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Biomedical subjects

A Matsuki

Publications and source records attributed to A Matsuki.

At least 127 records · Page 7Linked to original sources
PubMed1999

Prostaglandin E1 produces spasmolytic effects on histamine-induced bronchoconstriction in dogs.

OBJECTIVE: In this study, we evaluated the spasmolytic effect of intravenous prostaglandin (PG) E1 on histamine-induced bronchoconstriction with a direct visualization method using a superfine fiberoptic bronchoscope. SETTING: A university research laboratory. SUBJECTS: Mongrel dogs. INTERVENTIONS: The bronchial cross-sectional area (BCA) of mongrel dogs was measured by a direct visualization method using a superfine fiberoptic bronchoscope. Bronchoconstriction was elicited with histamine (H) infusion: 10 microg/kg iv bolus + 500 microg/kg/h continuous iv. The first protocol (n = 7) was designed to determine the effects of intravenous bolus of PGE1: 0 (saline), 0.01, 0.1, 1.0 and 10 microg/kg on H-induced bronchoconstriction. BCA was assessed before and 30 min after starting the H infusion and 5 min after each dose of intravenous PGE1. The second protocol was designed to determine whether continuous intravenous infusion of PGE1 reverses H-induced bronchoconstriction. In the PG group (n = 6), PGE1 was continuously infused at 0.1 microg/kg/min (20 mL/hr). In the control group (n = 6), saline was administered at a rate of 20 mL/hr iv. BCA was assessed before and 30 min after starting the H-infusion and at 5, 10, 30 and 60 min after commencing the PGE1 or saline infusion. Arterial blood was obtained simultaneously for measurement of plasma concentrations of epinephrine and norepinephrine by gas chromatography mass spectrometry. MEASUREMENTS AND MAIN RESULTS: In the first protocol, PGE1 produced a dose-dependent increase in the percentage of BCA and 10 microg/kg of PGE1 almost fully reversed the H-induced bronchoconstriction. Plasma catecholamines did not change significantly. In the second protocol, continuous infusion of PGE1 produced a time-dependent reversal of H-induced bronchoconstriction (percentage of BCA increased to 80.0+/-9.0% 60 min after the start of PGE1 infusion), whereas saline infusion did not reverse the bronchoconstriction. Plasma catecholamines did not change significantly in either group. CONCLUSIONS: Both intravenous bolus and continuous intravenous infusion of PGE1 reversed the H-induced bronchoconstriction. PGE1 may be used safely for patients with the hyperreactive airway and might be useful as a therapeutic agent for these patients.

Alprostadil↗
PubMed1999

Pituitary-adrenal and parasympathetic function in chronic schizophrenic patients with postoperative ileus or hypotension.

We studied the relationship between parasympathetic, sympathetic and pituitary-adrenal functions in chronic schizophrenic patients with complications such as postoperative paralytic ileus and hypotension during anaesthesia. Plasma epinephrine, norepinephrine (NE), adrenocorticotropin (ACTH), cortisol and the coefficient of variation (CV) of the R-R intervals on the electrocardiogram (ECG) as parasympathetic parameter were measured in schizophrenic and control patients. The CV value of the R-R interval on the ECG before the start of anaesthesia was significantly decreased to 2.3 +/- 0.2 in the schizophrenic patients as compared with 3.5 +/- 0.3 of the control patients. The CV value of the R-R interval on the ECG in schizophrenic patients with postoperative paralytic ileus was more diminished to 1.6 +/- 0.2. The CV values in schizophrenic patients with and without hypotension during anaesthesia were similar and we could not find any significant difference. Chronic schizophrenic patients developed a decrease in NE, ACTH and cortisol responses to surgical stress, while there were no significant differences in these hormonal changes between those patients with and without paralytic ileus and hypotension during anaesthesia. In conclusion, the CV value of the ECG R-R interval may be correlated inversely with the expectancy of postoperative ileus in chronic schizophrenic patients. Their suppressed pituitary-adrenal function and sympathetic system may be indirectly associated with the paralytic ileus and hypotension.

Adrenocorticotropic Hormone↗
PubMed1999

Middle latency auditory evoked potentials during total intravenous anesthesia with droperidol, ketamine and fentanyl.

