Since there are some patient groups whos symptoms do not improve despite the fact that the use of the antidepressants will alleviate the symptoms to some extent, we have conducted a TRH test for depression and found that there are not a few cases who show a low TSH response. We therefore used a small amount of T3 together with the antidepressants in these cases and have found that the therapy is useful for improvement of tye symptoms. When the TRH test is made at the time of improvement of the symptoms due to the combined use of these two drugs and compared with the state at pre-treatment, it has been confirmed that the TSH response will go back to normal. Hence, we would like to present here two markedly improved cases due to the combined use of imipramine and clomipramine plus T, and to refer to the result of the TRH test.

Zolpidem (10 mg/day) and zopiclone (7.5 mg/day), administered at night, were compared in a 14-day, double-blind, equivalence trial on 479 chronic primary insomniacs (zolpidem, 231; zopiclone, 248) throughout Japan, with a 1-week follow-up to assess rebound. The primary endpoint was the investigators' rating of global improvement of sleep disorders. A total of 32 patients in the zolpidem group (13.9%) and 45 patients in the zopiclone group (18.1%) withdrew from the study before the end of the treatment. In the zolpidem group, 67.9% (142/209) of patients were rated at least ‘moderately improved’ versus 61.6% (135/219) with zopiclone, zolpidem being at least as effective as zopiclone (90% confidence interval: −1.7, 14.3). With zolpidem, sleep onset latency improved in significantly more patients (85.8% versus 77.5%) and significantly fewer patients showed aggravated sleep onset latency relative to baseline at follow-up (4.5% versus 15.4%). Significantly fewer patients receiving zolpidem experienced drug-related adverse events (31.3% versus 45.3%), with bitter taste representing 5.8% (six of 104) of such complaints with zolpidem compared with 39.9% (69/173) with zopiclone. In conclusion, zolpidem was at least as effective as zopiclone, showed significantly less rebound on discontinuation and was better tolerated

Background: Studies have shown that women of reproductive age develop eating disorders (EDs). Few studies have examined EDs in women by performing long-term follow-ups during pregnancy and after delivery. Our study aimed to identify relapse of EDs during pregnancy and after delivery as well as postpartum depression in women who had complete remission of EDs. Methods: Of the 1008 patients with EDs who visited our outpatient clinic between 1994 and 2004, 55 experienced ED remission and pregnancy. Of these, 25 (21 with BN and 4 with AN) consented to participate in this study. Finally, 24 patients were included in this study after 1 patient was excluded owing to a miscarriage. They were interviewed every 2 weeks both during pregnancy and after giving birth. We used the Eating Attitudes Test-26 (EAT-26) and Edinburgh Postnatal Depression Scale (EPDS) as reference scales for diagnosing the EDs and the postpartum depression, respectively. We used a two-sided unpaired test for the statistical analysis. Results: Sixteen participants (67%) experienced ED relapse during pregnancy and twelve (50%) relapsed after birth. Twelve (50%) had postpartum depression, four of whom (33%) had low-birth-weight infants. Among the participants who did not have postpartum depression, there were no low-body-weight infants. There was no significant difference (p = 0.065) in birth weight between the postpartum depression and non-depression groups.Conclusions: Our study revealed that recurrence of EDs and the occurrence of postpartum depression were higher in this population, indicating the need to closely monitor EDs both during pregnancy and after birth.

Mental health problems have recently increased among Japan Overseas Cooperation volunteers since 1965, when the Ministry of Foreign Affairs (Japan International Cooperation Agency) launched this volunteer work project for improving hygiene and socioeconomic conditions in developing countries. There was little research on job stress among them dispatched despite previous surveys indicating job as an important stressor. To investigate stress and job-related stressors among them, we conducted a cross-sectional epidemiological study from October to December in 2003. The subjects were all 1,084 Japan Overseas Cooperation volunteers aged 20-40, who worked in 67 countries worldwide at the time of this study (485 and 599 males and females, 316, 332 and 436 for those staying overseas for 11, 7 and 4 months, respectively). Approximately 80% were involved in their dispatching occupational organizations as professionals in information technology, health & welfare, education, and research. Our main outcome measure used was the Brief Job Stress Questionnaire, which was developed to assess stress and job-related stressors or buffers for Japanese workers. Demographic and personality (Egogram) characteristics as well as other health information were obtained. The response rate was 86.9%. For psychological stress, prevalence was 5.5% (n = 49). Means (+/- SD) were 4.22 (+/- 3.98), and 4.89 (+/- 4.40) for males and females (p < 0.05), and 5.15 (+/- 4.17), 5.05 (+/- 4.45), 3.93 (+/- 4.40) for those staying overseas for 11, 7 and 4 months (p < 0.01), respectively. For physical stress, prevalence was 2.9% (n = 26). Means (+/- SD) were 1.10 (+/- 1.68), and 1.41 (+/- 1.74) for males and females (p < 0.01), and 1.47 (+/- 1.77), 1.35 (+/- 1.89), 1.11 (+/- 1.55) for those staying overseas for 11, 7 and 4 months (p < 0.05), respectively. The factors significantly associated with psychological stress were high job demand, poor human relationships at work, low job suitability, low social support from supervisors and colleagues, and being dissatisfied with their life, according to multiple logistic regression analysis. The present study suggested that psychological stress was more prevalent than physical. It also implied a significant relationship between psychological stress and job-related stressors among the subjects of this study as in employees in Japan. Mental health check-ups and counseling in the early stage of psychological stress is important from the viewpoint of prevention of developing stress-related mental health disorders. Education on stress-coping skills should be considered in a training program before they are sent overseas.

The Pharmacokinetics of nipradilol (K-351 : 3, 4-dihydro-8-(2-hydroxy-3-iso propylamino) propoxy-3-nitroxy-2H-1-benzopyran ; NIP), a new potent antihyperten sive and antianginal agent, were investigated in healthy volunteers after single or repeated oral administration.After administration at single doses of 1 mg to 24 mg, NIP was rapidly absorbed, reaching a maximum plasma concentration (Cmax) at 2 hr, and then eliminated with a plasma half-life ( T1/2) of 3.7 hr, irrespective of the dose. Cmax and area under the plasma levels-time curve (AUC) of NIP, as well as the amounts of NIP and its metabolites excreted in the urine increased in proportion to the dose administered. The apparent volume of distribution, systemic availability, renal clearance, and plasma clearance were 5.621/kg,35%, 0.181/min, and 1.041/min, respectively, independent of the dose.Upon multiple oral administration of 6 mg two times daily for one or seven days, the experimental plasma concentrations of NIP and denitrated NIP coincided well with the 680 simulation curves. Furthermore, T1/2 values calculated from the plasma and urinary excretion rate did not differ significantly during repeated dosing, indicating no accumulation in the body.The amount of parent drug excreted into the urine was 6.3%. The major urinary metabolites arose from three metabolic pathways, namely, denitration, hydroxylation of the ring system and glucuronidation of NIP. Degradation of the isopropylaminopro panol side chain was a minor route.