Details of a Researcher - Uchida, Hiroyuki

Papers - Uchida, Hiroyuki

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Depression severity and effect of antidepressant medications.

Suzuki T, Uchida H, Nakajima S

JAMA 303 ( 16 ) 1597 - 8; author reply 1599 2010.04

ISSN 0098-7484

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In situ STM observation of morphological changes of the Pt(111) electrode surface during potential cycling in 10 mM HF solution.

Wakisaka M, Asizawa S, Uchida H, Watanabe M

Physical chemistry chemical physics : PCCP 12 ( 16 ) 4184 - 90 2010.04

ISSN 1463-9076

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Durability of Pt/graphitized carbon catalysts for the oxygen reduction reaction prepared by the nanocapsule method.

Yano H, Akiyama T, Bele P, Uchida H, Watanabe M

Physical chemistry chemical physics : PCCP 12 ( 15 ) 3806 - 14 2010.04

ISSN 1463-9076

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Are antipsychotic prescribing patterns different in older and younger adults?

Sproule Beth A., Lake Jennifer, Mamo David C., Uchida Hiroyuki, Mulsant Benoit H.

Canadian Journal of Psychiatry 55 ( 4 ) 248 - 254 2010.04

ISSN 0706-7437

Objective: To compare antipsychotic prescribing patterns in younger (aged 59 years or younger) and older (aged 60 years or older) patients with psychotic or mood disorders. Method: Pharmacy records of all patients discharged from the Centre for Addiction and Mental Health over a 21-month period were reviewed. A total of 1357 patients who were prescribed an antipsychotic at the time of their discharge were included in the analysis (956 with a primary psychotic disorder and 401 with a primary mood disorder). World Health Organization-defined daily doses were used as the standardized dosing unit. Results: Both in patients with a primary psychotic disorder and in patients with a primary mood disorder, the prescribing patterns were similar in older and younger patients, with no statistical difference in the proportions receiving first-generation antipsychotics, second-generation antipsychotics (SGAs), multiple antipsychotics, or long-acting (depot) antipsychotics. Overall, the mean daily antipsychotic doses were lower only in the older group of patients with a primary mood disorder. However, the mean dose of SGAs was about 30% lower in older patients in both diagnostic groups. Regardless of age, patients with a mood disorder were prescribed lower doses of antipsychotics than those with a psychotic disorder. Conclusions: Our data suggest that older patients are prescribed lower antipsychotic dosages primarily when using SGAs. This finding emphasizes the need for dose-finding studies assessing both the efficacy and the safety of antipsychotics in older patients with a psychotic or mood disorder.

Are antipsychotic prescribing patterns different in older and younger adults?: A survey of 1357 psychiatric inpatients in Toronto

Sproule B., Lake J., Mamo D., Uchida H., Mulsant B.

Canadian Journal of Psychiatry (Canadian Journal of Psychiatry) 55 ( 4 ) 248 - 254 2010.04

ISSN 07067437

Objective: To compare antipsychotic prescribing patterns in younger (aged 59 years or younger) and older (aged 60 years or older) patients with psychotic or mood disorders. Method: Pharmacy records of all patients discharged from the Centre for Addiction and Mental Health over a 21-month period were reviewed. A total of 1357 patients who were prescribed an antipsychotic at the time of their discharge were included in the analysis (956 with a primary psychotic disorder and 401 with a primary mood disorder). World Health Organization-defined daily doses were used as the standardized dosing unit. Results: Both in patients with a primary psychotic disorder and in patients with a primary mood disorder, the prescribing patterns were similar in older and younger patients, with no statistical difference in the proportions receiving first-generation antipsychotics, second-generation antipsychotics (SGAs), multiple antipsychotics, or long-acting (depot) antipsychotics. Overall, the mean daily antipsychotic doses were lower only in the older group of patients with a primary mood disorder. However, the mean dose of SGAs was about 30% lower in older patients in both diagnostic groups. Regardless of age, patients with a mood disorder were prescribed lower doses of antipsychotics than those with a psychotic disorder. Conclusions: Our data suggest that older patients are prescribed lower antipsychotic dosages primarily when using SGAs. This finding emphasizes the need for dose-finding studies assessing both the efficacy and the safety of antipsychotics in older patients with a psychotic or mood disorder.

