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Shigeru Morishita

Publications and source records attributed to Shigeru Morishita.

15 recordsLinked to original sources
PubMed2007

Possible predictors of response to clonazepam augmentation therapy in patients with protracted depression.

INTRODUCTION: Clonazepam has been shown to be an effective supplementary treatment for depression. Thus, it would be useful to determine which patient characteristics are associated with response to clonazepam. AIMS: The purpose of this study was to examine the possible predictors of response to clonazepam in the treatment of depression. METHOD: A retrospective cohort analysis was carried out in 120 patients with protracted depression who were being treated with clonazepam. RESULTS: A variety of clinical factors, including age, gender, type of depression, frequency of episodes, family history; and daily dose of clonazepam, were analyzed as possible predictors of response to clonazepam. A Weibull regression analysis showed that the factors that best predicted improvement with clonazepam augmentation were negative family history of psychiatric illness (e(coef) = 0.378), daily clonazepam dose of 2.5-4.0 mg (e(coef) = 0.160), and unipolar depression (e(coef) = 0.147). CONCLUSIONS: These factors should be considered when clonazepam augmentation therapy is selected for protracted depression.

Adult↗
PubMed2004

Differential effects of fluvoxamine, paroxetine and milnacipran for depression, especially with regard to age.

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) and dual serotonin and noradrenaline reuptake inhibitors (SNRIs) are the most commonly prescribed classes of antidepressants, yet it is not known whether one is superior to the other. It seems that an investigation of the characteristics of patients being treated with SSRIs and SNRIs would be useful in determining which patients would be most likely to benefit from these antidepressant medications. AIMS: The purpose of this retrospective study was to compare the response to fluvoxamine, paroxetine and milnacipran treatment for depression with regard to patient age. METHODS: A retrospective cohort analysis was carried out among depression outpatients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2001. A total of 159 patients who met the criteria and who were receiving fluvoxamine, paroxetine and milnacipran were identified. To examine the influence of antidepressants with regard to patient age, the response rate of patients aged 50 years or older was compared with that of those aged 49 years or younger. RESULTS: In patients aged 49 years or younger, the clinical effect of fluvoxamine was greater than that of the other antidepressants. Conversely, in those aged 50 years or older, milnacipran had a tendency to be more effective than the others. CONCLUSIONS: The differential response of SSRIs and SNRIs with regard to age should help to guide clinicians in determining the selection of antidepressants for depression.

Adolescent↗
PubMed2004

[Clonazepam as a therapeutic adjunct to improve the management of depression].

Clonazepam, which is a benzodiazepine structurally related to chlordiazepoxide hydrochloride, diazepam and nitrazepam, has been available for the treatment of seizure disorders in the USA since 1976 and in Japan since 1981. Increasingly, clonazepam has been used in the treatment of a variety of psychiatric disorders. The effect of clonazepam on depression was first reported by Jones and Chouinard in 1985. Since their report, many investigators have reported on the antidepressive properties of clonazepam. A daily dose of at least 3.0 mg clonazepam in augmentation of ongoing antidepressant treatment should be considered in depression. Regarding clonazepam augmentation therapy, if a patient does not show improvement by the end of four weeks, the treatment regimen should be altered. Age at onset of the first depressive episode and a history of family psychiatric illness should be considered the predictor of prognosis. The author discusses specific guidelines for the use of clonazepam in depression.

Anti-Anxiety Agents↗
PubMed2003

Possible predictors of response to fluvoxamine for depression.

INTRODUCTION: An investigation of the characteristics of patients being treated with antidepressants would seem to be useful in determining which patients would be most likely benefit from antidepressant medication. AIMS: The purpose of this preliminary study was to examine the possible predictors of response to fluvoxamine for depression. METHOD: A retrospective cohort analysis was carried out among depression patients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000. Seventy two patients were identified who were receiving fluvoxamine to treat depression. RESULTS: A variety of clinical factors including age, gender, type of depression, frequency of episodes, family history and daily dose of fluvoxamine were examined as possible predictors of the response to fluvoxamine. A Weibull regression analysis showed age, frequency of episodes and daily dose to be the independent predictive factors of improvement in fluvoxamine treatment. The most influential factor was age (ecoef = 2.109), followed by daily dose (ecoef = 0.648) and frequency of episode (ecoef = 0.512). An age of 49 years or younger (chi(2) = 6.767, df = 1, p = 0.0093), a first episode (chi(2) = 9.079, df = 1, p = 0.0026) and a daily dose of 100-150 mg (chi(2) = 5.353, df = 1, p = 0.02) were significantly better predictors of improvement. CONCLUSIONS: Age, the frequency of episodes and the daily dose of fluvoxamine may be considered as predictors of the response to fluvoxamine treatment for depression. This result should be examined in future prospective study.

Adolescent↗
PubMed2003

Differential period of onset of action of fluvoxamine, paroxetine and milnacipran for depression.

INTRODUCTION: Selective serotonin reuptake inhibitors (SSRIs) and dual serotonin and noradrenaline reuptake inhibitors (SNRIs) are the most commonly prescribed class of antidepressants, yet it is not known whether one is superior to another. AIMS: The purpose of this clinical practice was to compare the periods of onset of action of fluvoxamine, paroxetine and milnacipran. METHODS: A retrospective cohort analysis was carried out among out-patients with depression treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000 and 2001. A total of 206 patients receiving fluvoxamine, paroxetine and milnacipran were identified. RESULTS: The cumulative percentage of responders receiving milnacipran reached over 80% after 4 weeks, but it did reach this level for fluvoxamine or paroxetine until after 6 weeks. CONCLUSIONS: The differential period of onset of action should help guide clinicians in determining a suitable duration of antidepressants for depression.

