抗不安薬について(心身症に対する新しい薬物療法)(第35回日本心身医学会総会)

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Chlordiazexide was the first anti-anxiety agent marketed in Japan for the treatment of neurosis and psychosomatic disorders in 1960. And the treatment of neurosis and psychosomatic disorders was revolutionized by the clinical use of Chloradiazepoxide. Flutazolam was the first anti-anxiety agent in Japan that exclusively applied to the treatment of psychosomatic disorders in 1984. This report deals with a new therapy of anti-anxiety drugs for the treatment of psychosomatic disorders. It is based on the results of our clinico-pharmacological studies of anti-anxiety agents. 1. Cases with psychosomatic disorders display physical disorders, dysfunction of the central nervous system and social maladaptation. Anti-anxiety drugs have achieved improvement in clinical conditions through stabilizing and regulatory actions on the function of the central nervous system as shown in following case. Improvement in clinical symptoms and ulcer healing achieved by Clotiazepam treatment for 4 weeks satisfactorily paralleled the reduction of anxiety scores in the Manifest anxiety test and the normalization of circadian rhythms of blood corticosteroid in a psychosomatic case with gastric ulcer. Therefore, the drugs considered as subsidiary are now used as the primary medication in the treatment of psychosomatic disorders. 2. Anti-anxiety agents with selective action on specific organs have been developed and marketed after Flutazolam. For one thing, Alprazolam has an antiulcer action, Mexozolam has a hypotonic action, Etizolam has a muscle relaxant action, and Tofisopam has a regulatory action of the vegetative nervous system. We investigated the investigated the influence of three anti-anxiety agents on blood pressure in a psychosomatic case with essential hypertension. and a new effect of Ethyl loflazepate, a hypotonic action, was established as demonstrated in this report. Successively a new family of anti-anxiety agents, non-benzodiazepine derivative, is being investigated as a medication for vegetative dystonia. This agent improved low TII waves of the standing ECG as shown in a case with vegetative dystonia. Accordingly it is simple to select the anti-anxiety agents above mentioned to correspond to specific organ or organic system-disorders of psychosomatic patients. This is similar to drug therapy of essential hypertension with hypotonica. In Japan anti-anxiety drugs for the treatment of psychosomatic disorders have to show effects on both psychic symptoms and physical disorders of psychosomatic patients. For example, Etizolam has proved to improve anxiety symptoms and the healing process of ulcers in psychosomatic cases with gastric ulcers in our recent study. 3. The clinical effects of a daily 2mg of Ethyl loflazepate has been shown by the relationship between its plasma concentrations and its efficacy in cases with psychosomatic disorders. In conclusion, non-benzodiazepine anti-anxiety drugs display selective action of specific organs enabling a medication with low, once-daily dosages as a new pharmacotherapy for psychosomatic disorders.
日本心身医学会の論文
1995-02-01

抗不安薬について(心身症に対する新しい薬物療法)(第35回日本心身医学会総会)

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