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Potentials and current limitations of brain stimulation therapies to accelerate antidepressant response

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 ( 2 ) 439 - 440 2010.03

ISSN 0278-5846

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Accelerating response to antidepressant treatment in depression

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 ( 2 ) 259 - 264 2010.03

ISSN 0278-5846

Objective: The primary objective of this article is to review the literature regarding the speed of response to antidepressant drugs and potential strategies to accelerate the antidepressant response in new antidepressant-free patients with depression. Based on these data, we try to propose both an effective and safe antidepressant treatment strategy to alleviate depressive symptoms at the earliest opportunity. Data sources: Data were identified by searches of Medline (1966 to September 2009) and references from relevant articles and books. Search terms included depression, antidepressant, predictor, response, onset, acceleration, and augmentation. As our focus was on the acute phase treatment of depression, articles relevant to treatment-resistant depression were excluded. Only articles written in English or Japanese were consulted. Data selection: Studies, reviews, and books pertaining to the treatment of depression with a special regard to accelerating therapeutic effects were selected. Data synthesis: Most of the available treatment guidelines for major depressive disorders recommend the continuous use of antidepressants for 4 to 8. weeks based on the idea of a delayed onset of response to these drugs. Contrary to this conventional belief, the recent data indicate that antidepressants start to exert their effects within 2. weeks and early non-response could predict a subsequent unfavorable outcome. Conclusions: These findings suggest the need of revisiting the timing of an antidepressant switch for early non-responders, whereby switching could be commenced in as early as 2. weeks.

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Adverse effects of anticholinergic activity on cognitive functions in Alzheimer's disease

Konishi Kimiko, Hori Koji, Uchida Hiroyuki, Watanabe Koichiro, Tominaga Itaru, Kimura Masaki, Hosoyamada Makoto, Shibasaki Toshiaki, Kataoka Akira, Hachisu Mitsugu

Psychogeriatrics (Psychogeriatrics) 10 ( 1 ) 34 - 38 2010.03

ISSN 1346-3500

Background: Elderly patients with Alzheimer's disease (AD) take more medicines, other than those for anti-dementia agents, than healthy people and are sensitive to anticholinergic medications. There are only a few reports, however, on the relationship between cognitive function and anticholinergic activity in AD patients, which is caused by taking prescribed medication. Methods: We measured serum anticholinergic activity (SAA) in 76 AD patients referred to a Psychogeriatric Unit and separated them into SAA positive group (n = 26, SAA (+) group) and SAA negative group (n = 50, SAA (-) group). The difference in demographic data and cognitive functions were compared between the two groups. Results and Conclusions: The total scores of the Mini-Mental State Examination (MMSE), the score of MMSE domain of registration and recall were significantly lower (P < 0.05) and the Functional Assessment Staging (FAST) score, the number of different kinds of prescribed psychotropic medications (the number of prescribed psychotropic medications) were significantly higher (P < 0.05) in the SAA (+) group than in the SAA (-). These results suggest that a higher number of psychotropic medications prescribed leads to a tendency for SAA to be positive and that anticholinergic activity accelerates Alzheimer's pathology and decreases cognitive function, especially memory in AD patients. We should more prudently prescribe psychotropic medications to AD patients, because the prescribed psychotropic medications are one of the important causes of decline in cognitive function of AD patients by way of anticholinergic activity.

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Potential risks of adjunctive use of atypical antipsychotic drugs for the treatment of depression

Nakajima Shinichiro, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo, Uchida Hiroyuki

Progress in Neuro-Psychopharmacology and Biological Psychiatry 34 ( 2 ) 435 - 436 2010.03

ISSN 0278-5846

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Control of particle size of pt and pt alloy electrocatalysts supported on carbon black by the nanocapsule method.

Okaya K, Yano H, Uchida H, Watanabe M

ACS applied materials & interfaces 2 ( 3 ) 888 - 95 2010.03

ISSN 1944-8244

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Sensitivity to antipsychotic drugs in older adults

Leon Chloe, Gerretsen Philip, Uchida Hiroyuki, Suzuki Takefumi, Rajji Tarek, Mamo David C.

