Chlordiazepoxide （Balance）の治療経験

THE TREATMENT OF PSYCHIATRIC PATIENTS WITH CHLORDIAZEPOXIDE

緒言

　情動緊張を基調とする疾患，殊に神経症に対する薬物療法の意義は1）患者の感情的不安定，緊張感を速かに除去し2）症状の自動慣習化を中断して3）医師患者間のrapportをなめらかにし心理療法を容易にする等の利点に集約される。この観点から従来より使用されている薬物の効果を検討するといずれも功罪あい半ばするのが現状である。例えば鎮静剤と催眠剤（ブロム，バルビツール酸系化合物等）に共通の特徴として十分な鎮静を認める迄服用量を増していけば傾眠に誘い意識の清明性を損う。

　近来向精神薬の王座を占めるPhenothiazine誘導体やRauwolfiaアルカロイド製剤はしばしば患者の不安のみならず情動全般をも鈍麻化し又耐えがたい自律神経系副作用をおこす場合のある為，その適用範囲は主として精神病群に限られている。これに反しMeprobamateは毒性が少く視床の機能を選択的に抑制して情動の安定化に役立つので外来の神経症患者にも広く投与可能である。

1. 54 patients were treated with Balance for psychotic and psychoneurotic disor-ders. The following diagnostic categories were represented: Neurosis (34 patients): Depression (9): Schizophrenia (6): Epile-psy (3): Brovarin addiction (1): Parkin-sonism (1).

2. Most patients received 30-60 mg.: the highest daily dose was 120 mg., the low-est 30 mg.

3. The duration of administration ranged from 7 day to 3 months (average 1 mon-th).

4. An effectiveness of 56-85% was noted in neuroses.

It appears to be most efficacious in an xiety neurosis.

On the contrary it was not very effi-cacious in the hebephrenic type of schi-zophrenia and asthenic nervousness.

When used with Aleviatin (5, 5-diphenyl hydantoin), it was effective for stabiti-zation of emotion and as an anti-convul-sive agent.

It was rather effective in reactive or neurotic depression than in endogenous depression.

5. Balance produced a cessation of such sym-ptoms as anxiety, agitation and tension. It was also efficacious for physical con-comitants such as tachycardia, dizziness, nausea etc. But depressive and repressive symptoms were not particularly improv-ed.

6. The similar drug effect was observed both in acute and chronic states of above-mentioned disorders. In this connection it will be stated that the significant relation between duration of illness and pharmac-ological effect is not proved.

7. Improvement was mostly noted within 1 to 2 weeks after administration and was scarcely noted after the third week of medication.

8. Side effects, of which drowsiness and ataxia were the most prominent, were not severe and fully tolerable.

9. Balance is a rapid-acting drug. It is a va-luable specific agent against anxiety and tension states. And it also exerted as a psychostimulating drug. Besides the abo-vementioned effectivenes, side effects proved to he rare and tolerable. The-refore, it was supposed that Balance will have its greatest merits when used as ad-junct of psychotherapy.