We investigated whether total intravenous anesthesia with ketamine, fentanyl and droperidol would affect middle latency auditory evoked potentials and explicit memory, and whether dreams during the anesthesia are related to plasma concentrations of fentanyl and the infusion technique. A total number of 40 patients were the subjects for this study. Twenty patients (group A) were maintained with intravenous ketamine 2 mg kg-1 hr-1 and fentanyl 5 micrograms kg-1 hr-1 for the first 60 min and 3 micrograms kg-1 hr-1 for the next 90 min, and droperidol 0.1 mg kg-1. The remaining 20 patients (group B) were maintained with intravenous ketamine 2 mg kg-1 hr-1, droperidol 0.1 mg kg-1 and fentanyl 50-100 micrograms in a bolus intermittently as needed by vital signs such as increases in heart rate and arterial blood pressure. Middle latency auditory evoked potentials, plasma fentanyl and ketamine levels were measured; explicit memory and dreams were also estimated. There were no patients who recollected explicit memories of intraoperative events in both groups. The middle latency auditory evoked potentials were not significantly changed during the anesthesia in both groups. We could find no significant differences in latencies and amplitudes of the middle latency auditory evoked potentials between the both groups. Plasma fentanyl levels of group B patients were significantly lower than those of group A patients and the incidence of the dreams was significantly higher in group B patients. We conclude that the anesthesia with ketamine, fentanyl and droperidol is not associated with the explicit memories, though the middle latency auditory evoked potentials were not significantly changed as compared with those in the waking state. In addition, dreams during the anesthesia may correlate with plasma fentanyl concentrations or the infusion technique.

Adult↗
PubMed1999

[Total intravenous anesthesia for two patients complicated with myotonic dystrophy].

Total intravenous anesthesia with propofol, fentanyl and ketamine (PFK) was given to two patients complicated with myotonic dystrophy. Case-1: A 42-year-old female underwent a hemithyroidectomy. Anesthesia was induced slowly with intravenous ketamine 20 mg and propofol 60 mg. Her tracheal intubation was performed smoothly without any muscle relaxants. Anesthesia was maintained with propofol infusion of 5 mg.kg-1.h-1, ketamine infusion of 0.3 mg.kg-1.h-1 and fentanyl 200 micrograms in total. She regained consciousness 20 minutes after the end of propofol infusion, and 15 minutes later, her trachea was extubated without any troubles. Case-2: A 41-year-old female underwent a removal of left parotid tumor. Anesthesia was induced slowly with ketamine 40 mg and propofol 100 mg intravenously. Anesthesia was maintained with propofol infusion of 5-10 mg.kg-1.h-1, ketamine infusion of 0.5 mg.kg-1.h-1 and fentanyl 350 micrograms in total. No muscle relaxant was used through the surgical procedure. Emergence from anesthesia was observed 10 minutes after the end of propofol infusion and her trachea was extubated. When a nasogastric tube was pulled out, her respiration stopped suddenly and she was intubated again only for two hours without any troubles. In both cases their serum CPK levels and rectal temperatures were very stable. PFK method would be a choice for patients with myotonic dystrophy.

Adult↗
PubMed1999

Expression of genes for proinflammatory cytokines in alveolar macrophages during propofol and isoflurane anesthesia.

UNLABELLED: Anesthesia and surgery induce macrophage aggregation and neutrophil influx, responses that characterize an inflammatory reaction in the distal airway. We thus evaluated the time-dependent expression of genes for proinflammatory cytokines during propofol and isoflurane anesthesia. We studied patients anesthetized with propofol (n = 20) or isoflurane (n = 20). Alveolar macrophages were harvested by bronchoalveolar lavage immediately, 2, 4, and 6 h after induction of anesthesia, and at the end of surgery. RNA was extracted from harvested cells and cDNA was synthesized by reverse transcription. Expression of interleukin-1beta (IL-1beta), IL-6, IL-8, interferon gamma, and tumor necrosis factor-alpha was measured by semiquantitative polymerase chain reaction using beta-actin as an internal standard. We observed two 10-fold increases in gene expression of all proinflammatory cytokines except IL-6. The increases in IL-8 and interferon gamma were 1.5-3 times greater during isoflurane than propofol anesthesia. Expression of the genes for IL-1beta and tumor necrosis factor-alpha was similar with each anesthetic. Our data thus indicate that the pulmonary inflammatory response accompanying anesthesia and surgery is accompanied by the expression of proinflammatory cytokines, and that this expression was in some cases greater during isoflurane than propofol anesthesia. IMPLICATIONS: Gene expression of proinflammatory cytokines in alveolar macrophages increased significantly over time. The increases were greater during isoflurane than propofol anesthesia, suggesting that inflammatory responses at transcriptional levels in alveolar macrophages are modulated by the type and duration of anesthesia.