Current Psychiatry Reports (Current Psychiatry Reports) 12 ( 1 ) 28 - 33 2010.02

ISSN 1523-3812

Antipsychotic medications are widely used to manage psychotic and behavioral disorders in older adults, including primary psychotic disorders such as schizophrenia, and psychosis and behavioral disturbances associated with dementia. These two broad diagnostic indications are associated with contrasting recommended treatment durations, with the former requiring indefinite treatment across the life span. Antipsychotic drug dosing for schizophrenia is based primarily on studies of younger patients and thus may not apply to older adults. It is critically important to address the effects of aging on antipsychotic dosing given the recent emergence of data that suggest a critical role for age-related sensitivity to these drugs. Antipsychotic drugs are not only associated with somatic and neurological adverse effects but also increased all-cause mortality and sudden cardiac death in this vulnerable population. This review focuses on the sensitivity of older adults to adverse effects from antipsychotic medications and the current pharmacokinetic and pharmacodynamic explanatory models of susceptibility. Implications of recent research findings for individualized pharmacotherapy are discussed.

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Changes in metabolic parameters following a switch to aripiprazole in Japanese patients with schizophrenia

Takeuchi Hiroyoshi, Uchida Hiroyuki, Suzuki Takefumi, Watanabe Koichiro, Kashima Haruo

Psychiatry and Clinical Neurosciences 64 ( 1 ) 104 - 106 2010.02

ISSN 1323-1316

The purpose of the present study was to evaluate changes in metabolic parameters after switching to aripiprazole in Japanese population. In this 1-year observation study, following a switch to aripiprazole, 32 patients with schizophrenia were observed and assessment was done of bodyweight, total cholesterol, triglyceride, serum prolactin level, and corrected QT (QTc) interval. Significant reductions were observed in these parameters other than QTc interval. Given known detrimental metabolic and hormonal effects of some atypical antipsychotics, a switch to aripiprazole may warrant serious consideration also in Asian patients who suffer those side-effects.

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Changes in metabolic parameters following a switch to aripiprazole in Japanese patients with schizophrenia: One-year follow-up study

Takeuchi H., Uchida H., Suzuki T., Watanabe K., Kashima H.

Psychiatry and Clinical Neurosciences (Psychiatry and Clinical Neurosciences) 64 ( 1 ) 104 - 106 2010.02

ISSN 13231316

The purpose of the present study was to evaluate changes in metabolic parameters after switching to aripiprazole in Japanese population. In this 1-year observation study, following a switch to aripiprazole, 32 patients with schizophrenia were observed and assessment was done of bodyweight, total cholesterol, triglyceride, serum prolactin level, and corrected QT (QTc) interval. Significant reductions were observed in these parameters other than QTc interval. Given known detrimental metabolic and hormonal effects of some atypical antipsychotics, a switch to aripiprazole may warrant serious consideration also in Asian patients who suffer those side-effects. © 2009 Japanese Society of Psychiatry and Neurology.

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Clozapine and global cognition in schizophrenia

Rajji Tarek K., Uchida Hiroyuki, Ismail Zahinoor, Ng Wenzie, Mamo David C., Remington Gary, Pollock Bruce G., Mulsant Benoit H.

Journal of Clinical Psychopharmacology (Journal of Clinical Psychopharmacology) 30 ( 4 ) 431 - 436 2010

ISSN 0271-0749

Objective: Clozapine (CLZ) has been shown to have a beneficial effect on cognition in schizophrenia in some studies and a detrimental effect in others. The relative effect and exposure to CLZ and its major metabolite-N- desmethylclozapine (NDMC)-could explain these discrepancies. Methods: Using a validated measure of global cognition, we performed 2 binary logistic regression models to assess the relationship among cognition, age, sex, CLZ dose, CLZ and NDMC plasma levels, and their ratio (CLZ/NDMC) in individuals with schizophrenia spectrum disorders. Model 1 included age, sex, CLZ dose, and CLZ and NDMC levels. Model 2 included age, sex, CLZ dose, and CLZ/NDMC. Results: Among 73 subjects (mean [SD] age, 41.6 [12.0] years), 16 (21.9%) had high cognitive impairment, whereas the rest had low cognitive. In model 1, age and CLZ level were associated with high cognitive impairment (odds ratio [95% confidence interval] for age, 1.079 [1.011-1.152]; CLZ level, 1.010 [1.003-1.017]), whereas NDMC level was associated with its absence (NDMC level, 0.987 [0.977-0.997]). In model 2, age, male sex, and CLZ/NDMC were associated with cognitive impairment (age, 1.083 [1.015-1.154]; sex, 0.178 [0.032-0.994]; CLZ/NDMC, 7.302 [1.823-29.253]). Clozapine dose was not associated with cognition in either model. Conclusions: After controlling for age, sex, and dose, CLZ/NDMC was more strongly associated with cognition than CLZ or NDMC levels. N-desmethylclozapine agonist activity versus CLZ antagonist activity at the muscarinic receptors could explain the strength of the association of CLZ/NDMC with cognition.

