竹内 啓善 (タケウチ ヒロヨシ)

Takeuchi, Hiroyoshi

写真a

所属(所属キャンパス)

医学部 精神・神経科学教室 (信濃町)

職名

専任講師(有期)

 

研究分野 【 表示 / 非表示

  • 精神神経科学

研究キーワード 【 表示 / 非表示

  • 抗精神病薬

  • 統合失調症

 

論文 【 表示 / 非表示

  • Relationship between polydipsia and antipsychotics: A systematic review of clinical studies and case reports

    Kirino S., Sakuma M., Misawa F., Fujii Y., Uchida H., Mimura M., Takeuchi H.

    Progress in Neuro-Psychopharmacology and Biological Psychiatry (Progress in Neuro-Psychopharmacology and Biological Psychiatry)  96 2020年01月

    ISSN  02785846

     概要を見る

    © 2019 Elsevier Inc. Objective: This systematic review aimed to elucidate the relationship between polydipsia and antipsychotics. Methods: We systematically searched MEDLINE, Embase, and PsycINFO, and included clinical studies and case reports on polydipsia induced or improved by antipsychotics. Results: We identified 61 articles: 1 double-blind randomized controlled trial (RCT), 4 single-arm trials, 1 cross-sectional study, 3 case series, and 52 case reports. The double-blind RCT demonstrated no significant difference in improvement in polydipsia between olanzapine and haloperidol. Two single-arm trials showed that polydipsia improved during clozapine treatment, whereas the other 2 showed that risperidone did not improve polydipsia. The cross-sectional study showed the prevalence of hyponatremia with first-generation antipsychotics (FGAs: 26.1%) and second-generation antipsychotics (SGAs: 4.9%). Two case series reported that clozapine improved polydipsia; the other one indicated that patients with polydipsia who were treated with FGAs had schizophrenia (70.4%) and mental retardation (25.9%). Of 90 cases in the case reports, 67 (75.3%) were diagnosed with schizophrenia. Of 83 cases in which antipsychotic treatment started before the onset of polydipsia, 75 (90.3%) received FGAs, particularly haloperidol (n = 24, 28.9%), and 11 (13.3%) received risperidone. Among 40 cases in which polydipsia was improved following antipsychotic treatment, 36 (90.0%) received SGAs, primarily clozapine (n = 14, 35.0%). Conclusions: Although the causal relationship between polydipsia and antipsychotics remains unclear because of the paucity of high-quality studies, antipsychotics with high affinity to dopamine D2 receptors may be associated with an increased risk of polydipsia while clozapine may be effective for treating polydipsia.

  • Circadian patterns of hallucinatory experiences in patients with schizophrenia: Potentials for chrono-pharmacology

    Koizumi T., Suzuki T., Pillai N., Bies R., Takeuchi H., Yoshimura K., Mimura M., Uchida H.

    Journal of Psychiatric Research (Journal of Psychiatric Research)  117   1 - 6 2019年10月

    ISSN  00223956

     概要を見る

    © 2019 Elsevier Ltd The objective of this study was to investigate possible circadian pattern of psychotic symptoms in patients with schizophrenia, which could be reflected on the dosing schedule/regimen, i.e. chrono-pharmacology. Patients with schizophrenia (ICD-10) who reported having auditory hallucination, receiving monotherapy with risperidone, olanzapine or paliperidone for at least two weeks were included. The subjects were provided a diary and asked to record the time and duration of auditory hallucinations during the eight time periods (i.e. 00:00–03:00, 03:00–06:00, 06:00–09:00, 09:00–12:00, 12:00–15:00, 15:00–18:00, 18:00–21:00, and 21:00–24:00). In the diary, times of medication doses and sleep were also recorded. Time and degree of peak and trough dopamine D2 receptor blockade with antipsychotics were estimated from 2 sparsely collected plasma drug concentrations. The prevalence and duration of auditory hallucinations were statistically examined among the eight time periods, respectively. Forty-nine patients participated in this study (mean ± SD age, 50.7 ± 14.8 years; 36 men (73.5%); 34 inpatients (69.4%)). Auditory hallucinations occurred most frequently and lasted for the longest duration in the period of 18:00–21:00 (75.5% (37/49) and 1.37 ± 1.67 h). This happened despite the fact that the difference in D2 receptor occupancy between the peak and trough was less than 2%, indicating a stable drug delivery. Since the dopamine D2 receptor blockade by antipsychotics was stable, the nocturnal circadian pattern found in this study may reflect intrinsic dopaminergic fluctuation or generally quieter environments at night. These circadian patterns may be considered to devise individualized treatment approach in the context of “chrono-pharmacology” for patients with schizophrenia.

