Comprehensive research for prevention, treatment, and evaluation of delirium with respect to melatonin and orexin neurotransmission
| Project/Area Number |
17K10342
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Psychiatric science
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| Research Institution | Juntendo University |
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Principal Investigator |
Hatta Kotaro 順天堂大学, 医学部, 教授 (90337915)
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| Co-Investigator(Kenkyū-buntansha) |
中村 裕之 金沢大学, 医学系, 教授 (30231476)
内村 直尚 久留米大学, 医学部, 教授 (10248411)
西村 勝治 東京女子医科大学, 医学部, 教授 (60218188)
岸 泰宏 日本医科大学, 医学部, 准教授 (60256930)
竹内 崇 東京医科歯科大学, 医学部附属病院, 講師 (70345289)
杉田 学 順天堂大学, 医学部, 教授 (20322414)
臼井 千恵 順天堂大学, 医学部, 准教授 (70453587)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000)
Fiscal Year 2019: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
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| Keywords | せん妄 / 予防 / メラトニン / オレキシン / ラメルテオン / スボレキサント / メラトニン受容体 / オレキシン受容体 / 予測 / 治療 / リエゾン精神医学 |
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| Outline of Final Research Achievements |
The aim of this study was to examine the effectiveness of ramelteon (RAM) and suvorexant (SVR) on delirium prevention in real-world practice. We examined whether RAM and/or SVR would affect delirium prevention among both patients at risk for but without delirium (patients-at-risk), and those with delirium (patients-with-delirium) on the night before a consultation. Patients who were age 65 years or older and hospitalized because of acute diseases or elective surgery, had risk factors for delirium, and had insomnia or delirium on the night before the consultation were prescribed RAM and/or SVR. Among 526 patients-at-risk, those taking RAM and/or SVR developed delirium significantly less frequently than those who did not. Similar results were found among 422 patients-with-delirium. RAM and SVR appears to be effective for delirium prevention in real-world practice.
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| Academic Significance and Societal Importance of the Research Achievements |
RCTで実証されているラメルテンおよびスボレキサントのせん妄予防効果が実臨床で大規模に実証された。本研究成果によってせん妄予防的な不眠対策が広く普及すれば、せん妄出現を減らすことができる。これは、せん妄出現の際に一般的に投与される抗精神病薬の使用頻度の減少につながる。抗精神病薬の使用減少は、その副作用としての錐体外路症状とそれに伴う誤嚥性肺炎や心血管性イベントのリスクを減じることにつながり、高齢者にとって著しい利益となる。同時に、従来不眠症に日常的に使用されてきたが転倒骨折やせん妄惹起のリスクがあるベンゾジアゼピン受容体作動薬の投与も減じることにつながり、これも高齢者にとって著しい利益となる。
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Report
(4 results)
Research Products
(42 results)
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[Presentation] Real-world effectiveness of ramelteon and suvorexant on delirium prevention in 967 patients with delirium risk factors2019
Author(s)
Kotaro HATTA, Yasuhiro KISHI, Ken WADA, Takashi TAKEUCHI, Naoko HASHIMOTO, Kiyoko SUDA, Toshihiro TAIRA, Kazuo TSUCHIDA, Takashi OHMORI, Nobuya AKIZUKI, Yuko NISHIO, Yukiko NAKANISHI, Chie USUI, Akiko KURATA, Naoki HORIKAWA, Hiroshi EGUCHI, Shigeo ITO, Hitoshi MUTO, Hiroyuki NAKAMURA, Naohisa UCHIMURA for the DELIRIA-J
Organizer
6th Congress of Asian College of Neuropsychopharmacology (AsCNP)
Related Report
Int'l Joint Research
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[Presentation] Delirium prevention from sleep-wake cycle improvement2018
Author(s)
Hatta K, Kishi Y, Wada K, Takeuchi T, Odawara T, Usui C, Ito S, Kurata A, Murakami K, Nakamura H, for the DELIRIA-J Group
Organizer
WFSBP Asia Pacific Regional Congress of Biological Psychiatry 2018
Related Report
Int'l Joint Research
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