正QT時間は正常群では変化なく，異常群では平均0.46秒と病的に延長していたものが0.42秒へと短縮（正常化）した。4）PQ，QRS時間，および収縮期，拡張期血圧には両群とも有意な変化がみられなかった。以上より，Cateololは5mg朝・夕2回の投与で，向精神薬による頻脈と心電図再分極相の異常を有意に改善するといえる。

　We studied the effects of Carteolol, a β-blocker, on 22 patients (13 males, 9 females ; average age, 39.5 years old) with ECG abnormalities which had been induced by the treatment with major tranquilizers such as chlorpromazine, levomepromazinc, thioridazine, haloperidol, floropipamide, etc. The average daily doses used were calculated to be about 900 mg in terms of chlorpromazine. The abnormalities include sinus tachycardia, decreased amplitude of T wave, and prolongation of corrected QT interval (QTc). Carteolol was administered 5 mg b.i.d. for 7 days and the ECG just before and onthe 7th day of the treatment were compared.

　Results are as follows : 1) Carteolol significantly decreased the heart rate from 82.3+2.3 (mean+ S.E.)/min. to 64.7+1.4/rnin. 2) Carteolol shortened the QTc significantly from 0.445+0.007 sec to 0.422±0.006 sec. 3) Carteolol significantly increased the amplitude of the T wave (measured at V5 lead) in the low T group (9 cases) in which the amplitude of T wave was equal to or smaller than 1/5 of the R wave. 4) Carteolol produced no significant change in either systolic or diastolic blood pressure.

　In contrast, the drug did not produce any significant changes, in all parameters described above, in 15 patients (8 males, 7 females ; average age, 31.0 years old) who had been treated with the equivalent doses of similar major tranquilizers but without ECG abnormalities.

　We conclude that Carteolol normalizes the sinus tachycardia and the abnormalities of ventricular repolarization which have been encountered during antipsychotic drug therapy, but that the drug did not have any significant effects on the patients without ECG abnormalities.