中枢神経刺激剤の臨床効果

CLINICAL TRIALS OF METHYLPHENIDYLACETATE HYDROCHLORIDE

いとぐち

　最近，精神活動刺激剤の薪しい薬剤として，スイスでRitalinが合成された。このRitalinの化学構造はmethylphenidylacetate hydro-chlorideで，第1表に示すような構造であるが，他の刺激剤とは若干異つている。とりわけ本剤がcephalotrophic amineであつて，中枢神経系に対し興奮的に働く作用があるという点に特色がある。このような理由から本剤は"antidepres-sant"とか"mild central nervous system　stimulant"といわれている。従つてRitalinでは主として"emotional fatigue state"，"mild　depression"という精神状態に対する効果が期待されている。尚本剤は，中枢神経系刺激作用という点では，amphetamineとcaffeineの中間に位し，自律神経系に対しては作用が比較的少なくて軽度であり，且つ所謂antidepressantとして臨床的応用が試みられつつある。

　我々は最近，上述のRitalinを精神神経疾患者に試用する機会を得たので，ここにその臨床経験，とくに臨床効果について報告する。

In the course of clinical trials of Ritalin, a new central nervous stimulant, to the 28 cases composed of both normal and abnormal subjects, we obtained the following results.

1) For normal adults (6 cases) such a dosage of Ritalin as 10mg at a time was adequate a quite effective.

2) Ritalin was the most effective in cases of depression (6 cases) and epilepsy (3 cases) being under drowsiness or somnolent states due to overdosage of anti-epileptic drugs.

3) Good effects were obtained in all 6 neu-rotics with hypochondria], weary and depres-sive states.

4) No significant in clinical pictures were obtained in both chronic schizophrenics and post-traumatic psychoses.

5) As undesirable side-effect, psychomotor-mimetic or anxiety states were recognized, though those were only transient.

6) Basing upon those findings as above described, we would like to recommend this Ritalin-therapy to certain cases of nervous or mental disorders, if its therapeutic method were adequately arranged according to each condition of individual cases. However, its final criteria should be obtained by further investigations.