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Proton-conductive aromatic ionomers containing highly sulfonated blocks for high-temperature-operable fuel cells.

Bae B, Yoda T, Miyatake K, Uchida H, Watanabe M

Angewandte Chemie (International ed. in English) 49 ( 2 ) 317 - 20 2010

ISSN 1433-7851

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D2 receptor blockade by risperidone correlates with attention deficits in late-life schizophrenia

Uchida Hiroyuki, Rajji Tarek K., Mulsant Benoit H., Kapur Shitij, Pollock Bruce G., Graff-Guerrero Ariel, Menon Mahesh, Mamo David C.

Journal of Clinical Psychopharmacology (Journal of Clinical Psychopharmacology) 29 ( 6 ) 571 - 575 2009.12

ISSN 0271-0749

The negative impact of antipsychotic drugs on attention is expected to be greater in late-life schizophrenia because of the age-related changes in the dopamine receptor reserve. The objective of this study was to examine the relationship between dopamine D2 receptor blockade by risperidone and the cognitive function in late-life schizophrenia. Subjects with schizophrenia or schizoaffective disorder aged 50 or older who were receiving risperidone completed a [C]raclopride positron emission tomography scan to measure D2-binding potential in the striatum. The D2 receptor blockade by risperidone was calculated using age-corrected measures from healthy individuals and region of interest analysis of dynamic positron emission tomography data coregistered to the subjects' magnetic resonance imaging scans. Cognitive function was assessed using a battery of neuropsychological tests that included the Dementia Rating Scale-2 (DRS). Eleven subjects (mean ± SD age, 64 ± 8 years) participated in this study. The mean ± SD D2 receptor blockade was 69% ± 14% (range, 34%-80%). The age-corrected score on the attention subscale in the DRS was negatively correlated with the D2 receptor blockade. The DRS attention subscale score was lower in the subjects who experienced 74.9% or higher D2 blockade (median value, corresponding to a daily risperidone dose of >3.0 mg) than in those who did not. Although a causal attribution cannot be made in light of the cross-sectional nature of this study, the results suggest the critical importance of identifying the lowest effective dose of antipsychotic drugs in older patients with schizophrenia.

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Predicting age-specific dosing of antipsychotics

Uchida H., Pollock B. G., Bies R. R., Mamo D. C.

Clinical Pharmacology and Therapeutics (Clinical Pharmacology and Therapeutics) 86 ( 4 ) 360 - 362 2009.10

ISSN 0009-9236

Antipsychotic medications are the standard of care for both acute and maintenance treatment of schizophrenia, the latter requiring an indefinite treatment across a patients life span. However, dosing and tolerability of antipsychotics have been studied primarily in younger patients, and very limited data are available for age- and phase-specific dosing. This leaves the clinician with no guidance on dose adjustment as patients grow olderan issue of critical importance, especially in light of recent concerns about increased morbidity and mortality associated with antipsychotics.

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Impacts of switching antidepressants after successful electroconvulsive therapy on the maintenance of clinical remission in patients with treatment-resistant depression

Nakajima Shinichiro, Ishida Takuto, Akaishi Rei, Takahata Keisuke, Kitahata Ryosuke, Uchida Hiroyuki, Suzuki Takefumi, Takeuchi Hiroyoshi, Nomura Kensuke, Nakagawa Atsuo, Watanabe Koichiro, Kashima Haruo