Antidepressive Agents↗
PubMed2003

Induction of mania in depression by paroxetine.

INTRODUCTION: An investigation of the proportion of patients who have experienced mania with antidepressant treatment and their characteristics would seem to be of clinical use. AIMS: The purpose of this clinical study was to examine the predictors of induction of mania in depression patients as a result of paroxetine treatment. METHOD: A retrospective cohort analysis was carried out among depression patients treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000 and 2001. Some 79 patients were identified who were receiving paroxetine to treat depression. A variety of clinical factors including gender, the type of depression, frequency of episodes, family history, age and daily dose were examined as possible predictors of induction of mania by paroxetine. RESULTS: Seven (8.86%) of the 79 paroxetine-treated patients developed mania. A Cox proportional hazards analysis showed the type of depression and the history of family psychiatric illness to be independent predictive factors of the induction of mania by paroxetine treatment. CONCLUSIONS: The rate of mania induction of paroxetine is not substantially different from that found for conventional antidepressants. The type of depression and the history of family psychiatric illness may be considered as predictors of mania induction in depression patients taking paroxetine treatment.

Adult↗
PubMed2003

The clinical use of milnacipran for depression.

We examined the relation between dosage and efficacy, and the predictors of response to milnacipran. There was no difference between 50 and 100 mg dose. However, the 100 mg dose had a faster onset of action than the 50 mg dose. An age and an episode have been predictors of milnacipran.

Adult↗
PubMed2003

Suitable dose and duration of fluvoxamine administration to treat depression.

The purpose of the present paper was to determine the suitable dose and appropriate trial duration of fluvoxamine to treat for depression. A retrospective cohort analysis was performed among depression patients who were treated in the Department of Psychiatry, Kawasaki Medical School Hospital, Kurashiki, Japan, in 2000. A total of 72 patients received fluvoxamine to treat depression. The dose-response was compared and the initial significant clinical action was examined. The percentage showing improvement after receiving a high daily dose (100-150 mg) of fluvoxamine was 73.7%, but that showing improvement on a low daily dose (50-75 mg) was 47.1%. A significant difference between the two groups was seen on Kaplan-Meier analysis and log-rank test (chi2 = 4.814; d.f. = 1; P = 0.0282). The cumulative percentage of responder patients was more than 80% at the end of a 6-week period. Fluvoxamine is recommended at a daily dose of 100 mg or 150 mg as the initial dose. If a patient does not show improvement by the end of 6 weeks the treatment regimen of fluvoxamine should be altered.

Adolescent↗
PubMed2002

Effects of tricyclic antidepressants on protein kinase C activity in rabbit and human platelets in vivo.

BACKGROUND: The purpose of this study was to examine the effects of tricyclic antidepressants (TCA) on protein kinase C (PKC) in vivo. METHODS: PKC activity in rabbit and human platelets in vivo was measured after administration of TCA and in controls. RESULTS: Administration of TCA increased PKC activity in rabbit and human platelets in vivo. CONCLUSIONS: It has been reported that activation of PKC mediates inhibition of neurotransmitter uptake and down-regulation of beta-adrenergic receptor. We suppose that TCA-induced activation of PKC may be associated, at least in part, with the mechanism of TCA. LIMITATIONS: Other signal transduction systems, such as those of protein kinase A, protein kinase G, and cyclic-AMP, also affect neurotransmitter uptake and/or down-regulation. In this study, the relationship between the TCA-PKC system and other signal transduction systems was not investigated.

Aged↗
PubMed2002

Clonazepam augmentation of antidepressants: does it distinguish unipolar from bipolar depression?

BACKGROUND: The authors compared the effect of clonazepam supplement treatment on unipolar depression and bipolar depression. METHODS: A total of 38 protracted depression patients with unipolar depression (n = 19) or bipolar depression (n = 19) were treated with 3.0 mg clonazepam for 4 weeks. RESULTS: In the unipolar depression group, 84.2% of the subjects fulfilled the response criteria (at least an 80% reduction in their HDRS score). However, in the bipolar depression group, only 10.5% of them fulfilled these criteria. CONCLUSIONS: The difference in responses between the two groups supposes that the underlying abnormality in unipolar depression is not the same as that in bipolar depression. This trial also supposed that clonazepam can play active role in the treatment of protracted depression in patients with unipolar depression. LIMITATIONS: This finding was made in an open study, and the effect on clonazepam alone was not established.

Adult↗
PubMed2002

[Clonazepam in the treatment of protracted depression: a hundred-case report].

Clonazepam, which presently is recommended for the treatment of seizure disorders, has been reported to be useful as an adjunctive treatment for depression. The purpose of this paper was to examine the suitable adjunctive dose and the characteristics of clonazepam for the treatment of protracted depression. A hundred protracted depressive patients treated with clonazepam were studies by the retrospective method. A daily dose of 3.0 mg clonazepam as augmentation expressed high effectiveness (78.4%) on protracted depression. Most of the improved patients showed a rapid onset of action within two weeks. Gender, age, phase number, family history of psychosis, and clinical symptoms did not change the effectiveness of clonazepam treatment. A daily dose of at least 3.0 mg clonazepam as augmentation of ongoing antidepressant treatment should be considered for protracted depressive patients with suboptimal improvement. Unipolar depression was significantly more effective than bipolar depression on clonazepam treatment. The clear-cut difference in response to unipolar and bipolar depression suggests that the underlying abnormality in unipolar depression is not the same as that in bipolar depression. A continuance of clonazepam after improvement disturbed the recurrence of depression, and it seems that clonazepam augmentation has a preventive effect.

Adult↗