  • Switching to antipsychotic monotherapy vs. staying on antipsychotic polypharmacy in schizophrenia: A systematic review and meta-analysis

    Matsui K., Tokumasu T., Takekita Y., Inada K., Kanazawa T., Kishimoto T., Takasu S., Tani H., Tarutani S., Hashimoto N., Yamada H., Yamanouchi Y., Takeuchi H.

    Schizophrenia Research (Schizophrenia Research)  209   50 - 57 2019年07月

    ISSN  09209964

     概要を見る

    © 2019 Elsevier B.V. Background: While recent meta-analyses have reported the superiority of antipsychotic polypharmacy (APP) over antipsychotic monotherapy (APM) in schizophrenia, switching to APM can be beneficial in terms of side effects. To determine whether patients receiving APP should switch to APM or stay on APP, we conducted a systematic review and meta-analysis. Methods: Randomized controlled trials (RCTs) examining a switch from APP to APM vs. staying on APP were systematically selected from a previous meta-analysis comparing APP with APM in patients with schizophrenia. In addition, we conducted an updated systematic literature search using MEDLINE, Embase, and Cochrane Central Register of Controlled Trials. Data on study discontinuation, relapse, psychopathology, neurocognition, extrapyramidal symptoms, and body weight/body mass index (BMI) were extracted and synthesized. Results: A total of 6 RCTs involving 341 patients were included. All studies examined a switch from 2 antipsychotic agents to a single agent. Clozapine-treated patients were included in 3 studies. There was a significant difference in study discontinuation due to all causes in favor of staying on APP (N = 6, n = 341, RR = 2.28, 95% CI = 1.50–3.46, P < 0.001). There were no significant differences in relapse, any psychopathology, neurocognition, extrapyramidal symptoms, or body weight/BMI between the 2 groups. The quality of evidence was low to very low. Conclusions: The findings suggest that clinicians should closely monitor patient condition when switching to APM after receiving 2 antipsychotics. Given the low to very low overall quality of the evidence, the findings should be considered preliminary and inconclusive.

  • Pharmacological interventions for prevention of weight gain in people with schizophrenia

    Agarwal S., Ahsan Z., Lockwood J., Duncan M., Takeuchi H., Cohn T., Taylor V., Remington G., Faulkner G., Hahn M.

    Cochrane Database of Systematic Reviews (Cochrane Database of Systematic Reviews)  2019 ( 6 )  2019年06月

     概要を見る

    © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effects of pharmacological interventions for preventing weight gain in people with schizophrenia.

  • Pharmacological interventions for reduction of weight gain in people with schizophrenia

    Hahn M., Agarwal S., Ahsan Z., Lockwood J., Duncan M., Takeuchi H., Cohn T., Taylor V., Remington G., Faulkner G.

    Cochrane Database of Systematic Reviews (Cochrane Database of Systematic Reviews)  2019 ( 6 )  2019年06月

     概要を見る

    © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effects of pharmacological interventions for treating weight gain in people with schizophrenia.

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総説・解説等 【 表示 / 非表示

研究発表 【 表示 / 非表示

  • Antipsychotic treatment algorithm for first episode schizophrenia - a guide for clinicians

    竹内 啓善

    EARLY INTERVENTION IN PSYCHIATRY, 2016年10月

  • Depressive Symptoms and Progressive Hippocampal Volume Atrophy Accelerates the Conversion Process to Dementia from Mild Cognitive Impairment

    竹内 啓善

    INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 2016年06月

  • Synergic Effect of Depressive Symptoms and Small Hippocampal Volume Accelerates the Conversion Process to Dementia from Mild Cognitive Impairment

    竹内 啓善

    BIOLOGICAL PSYCHIATRY, 2016年05月

  • Estimated dopamine D2 receptor occupancy from plasma concentrations of atypical antipsychotics and subjective experience/drug attitude in schizophrenia: An analysis of the CATIE data (vol 150, pg 373, 2013)

    竹内 啓善

    SCHIZOPHRENIA RESEARCH, 2015年03月

  • 非定型抗精神病薬の普及度と適応に関する研究

    冨田真幸,渡邊衡一郎,菊地俊暁,竹内啓善,岸本泰士郎,野村健介,中川敦夫,山澤涼子,内田裕之,鈴木健文,野崎昭子,冨田敦子,高野晴成,稲垣中,八木剛平

    第12回日本臨床精神神経薬理学会, 2002年10月, ポスター(一般)

競争的資金等の研究課題 【 表示 / 非表示

  • 投与回数とゲノム薬理学による統合失調症の抗精神病薬アドヒアランス向上戦略

    2018年04月
    -
    2021年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 竹内 啓善, 若手研究, 補助金,  代表

 

担当授業科目 【 表示 / 非表示

  • 精神医学講義

    2020年度

  • 精神病態学各論

    2020年度