1995 Fiscal Year Final Research Report Summary
Brain cholinergic system and Delirium in the aged
| Project/Area Number |
06670990
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Psychiatric science
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| Research Institution | National Institute of Mental Health, National Center of Neurology and Psychiatry |
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Principal Investigator |
UCHIYAMA Makoto National Institute of Mental Health, Dept.of Psychophysiology section chief, 精神保健研究所, 室長 (20221111)
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| Co-Investigator(Kenkyū-buntansha) |
OZAKI Shigeru National institute of Mental Health, Dept.of Psychophysiology researcher, 神経センター・精神保健研究所, 研究員
SHIRAKAWA Shuichiro National institute of Mental Health, Dept.of Psychophysiology section chief, 神経センター・精神保健研究所, 室長 (20100141)
OKAWA Masako National institute of Mental Health, Dept.of Psychophysiology Director, 神経センター・精神保健研究所, 部長 (80160430)
ISSE Kunihiro Tokyo metropolitan Ebara general Hospital, Director of psychiatry, 精神科, 医長 (30126205)
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| Project Period (FY) |
1994 – 1995
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| Keywords | Delirium / Central cholinergic agent / Drag intoxication / Circadian rhythm / Melatonin rhythm |
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| Research Abstract |
1) Clinical study
We studied consecutive 120 elderly patients (range of age, 60-93y) who developed delirium in a geriatric general hospital. Clinical investigation revealed that 20 cases out of 120 were diagnosed as drug intoxication delirium. Administration of anti-cholinergic agents such as anti-parkinsonian drug, or anti-depressants, were the main cause of drug intoxication delirium (18/20). These results indicate that anti-cholinergic agents may frequently develop delirium in the aged. This study was presented in 19th CINP Congress held in Washington. A part of this study was also published in Neurology.
2) Development of new drug treatment for delirium
We conducted an open trial study to validate an efficacy of tetra-cyclic antidepressant mianserin on symptoms of delirium in the aged. Subjects were 62 elderly patients with delirium. We found that mianserin had favorable effect on delirium and that this efficacy may be related to the drug's less anti-cholonergic property. This study w
… More
as submitted and accepted for publication in Progress in Neuro-Psychopharmacology and Biological Psychiatry (in press 1996).
3) Proposal of possible newer treatment for delirium
We aimed to activate human cholinergic system in the brain. We found that vitamin B12 was the safest drug among central cholinergic agents available in Japan. We administered vitamin B12 on healthy normal volunteers and assessed its effect on the circadian rhythm. We found that vitamin B12 enhanced the amplitude of circadian rhythm and increased the vigilance of the daytime. This property of vitamin B12 may be applicable to treatment of delirium because most patients with delirium displayd disturbances of the circadian rhythm.
4) Estrogen as a central cholinergic enhancer
Delirium is one of the most frequent symptoms in demented elderly. We administered estrogen on demented female patients. We found that this hormone had a property to ameliorate the symptoms of dementia including delirium. We postulated that this property may be related to estrogen's activating effect on cholin acetyl transferase in the brain. Less
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