Effects of aromatherapy (odorless condition, lavender, and hiba oil) on mood and anxiety were investigated in 14 female patients who were being treated with chronic hemodialysis. A control period consisting of natural hospital smells was established before each test session, and then aromatic test conditions were systematically evaluated for odorless conditions as well as aromatic conditions containing lavender and hiba oil aromas. The effects of aromatherapy were measured using the Hamilton rating scale for depression (HAMD) and the Hamilton rating scale for anxiety (HAMA). Hiba oil aroma significantly decreased the mean scores of HAMD and HAMA, and lavender aroma significantly decreased the mean scores of HAMA. The mean scores of HAMD and HAMA in an odorless condition were not significantly different from those of the control conditions. These results indicate that in chronic hemodialysis patients hiba oil is an effective, non-invasive means for the treatment of depression and anxiety, and that lavender alleviates anxiety.

BackgroundAdministration of valproic acid (VPA) is complicated with approximately 0.9% of patients developing hyperammonemia, but the pathogenesis of this adverse effect remains to be clarified. The aim of the present study was to search for mechanisms associated with VPA-induced hyperammonemia in the light of changes in serum amino acids concentrations associated with the urea cycle of schizophrenic patients.MethodBlood samples (10 mL) were obtained from 37 schizophrenic patients receiving VPA for the prevention of violent behaviors in the morning after overnight fast. Blood concentrations of ammonia, VPA, free carnitine, acyl-carnitine, and 40 amino acids including glutamate and citrulline were measured for each patient. Univariate and multivariate regression analyses were performed to identify amino acids or concomitantly administered drugs that were associated with variability in the blood concentrations of ammonia.ResultThe blood ammonia level was positively correlated with the serum glutamate concentration (r = 0.44, p < 0.01) but negatively correlated with glutamine (r = −0.41, p = 0.01), citrulline (r = −0.42, p = 0.01), and glycine concentrations (r = −0.54, p < 0.01). It was also revealed that the concomitant administration of the mood stabilizers (p = 0.04) risperidone (p = 0.03) and blonanserin (p < 0.01) was positively associated with the elevation of the blood ammonia level.ConclusionWe hypothisized that VPA would elevate the blood ammonia level of schizophrenic patients. The observed changes in serum amino acids are compatible with urea cycle dysfunction, possibly due to reduced carbamoyl-phosphate synthase 1 (CPS1) activity. We conclude that VPA should be prudently prescribed to schizophrenic patients, particularly those receiving mood stabilizers or certain antipsychotics.