Anesthesia↗
PubMed1999

New information about Seishu Hanaoka's family tree according to the burial records of Jizoji Temple.

Since Shuzo Kure published his voluminous monograph entitled "Seishu Hanaoka and His Surgery" in 1923, the biography of Hanaoka has been widely studied and two monographs were published in 1964 and 1973 to describe in detail the life and activities of Hanaoka. In spite of these historical studies, for more than seventy years several important persons have been unclarified in the pedigree of the Hanaokas. Recently the author made a repeated survey of two volumes of the burial records of Jizoji temple of Naka town, Wakayama Prefecture. The temple had been the family temple of the Hanaokas during Seishu Hanaoka's lifetime. About one hundred and eight posthumous names, given names, and death dates of the Hanaokas were found in the records, which can be classified into several branches. The most important findings are: 1) the given and posthumous name and death date of Seishu's younger sister (Otane) was identified and another younger sister's posthumous name and death date were guessed with a strong probability; 2) Seishu's third son's death date was identified and the given and necromancy name and, death date of Seishu's third daughter were made clear. In addition, several important findings on Seishu's ancestors are presumed from this investigation of the burial records. These new findings are very useful to understand the background of Hanaoka's study on "Mafutsu-to" and his biography.

Biographies as Topic↗
PubMed1999

On the circumstances of the publication of the 1855 edition of "Roshia Gyuto Zensho" (Russian Vaccination Book).

There is a report that the 1850 edition of "Roshia Gyuto Zensho" (Russian Vaccination Book) translated by Sajuro Baba and edited by Sen-an Riko is not extant and that the 1855 edition of the book is the first edition. The author found an important document entitled "Shichu-Torishimari Zokuruishu - Shoseki-no-bu" at the National Diet Library, which includes several official records describing the publication circumstances of "Roshia Gyuto-Zensho" issued in 1856. This document has scarcely been referred to by medical historians before. It reads as follows: "Ihachi Subaraya, the publisher, asked the magistrate of Edo to permit him to publish and sell two volumes of the translated vaccination book entitled "Roshia Gyuto Zensho" in 1856. The magistrate consulted the members of astronomy division of the Tokugawa Shogunate concerning its possible publication and gave finally a sanction to the publisher after careful consideration. There is a description in the records which shows that two volumes of the 1850 edition were submitted for check, indicating that the 1855 edition is the second and the 1850 edition is the first edition. Behind the situation regarding the granting of permission to the publisher by the Shougunate, there would have been the fact that Sajuro Baba, the translator of the book, was one of the founders of the division of astronomy of the Shogunate.

History, 19th Century↗
PubMed1999

A bibliographical study on Shutei Nakagawa's "Mayaku-ko" (a collection of anesthetics and analgesics)--a comparism of four manuscripts.

The greatest achievement of Seishu Hanaoka, one of the greatest surgeons in the Edo period, was the innovation of an oral general anesthetic called "Mafutsu-San" and its clinical application, however, the detailed circumstances of the innovation remain unkown to us. Shutei Nakagawa, a close friend of Hanaoka, wrote a small pamphlet entitled "Mayaku-ko" in 1796. This brochure is very important for clarifying the process of Hanaoka's study on the general anesthetic. At present I have found four manuscripts of "Mayaku-ku" which are in the Fujikawa Library of Kyoto University, Soda's Library (Personal Library), the Kyo-u Library of Takeda Pharmaceutical Company, and Matsuki's Library (Author's Library). They are classified bibliographically into two groups. The one includes two manuscripts of the Fujikawa Library and Soda's Library, which describe twenty prescriptions. The other two are the manuscripts of Kyo-u and Matsuki's Libraries describing only fourteen recipes. Among them, the Fujikawa's manuscript is the best, because it has a postscript by Yakushi Mori who transcribed this manuscript from the orginal by Shutei Nakagawa. The Fujikawa manuscript has four illustrations of plants in the end of the manuscript which the other three manuscripts lack. As the original manuscript by Nakagawa was lost in a fire in 1867, it is possible to make an accurate reproduction of the original by bibliographical comparison of four extant manuscripts.

