Publications by authors named "Ryo Sawagashira"

7 Publications

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The type rather than the daily dose or number of antipsychotics affects the incidence of hyperglycemic progression.

Prog Neuropsychopharmacol Biol Psychiatry 2021 Oct 9:110453. Epub 2021 Oct 9.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, North 15, West 7, Sapporo 060-8638, Japan. Electronic address:

There have been concerns that antipsychotics increase the incidence of hyperglycemic progression. Many factors have been suggested to contribute to the risk of antipsychotic-induced hyperglycemic progression, including the type, daily dose, and number of antipsychotics; however, few studies have examined these relationships. This study aimed to examine the affect of antipsychotic treatment-associated factors on hyperglycemic progression, after adjustment for the affect of background factors suggested to be associated with hyperglycemic progression. This was a nationwide, multicenter, prospective cohort study examining the incidence of hyperglycemic progression during a 12 mo period following the initiation of newly prescribed antipsychotic medication. Demographic data, medication history, and blood test values were collected from 631 study participants with normal blood glucose levels at baseline for 12 mo. The primary endpoint (incidence of hyperglycemic progression) was defined as progression from normal to prediabetic or probable diabetic status, and was evaluated based on the Japanese monitoring guidance in patients with schizophrenia. To further examine the affect of antipsychotics on glucose metabolism over time, we examined changes in HbA1c levels 3, 6, and 12 mo after the initiation of treatment with each antipsychotic. We found that treatment with zotepine and clozapine was associated with a significantly high incidence of hyperglycemic progression. Furthermore, changes in HbA1c levels 6 mo after the initiation of zotepine treatment were significantly higher than those following blonanserin and haloperidol treatments. In contrast, there was no significant difference in the change in total cholesterol, triglycerides, HDL cholesterol, and BMI during the same period. Moreover, the "daily dose" and "number" of antipsychotics did not show an association with the incidence of hyperglycemic progression. However, in a post hoc analysis in which the antipsychotics were divided into two groups according to the strength of blockade of H, M, M, and 5-HT receptors, the incidence of hyperglycemic progression was higher in the medium- and high-daily dose groups than in the low-daily dose group in the antipsychotic group with strong blockade of these receptors. Our study indicated that the type of antipsychotic had a greater affect on the incidence of hyperglycemic progression than the daily dose of antipsychotics or their number. Among these, zotepine was most likely to increase the incidence of hyperglycemic progression, suggesting the need for caution when these antipsychotics are prescribed.
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http://dx.doi.org/10.1016/j.pnpbp.2021.110453DOI Listing
October 2021

Sick Sinus Syndrome Mimicking Autonomic Dysfunction of Dementia With Lewy Bodies.

Cureus 2021 Apr 24;13(4):e14667. Epub 2021 Apr 24.

Psychiatry, Otaru General Hospital, Otaru, JPN.

Dementia with Lewy bodies (DLB) is recognized as the second most common form of dementia in aged people. It is well known that patients with DLB often develop various autonomic symptoms. Here, we present a case in which there was sick sinus syndrome mimicking the DLB-related autonomic dysfunctions. After the pacemaker implantation, the patient's symptom perfectly extinguished.It is essential for psychiatrists or other professionals who are mainly seeing dementia patients to rule out critical causes that may mimic autonomic symptoms in patients with DLB.
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http://dx.doi.org/10.7759/cureus.14667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159329PMC
April 2021

Ketamine-Induced Alteration of Working Memory Utility during Oculomotor Foraging Task in Monkeys.

eNeuro 2021 Mar-Apr;8(2). Epub 2021 Apr 6.

Department of Physiology, Hokkaido University School of Medicine, Sapporo 060-8638, Japan

Impairments of working memory (WM) are commonly observed in a variety of neurodegenerative disorders but they are difficult to quantitatively assess in clinical cases. Recent studies in experimental animals have used low-dose ketamine (an NMDA receptor antagonist) to disrupt WM, partly mimicking the pathophysiology of schizophrenia. Here, we developed a novel behavioral paradigm to assess multiple components of WM and applied it to monkeys with and without ketamine administration. In an oculomotor foraging task, the animals were presented with 15 identical objects on the screen. One of the objects was associated with a liquid reward, and monkeys were trained to search for the target by generating sequential saccades under a time constraint. We assumed that the occurrence of recursive movements to the same object might reflect WM dysfunction. We constructed a "foraging model" that incorporated (1) memory capacity, (2) memory decay, and (3) utility rate; this model was able to explain more than 92% of the variations in behavioral data obtained from three monkeys. Following systemic administration of low dosages of ketamine, the memory capacity and utility rate were dramatically reduced by 15% and 57%, respectively, while memory decay remained largely unchanged. These results suggested that the behavioral deficits during the blockade of NMDA receptors were mostly due to the decreased usage of short-term memory. Our oculomotor paradigm and foraging model appear to be useful for quantifying multiple components of WM and could be applicable to clinical cases in future studies.
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http://dx.doi.org/10.1523/ENEURO.0403-20.2021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026253PMC
June 2021

Case of myxedema coma induced by lithium carbonate in a patient with schizophrenia.

Psychiatry Clin Neurosci 2018 02 23;72(2):131. Epub 2017 Dec 23.

Department of Psychiatry, Otaru General Hospital, Hokkaido, Japan.

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http://dx.doi.org/10.1111/pcn.12626DOI Listing
February 2018

Transient lesions of the splenium of the corpus callosum following rapid withdrawal of levetiracetam.

Epileptic Disord 2017 Sep;19(3):379-382

Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido.

Transient lesions of the splenium of the corpus callosum are characterized by MRI findings. The lesions are very rare, but significant from a clinical standpoint as differential diagnoses include serious conditions such as encephalitis, meningitis, and neuroleptic malignant syndrome. In addition, it is reported that some are attributed to the withdrawal of antiepileptic drugs. Here, we present a case of transient lesions of the splenium of the corpus callosum following rapid withdrawal of levetiracetam alone. To the best of our knowledge, this is the first report of such a case. Moreover, it is reported that cases of incidental transient lesions of the splenium of the corpus callosum are detected in Japan more often than in other countries, and as a result are prone to over-triage. Taking this into consideration, in the event of transient lesions of the splenium of the corpus callosum, the utmost attention must be paid to clinical symptoms and history relating to any of the aforementioned serious conditions.
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http://dx.doi.org/10.1684/epd.2017.0923DOI Listing
September 2017

Clinical pharmacokinetic interactions between lamotrigine and hormonal contraceptives in bipolar I disorder.

Psychiatry Clin Neurosci 2017 Apr 16;71(4):290. Epub 2017 Mar 16.

Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

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http://dx.doi.org/10.1111/pcn.12512DOI Listing
April 2017
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