著者
高橋 徹 松下 正明 鷲塚 伸介 萩原 徹也
出版者
信州大学
雑誌
挑戦的萌芽研究
巻号頁・発行日
2016-04-01

以下の2編の論文を発表した。①作家・北杜夫と躁うつ病 ― 双極性障害の診断 ―.病跡学雑誌95:58-74,2018.②作家・北杜夫と躁うつ病 ― 顕在発症前エピソードと『どくとるマンボウ航海記』―.信州大学附属図書館研究8:57-87,2019.第一報において、北杜夫における「躁うつ病」の病名が、現代の診断基準における双極Ⅰ型障害に該当すること、また「混合状態」「急速交代型」の特徴を有していたことを考察した。第二報において、顕在発症とされている39歳前にも気分変動が存在し、『どくとるマンボウ航海記』(1960年:33歳時)の執筆にも躁状態とうつ状態が創作に影響を及ぼしていた可能性を指摘した。
著者
寺澤 美穂 山折 大 勝山 善彦 二村 緑 久富 由里子 田中 章 荻原 朋美 萩原 徹也 杉山 暢宏 鷲塚 伸介 大森 栄
出版者
一般社団法人日本医療薬学会
雑誌
医療薬学 (ISSN:1346342X)
巻号頁・発行日
vol.43, no.7, pp.362-372, 2017-07-10 (Released:2018-07-10)
参考文献数
23

This study analyzed factors affecting plasma lamotrigine (LTG) concentrations in patients with bipolar disorder. The mean concentration/dose (C/D) ratio of LTG was significantly higher in patients co-treated with LTG and valproic acid (VPA) [3.72 (μg/mL)/(mg/kg/day), n = 9] than in those receiving LTG monotherapy [1.76 (μg/mL)/(mg/kg/day), n = 9; P < 0.01]. LTG monotherapy patients were genotyped for UDP-glucuronosyltransferase 2B7 (UGT2B7) *1/*1 (n = 5) and *1/*2(n = 4), whereas VPA co-administration patients were genotyped for UGT2B7*1/*1 (n = 6), *1/*2 (n = 2) and *2/*2 (n = 1). *There were no significant differences in mean C/D ratios between patients carrying the UGT2B7*1/*1 genotype and the 1/*2 or *2/*2 genotype regardless of pharmacotherapy (P ≥ 0.150). In the LTG monotherapy group, the mean C/D ratio was similar in smoking patients [1.52 (μg/mL)/(mg/kg/day), n = 3] and non-smoking patients [1.88 (μg/mL)/(mg/kg/day), n = 6; P = 0.393]. In the VPA co-administration group, however, the mean C/D ratio in smoking patients [2.62 (μg/mL)/(mg/kg/day), n = 4] was significantly lower than that in non-smoking patients [4.61 (μg/mL)/(mg/kg/day), n = 5; P < 0.01]. In vitro studies with HepG2 cells indicated that benzo[a]pyrene, one of the polycyclic aromatic hydrocarbons contained in tobacco smoke, as well as 3-methylcholanthrene efficiently induced expression of UGT1A4 mRNA but not UGT2B7 mRNA and that VPA potently enhanced their induction. These results suggest that concomitant VPA administration and/or smoking may influence LTG concentrations in patients with bipolar disorder.