Analgesia↗
PubMed1998

Haemodynamic and electroencephalograph responses to intubation during induction with propofol or propofol/fentanyl.

PURPOSE: To observe the changes in EEG bispectral index (BIS), 95% spectral edge frequency (95% SEF) and median frequency (MF) with haemodynamic changes to intubation during induction with propofol or propofol and 2 micrograms.kg-1 fentanyl i.v. METHODS: Twenty four ASA I-II patients were randomized to receive either propofol infusion preceded by normal saline (group P, n = 12) or propofol preceded by 2 micrograms.kg-1 fentanyl (group PF, n = 12). Intubation was performed five minutes after maintenance of BIS within 45 +/- 5. EEG and haemodynamic variables were recorded at before induction, and before and after intubation. RESULTS: Haemodynamic responses to intubation were greater in group P than in group PF (P < 0.05). Postintubation SBP, DBP and HR increased, compared with preinduction values, more in group P than in group PF. Postintubation BIS values increased from 45.5 +/- 3.5 and 44.2 +/- 4.1 to 51.1 +/- 4.1 and 50.9 +/- 5.3 in groups P and PF, respectively, compared with preintubation values. The BIS values were not different between treatment groups before and after intubation, and 95% SEF and MF values did not increase after intubation. CONCLUSION: Fentanyl, 2 micrograms.kg-1 i.v., blunted the haemodynamic responses to intubation, but failed to attenuate the arousal of cerebral cortical activity. The different haemodynamic responses postintubation but similar BIS and 95% SEF changes in the two groups suggest that BIS or 95% SEF cannot predict the haemodynamic responses to intubation during anaesthesia induction with propofol and fentanyl.

Adolescent↗
PubMed1998

Detection of capillary protein leakage by glucose and indocyanine green dilutions during the early post-burn period.

Overestimation of the plasma volume determined by the indocyanine green (ICG) dilution method (PV-ICG) may occur after burns, since this dye has the potential of extravasation in the presence of the capillary protein leakage. Assuming that the initial distribution volume of glucose (IDVG) consistently indicates the extracellular fluid volume of highly perfused organs including plasma, overestimation of the PV-ICG can be detected by a higher PV-ICG/IDVG ratio. The present study was designed to test whether a higher PV-ICG/IDVG ratio is observed within 24 h post-burn compared to the subsequent days. Ten severely burned adult patients admitted to the ICU were studied through the 2nd post-burn day. The daily IDVG and PV-ICG were calculated using a one compartment model by simultaneous administration of glucose, 5 g, and ICG, 25 mg. Although the IDVG increased on the 1st post-burn day (p < 0.05), the PV-ICG remained unchanged. The PV-ICG/IDVG ratio within 24 h post-burn was significantly higher than that on the 1st post-burn day (p < 0.01). Results indicate that overestimation of the PV-ICG can occur within 24 h post-burn and suggest that simultaneous measurement of the IDVG and the PV-ICG would help predict the generalized capillary protein leakage after burns.

Adult↗
PubMed1998

Ratio of indocyanine green and glucose dilutions detects capillary protein leakage following endotoxin injection in dogs.

This study was designed to determine whether endotoxin-induced generalized capillary protein leakage can be detected using the ratio of indocyanine green (ICG) and glucose dilutions. Plasma volume determined by the ICG dilution method (Vd-ICG) and the initial distribution volume of glucose (IDVG) were assessed simultaneously before and after either the administration of lipopolysaccharide (LPS) 0.3 mg kg-1 or equal amounts of isotonic saline in two groups of eight dogs, using a one-compartment model after simultaneous infusions of both ICG 0.5 mg kg-1 and glucose 100 mg kg-1. The IDVG has been shown to indicate the extracellular fluid volume of highly perfused organs including plasma. All post-treatment values decreased compared with the pre-treatment values (P < 0.05), except Vd-ICG in the LPS group, even though the post-treatment total plasma protein concentration of the LPS group decreased significantly compared with the pre-treatment value (P < 0.05). The post-treatment Vd-ICG/IDVG ratio of the saline group remained unchanged compared with that of the pre-treatment, and the post-treatment ratio of the LPS group increased significantly (P < 0.01). It can be concluded that overestimation of the Vd-ICG can occur after endotoxin injection, which can be detected by simultaneous measurements of the Vd-ICG and the IDVG.

