Okuma T, Kishimoto A
National Center of Neurology and Psychiatry, Okuma Clinic, Tokyo, Japan.
Psychiatry Clin Neurosci. 1998 Feb;52(1):3-12. doi: 10.1111/j.1440-1819.1998.tb00966.x.
A history of investigation on the antimanic and prophylactic effects of carbamazepine in Japan is described. Following the initial open trials in the early 1970s in which the antimanic and prophylactic effects of carbamazepine were indicated for the first time in the world, the mood stabilizing effect was confirmed by the double blind studies which were performed with a multi-institutional cooperation in Japan in the late 1970s. During the course of the double blind trials, the problem of different therapeutic dosages of psychotropic drugs between Japan and Western countries emerged; that is, the doses of chlorpromazine and lithium carbonate, which were used as the control drugs to carbamazepine in the two double-blind group-comparison studies in Japan, were both much lower than the dosage used in most of the Western countries. The low dosage of control drugs made the evaluation of the results of the double blind studies performed in Japan difficult, and caused a delay of publication in the Western journals of the results. Whether the difference is due to biological factors or to psychosocial and cultural factors is an important problem in psychopharmacology and should be investigated further.
本文描述了日本对卡马西平抗躁狂和预防作用的研究历史。20世纪70年代初首次进行的开放性试验表明，卡马西平具有抗躁狂和预防作用，这在世界上尚属首次。20世纪70年代末，日本通过多机构合作进行的双盲研究证实了其情绪稳定作用。在双盲试验过程中，出现了日本与西方国家精神药物治疗剂量不同的问题；也就是说，在日本的两项双盲组比较研究中，用作卡马西平对照药物的氯丙嗪和碳酸锂的剂量均远低于大多数西方国家使用的剂量。对照药物的低剂量使得对日本进行的双盲研究结果的评估变得困难，并导致了研究结果在西方期刊上发表的延迟。这种差异是由于生物学因素还是心理社会和文化因素造成的，是精神药理学中的一个重要问题，需要进一步研究。
