精神科領域におけるChlordiazepoxide （balance）の使用経験

CLINICAL EXPERIENCE WITH CHLORDIAZEPOXIDE ON MENTAL ILLNESS

緒言

　最近ロッシュ研究所の開発になるChlordiaze—poxide （Librium）は，不安・緊張状態を有する各種疾患に広い適用域をもつ新しい精神治療剤として欧米の研究者の注目を集めている。

　本剤は，これまでの種々の精神治療剤とはまつたく化学構造を異にし（第1図），その作用はRandall^1）2）らの動物実験によると，1）催眠作用をきたすより遙かに少い用量で静穏化する作用，2）筋弛緩作用，3）抗痙攣作用，4）抗炎症作用，5）食欲亢進作用などがあげられている。さらに催眠作用のない点でメプロバメート，フェノバルビタールと異なり，また自律神経遮断作用のないこともクロールプロマジン，レセルピンとは異なつている。Monoaminoxidase阻害作用もない。

35 patients with anxiety, tension and hypo-chondriac complaines, including 23 psychone-urotics, 4 involutional psychoses, 3 depressions, 2 schizophrenics, 1 epilepsy and 1 psychopathic personality, were administered Chlordiazepo-xide by mouth in dose from 10 to 90 mg. daily. (an average daily dose: 30 to 40 mg.) And the clinical results obtained as follows:

1) Among 35 cases, 6 (17%) showed mark-ed, 14 (40%) moderate and 6 (17%) slight improvement. Especially, of the 23 psychone-urosis, 5 (22%) showed marked, 8 (35%) moderate and 6 (26%) slight improvement. Therefore, effect of the drug on psychoneu-rosis seemed to be somewhat better than other diseases.

2) Of the clinical symptoms, anxiety, tension, apprehension, sleeplessness and hy-pochondria were favorably improved

3) Generally, the drug showed rapid effect and in 15 of 20 improved cases the clinical effect appeared within 7 days.

4) Some side effects, though they were slight and easily controllable, appeared in 10 cases, e.g. drowsiness in 6 cases, nausea in 2, and skin rash and sleeplessness in each 1 case.

From our clinical experience, it was suppos-ed that Chlordiazepoxoide would be effective especially on anxiety and tension, and certain-ly play a roll as an adjunct to psychotherapy for the mental illness.