Animals↗
PubMed1998

Effects of thiopental on airway calibre in dogs: direct visualization method using a superfine fibreoptic bronchoscope.

Induction of anaesthesia with thiopental sometimes causes bronchospasm. Although the mechanism by which thiopental induces bronchospasm may involve cholinergic stimulation, direct spastic effect and histamine release, the spastic effects of thiopental have not been comprehensively defined. In this study, we have assessed the effect of thiopental on in vivo airway smooth muscle tone using direct visualization method with a superfine fibreoptic bronchoscope as previously reported. Twenty-one mongrel dogs were anaesthetized with pentobarbital (30 mg kg-1) and paralysed with pancuronium (200 micrograms kg-1 h-1). The trachea was intubated with a tube that had a second lumen for insertion of the bronchoscope (od: 2.2 mm) to continuously measure bronchial cross-sectional area. The tip of the bronchoscope was placed between the second and third bronchial bifurcation of the right lung. The dogs were allocated to three groups of seven: group T, A+T, H+T. In group T, thiopental 0 (saline), 0.1, 1.0 and 10 mg kg-1 was given i.v. In group A+T, saline i.v., 5 min later atropine 0.1 mg kg-1 i.v., and 5 min later thiopental 10 mg kg-1 was administered. In group H+T, bronchoconstriction was produced with histamine 10 micrograms kg-1 i.v. followed by infusion at 500 micrograms kg-1 h-1. Thirty minutes later, thiopental 0, 1.0 and 10 mg kg-1 were given. Arterial blood sampling was performed for measurement of plasma catecholamines and histamine. In group T, thiopental significantly reduced bronchial cross-sectional area (maximally by 28.7 (5.6% at 0.5 min after thiopental 10 mg kg-1), which returned to the baseline in 3 min, while any changes in plasma concentrations of catecholamines and histamine were not observed except norepinephrine level at 1 min following thiopental 10 mg kg-1 i.v. Atropine pretreatment completely prevented thiopental-induced bronchospasm in group A+T. In group H+T, thiopental 10 mg kg-1 transiently but significantly decreases bronchial cross-sectional area. Therefore, the present study indicates that the mechanism of thiopental bronchospasm may result from cholinergic nerve stimulation.

Anesthetics, Intravenous↗
PubMed1998

The role of the N-methyl-D-aspartic acid receptor in the relaxant effect of ketamine on tracheal smooth muscle.

UNLABELLED: Ketamine and magnesium (Mg2+), well known bronchodilators, have been used to treat patients with status asthmaticus. Both can block the N-methyl-D-aspartic acid (NMDA) receptor. NMDA receptors exist in the airway, and their activation seems to be linked to the release actions of sensory neuropeptides resulting in increased airway tone. We sought to determine whether ketamine relaxes the guinea pig trachea contracted by histamine by blocking the NMDA receptor. Female guinea pigs (250-400 g) were killed with an overdose of pentobarbital. The trachea was removed and cut spirally into strips 3 mm wide and 15 mm long. The strips were mounted in a 10-mL organ bath filled with Tyrode's solution bubbled through with 95% O2/5% CO2 at 37 degrees C. Strip contractions were measured isometrically with a force displacement transducer. We then studied the effect of NMDA receptor antagonists on histamine-induced tracheal contraction. In this protocol, we examined the effect of ketamine, Mg2+, zinc (Zn2+), or MK-801 (a noncompetitive NMDA receptor blocker) on strips contracted by 10(-5) M histamine. After full contraction was attained, ketamine (0.5-1.5 mM), MgSO4 (2-8 mM), ZnCl2(0.2-0.8 mM), or MK-801 (1.5-6 x 10(-5) M) was added, and the strip tension was measured again. We also studied the effect of NMDA on the relaxation by ketamine. After full contraction by 10(-5) M histamine, 0.5-1.5 mM KET was added alone or in combination with 0.1 mM NMDA, and the strip tension was measured again. Finally, we measured the effect of MK-801 on the relaxant effect of ketamine. After full contraction by 10(-5) M histamine, 0.5-2 mM ketamine was added alone or in combination with 0.75 or 1.5 x 10(-5) M MK-801, and the strip tension was measured again. All NMDA receptor antagonists tested reversed the tracheal contraction induced by histamine in a dose-dependent manner. However, neither the agonist NMDA nor the noncompetitive receptor blocker MK-801 affected tracheal relaxation induced by ketamine. We conclude that ketamine relaxes the tracheal smooth muscle contracted by histamine through a mechanism independent of NMDA receptors. The decreased bronchomotor tone induced by ketamine is probably due to interference with a Ca2+-requiring step necessary to maintain the contraction caused by histamine. IMPLICATIONS: Stimulation of the N-methyl-D-aspartic acid (NMDA) receptor in the airway results in airway constriction. The bronchodilator ketamine blocks the NMDA receptor. However, ketamine relaxes the guinea pig trachea contracted by histamine through a mechanism independent of the NMDA receptor.

