A Case of Improvement to a Depressive State with the Administration of an Antianxiety Drug, Flutoprazepam, During Dental Therapy.

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  • 抗不安薬フルトプラゼパムによるうつ状態の改善と共に進めた歯科治療の１例

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This study describes a case of depressive syndrome for which the antidepressant and classical antianxietic drugs prescribed elsewhere had proven ineffective, but which improved when using the some antianxiety drugs, principally flutoprazepam, during a course of dental therapy at the clinic of the author.<BR>Patient: 58 year old woman (married), independent practice.<BR>First examination: July 3, 1994.<BR>Chief complaint: Dull pain in upper molars, marked fatigue, lumbago and insomnia<BR>History of present illness: The patient complained of depression, the inability to work and sleeplessness due to cohabitation with her single daughter and her daughter's boyfriend. She had received benzodiazepine hypnotic and antianxiety drugs and also an antidepressant drug at a specialists of psychiatric clinic for such disturbances for a period of two years. she had an given insufficient psychosomatic counseling, however, and the syndrome had not improved.<BR>Status praesens: During the first period in the clinic of the author, she sometimes laid on the sofa of the waiting room due to marked fatigue and lumbago, while waiting to receive therapy from the author. However, her main disturbances, including caries affection were not marked, with the exception of hypertension. This was revealed in both physiological and biochemical examinations. In SRQ-D questioning, she scored 24, suggesting a masked depressive or depressive-neurotic state. The author advised her to stop taking the drugs prescribed at the previous psychiatric clinic, and counseled her repeatedly to accept and bear with her complaint, reassuring her that the sickness would heal, for about one hour once or twice every month. The author also continued dental therapy with great care during the period. Lorazepam was administered for three weeks but proved ineffective and then bromazepam for four weeks. This improved the hypertension but did not help so obviously with the other disturbances. Flutoprazepam, on the other hand, the after-drug, improved them considerably. The patient has since met her daughter several times. The current result of SRQ-D questioning, as of October, 1995, is 5, which suggests a normal state. Flutoprazepam administration is being continued at a minimum dosage.

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