Journal of ECT 25 ( 3 ) 178 - 181 2009.09

ISSN 1095-0680

Introduction: There is no consensus regarding whether a previously prescribed, that is, failed, antidepressant should be continued or switched after a successful electroconvulsive therapy (ECT) for the maintenance of clinical remission in patients with treatment-resistant depression (TRD). In this study, we conducted a chart review to examine impacts of the antidepressant switch after the successful ECT on 1-year outcome in patients with TRD. MATERIALS AND Methods: This retrospective chart review included inpatients with TRD (ie, those who failed to respond to adequate trials of 2 distinctly different classes of antidepressants) who showed clinical remission after ECT. Readmission rate and social functioning 6 months and 1 year after the successful ECT were compared between patients who experienced an antidepressant switch and those who continued prior regimen. Results: Twenty-eight patients (mean age, 59 years; 9 men) were followed-up for 1 year. The patients who changed antidepressants after ECT (n = 7) experienced a readmission significantly less frequent than the others (n = 21) in 1 year (0% vs 43%, P = 0.043). In addition, the former showed significantly better social contacts at 6 months (P = 0.022) and 1 year (P = 0.015). There were no significant differences in baseline characteristics between the 2 groups. Conclusions: The patients who experienced an antidepressant switch after ECT required a readmission less frequently in 1 year than those who were maintained with the same antidepressant. The findings of this preliminary study suggest that a switch to another antidepressant after successful ECT may be encouraged for the maintenance of clinical remission in patients with TRD.

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Impacts of switching antidepressants after successful electroconvulsive therapy on the maintenance of clinical remission in patients with treatment-resistant depression: A chart review

Nakajima S., Ishida T., Akaishi R., Takahata K., Kitahata R., Uchida H., Suzuki T., Takeuchi H., Nomura K., Nakagawa A., Watanabe K., Kashima H.

Journal of ECT (Journal of ECT) 25 ( 3 ) 178 - 181 2009.09

ISSN 10950680

Introduction: There is no consensus regarding whether a previously prescribed, that is, failed, antidepressant should be continued or switched after a successful electroconvulsive therapy (ECT) for the maintenance of clinical remission in patients with treatment-resistant depression (TRD). In this study, we conducted a chart review to examine impacts of the antidepressant switch after the successful ECT on 1-year outcome in patients with TRD. MATERIALS AND Methods: This retrospective chart review included inpatients with TRD (ie, those who failed to respond to adequate trials of 2 distinctly different classes of antidepressants) who showed clinical remission after ECT. Readmission rate and social functioning 6 months and 1 year after the successful ECT were compared between patients who experienced an antidepressant switch and those who continued prior regimen. Results: Twenty-eight patients (mean age, 59 years; 9 men) were followed-up for 1 year. The patients who changed antidepressants after ECT (n = 7) experienced a readmission significantly less frequent than the others (n = 21) in 1 year (0% vs 43%, P = 0.043). In addition, the former showed significantly better social contacts at 6 months (P = 0.022) and 1 year (P = 0.015). There were no significant differences in baseline characteristics between the 2 groups. Conclusions: The patients who experienced an antidepressant switch after ECT required a readmission less frequently in 1 year than those who were maintained with the same antidepressant. The findings of this preliminary study suggest that a switch to another antidepressant after successful ECT may be encouraged for the maintenance of clinical remission in patients with TRD. © 2009 by Lippincott Williams & Wilkins.

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Dosing of antipsychotics in schizophrenia across the life-spectrum

Uchida Hiroyuki, Mamo David C.

Progress in Neuro-Psychopharmacology and Biological Psychiatry 33 ( 6 ) 917 - 920 2009.08

ISSN 0278-5846

Age effects on dosing of antipsychotics in schizophrenia and mechanisms underlying those effects have not been well understood. The objective of this article is to review the literature regarding effects of age on antipsychotic dosing in schizophrenia and potential mechanisms underlying the age-related antipsychotic sensitivity. According to prescription surveys, age appears to have biphasic effects on prescribed antipsychotic dose. The dose increased with age through the third decade, subsequently plateaued, and decreased after the fifth decade. The first half of this inverted U-shaped relationship may be attributable to a deterioration process in the early phase of schizophrenia and the contribution of 'tachyphylaxis' of antipsychotics on the dopaminergic system. The following age-related decline in prescribed dose is likely associated with physiological aging. Recent data suggest that this increased antipsychotic sensitivity with age comes from age-related functional decline in the dopaminergic system, including endogenous dopamine level and dopamine receptor density. Although the evidence on potential mechanisms underlying age effects on antipsychotic dosing is still limited, alterations in the dopaminergic system due to aging and chronic exposure to this drug may contribute to the inverted U-shaped relationship between dose and age. This age-related antipsychotic sensitivity highlights the importance of finding the lowest possible effective dose of antipsychotic drugs as patients age to enhance therapeutic effects as well as minimize their side effects.

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