Animals↗
PubMed1998

Intraoperative modulation of alveolar macrophage function during isoflurane and propofol anesthesia.

BACKGROUND: Alveolar macrophages are a critical part of the defense against pulmonary infection. Thus the authors determined time-dependent changes in alveolar macrophage functions in patients having surgery who were anesthetized with isoflurane or propofol. METHODS: Patients anesthetized with propofol (n = 30) or isoflurane (n = 30) during orthopedic surgery were studied. Alveolar macrophages were harvested by bronchoalveolar lavage immediately, and 2, 4, and 6 h after induction anesthesia and at the end of surgery. The fraction of aggregated and nonviable macrophages was determined. Then phagocytosis was measured by ingestion of opsonized and unopsonized particles. Finally, microbicidal activity was determined as the ability of the macrophages to kill Listeria monocytogenes directly. RESULTS: Demographic and morphometric characteristics of the patients given propofol and isoflurane were similar, as were their levels of pulmonary function and hemodynamic responses. The fraction of alveolar macrophages ingesting opsonized and unopsonized particles, and the number of particles ingested, decreased significantly over time, with the decrease slightly but significantly greater during isoflurane anesthesia. Microbicidal function decreased progressively during anesthesia and surgery, with the decrease almost twice as great during isoflurane compared with propofol anesthesia. The fraction of aggregated macrophages and recovered neutrophils increased over time in the patients given each anesthetic. CONCLUSIONS: Pulmonary immunologic function changed progressively during anesthesia and surgery. The data from this study suggest that pulmonary defenses are modulated by the type of anesthesia and by the duration of anesthesia and surgery.

Adult↗
PubMed1998

Effect of carbamazepine on pain scores of unipolar depressed patients with chronic pain: a trial of off-on-off-on design.

OBJECTIVE: The purpose of this study was to evaluate the effect of carbamazepine on chronic pain in patients with major depression. DESIGN: Off-on-off-on carbamazepine treatment design. SETTING: Department of Anesthesiology, Hirosaki University Hospital, Japan. PATIENTS: Fifteen patients with a diagnosis of major depression and chronic pain. INTERVENTION: Depressed patients maintained on antidepressants that had failed to help depression or pain were initially placed on 450 mg carbamazepine at 150 mg three times per day. Carbamazepine was then increased until the patients experienced satisfactory relief of pain. This dose was then maintained for 3 weeks. Afterward, the medication was stopped, and a lactose placebo was administered orally three times per day for 3 weeks. Thereafter, carbamazepine was given for 3 additional weeks at the dose that previously produced satisfactory pain relief. OUTCOME MEASURE: Pain scores were assessed four times during the course of the study: before and after the first and the second treatments with carbamazepine, using a visual analog scale in which 0 represents no pain and 10 unbearable pain. The Hamilton Depression scale was used to judge improvement in the symptoms of depression. RESULTS: Carbamazepine produced a statistically significant reduction in the pain scores, from 8.2 +/- 2.3 to 4.0 +/- 1.1 after the first treatment. The pain score significantly increased to 8.0 +/- 1.0 after stopping carbamazepine, but it decreased significantly to 4.1 +/- 1.8 after the second treatment. The Hamilton scores significantly decreased from 27.4 +/- 7.2 to 20.2 +/- 6.1 after the carbamazepine treatment. CONCLUSIONS: These results may indicate that carbamazepine has both an antidepressive and an analgesic action in depressed patients. Thus, carbamazepine may offer an acceptable therapeutic option in depressed patients with chronic pain that is unresponsive to antidepressants. Alternatively, these results may indicate that carbamazepine appears to help depression in this group of pain patients because of its analgesic effect (i.e., helps depression as a result of helping pain or vice versa).

Adult↗