{"id":751,"date":"2016-09-02T02:31:10","date_gmt":"2016-09-01T17:31:10","guid":{"rendered":""},"modified":"2025-07-01T16:21:49","modified_gmt":"2025-07-01T07:21:49","slug":"ezzrv","status":"publish","type":"post","link":"https:\/\/www.kusurinomadoguchi.com\/column\/articles\/ezzrv\/","title":{"rendered":"\u85ac\u5264\u5e2b\u304c\u8a9e\u308b\u300c\u30ec\u30af\u30b5\u30d7\u30ed\u306f\u592a\u308b\u300d\u306f\u8003\u3048\u306b\u304f\u30442\u3064\u306e\u6839\u62e0"},"content":{"rendered":"
\n

\u76ee\u6b21\uff1aEBM\u85ac\u5264\u5e2b\u304c\u8a9e\u308b\u300c\u30ec\u30af\u30b5\u30d7\u30ed\u306f\u592a\u308b\u300d\u306f\u8003\u3048\u306b\u304f\u30442\u3064\u306e\u6839\u62e0<\/h2>\n<\/div>\n
\n
\u2460\u6709\u52b9\u6210\u5206
\u2461\u4f5c\u7528\u30e1\u30ab\u30cb\u30ba\u30e0
\u2462\u4f7f\u7528\u3067\u304d\u308b\u75c5\u6c17
\u2463\u85ac\u306e\u5f62
\u2464\u7279\u5fb4
\u2465\u6cbb\u7642\u52b9\u679c
\u2466\u526f\u4f5c\u7528\u300c\u592a\u308b\u300d\u304c\u8003\u3048\u306b\u304f\u30442\u3064\u306e\u6839\u62e0
\u2467\u307e\u3068\u3081<\/div>\n<\/div>\n
\n

\u2460\u30ec\u30af\u30b5\u30d7\u30ed\u306e\u6709\u52b9\u6210\u5206\u306f\u300c\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u300d<\/h2>\n<\/div>\n
\n
\u30ec\u30af\u30b5\u30d7\u30ed\u306e\u6709\u52b9\u6210\u5206\u306f\u300c\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u300d\u3068\u3044\u3044\u307e\u3059 (1)\u3002<\/p>\n

\u3053\u306e\u85ac\u306f\u3001\u3082\u3068\u3082\u3068\u30c7\u30f3\u30de\u30fc\u30af\u3067\u958b\u767a\u3055\u308c\u305f\u300c\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u300d\u3068\u3044\u3046\u85ac\u306e\u93e1\u50cf\u7570\u6027\u4f53\u306e\u3046\u3061\u3001S\u4f53\u3060\u3051\u3092\u53d6\u308a\u51fa\u3057\u305f\u3082\u306e\u3067\u3059 (2)\u3002\u300c\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u300d\u306e\u300c\u30a8\u30b9\u300d\u4f53\u306a\u306e\u3067\u3001\u300c\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u300d\u3068\u540d\u4ed8\u3051\u3089\u308c\u307e\u3057\u305f\u3002<\/p><\/div>\n<\/div>\n

\n

\u2461\u30ec\u30af\u30b5\u30d7\u30ed\uff08\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\uff09\u306e\u4f5c\u7528\u30e1\u30ab\u30cb\u30ba\u30e0<\/h2>\n<\/div>\n
\n

\u30bb\u30ed\u30c8\u30cb\u30f3\u306e\u518d\u53d6\u308a\u8fbc\u307f\u3092\u963b\u5bb3\u3059\u308b<\/h3>\n<\/div>\n
\n
\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306f\u3001\u300c\u9078\u629e\u7684\u30bb\u30ed\u30c8\u30cb\u30f3\u518d\u53d6\u308a\u8fbc\u307f\u963b\u5bb3\u5264 (SSRI)\u300d\u3068\u547c\u3070\u308c\u308b\u30b0\u30eb\u30fc\u30d7\u306b\u5c5e\u3059\u308b\u6297\u3046\u3064\u85ac\u3067\u3059\u3002<\/p>\n

\u3053\u308c\u306f\u3001\u4ee5\u524d\u306e\u8a18\u4e8b\u3067\u7d39\u4ecb\u3057\u305f\u3001\u795e\u7d4c\u4f1d\u9054\u7269\u8cea\u3067\u3042\u308b\u300c\u30bb\u30ed\u30c8\u30cb\u30f3\u300d\u306e\u30b7\u30ca\u30d7\u30b9\u304b\u3089\u306e\u518d\u53d6\u308a\u8fbc\u307f\u3092\u963b\u5bb3\u3059\u308b\u52b9\u679c\u306e\u3042\u308b\u85ac\u3067\u3059\u3002<\/p>\n

\u8133\u306e\u30b7\u30ca\u30d7\u30b9\u306b\u304a\u3051\u308b\u30bb\u30ed\u30c8\u30cb\u30f3\u306e\u6e1b\u5c11\u306f\u3001\u3046\u3064\u75c5\u306e\u75c7\u72b6\u3092\u5f15\u304d\u8d77\u3053\u3057\u307e\u3059 (3)\u3002\u305d\u306e\u305f\u3081\u3001\u518d\u53d6\u308a\u8fbc\u307f\u3092\u963b\u5bb3\u3059\u308b\u3053\u3068\u3067\u3001\u30bb\u30ed\u30c8\u30cb\u30f3\u306e\u91cf\u3092\u5897\u3084\u3059\u3053\u3068\u3092\u76ee\u7684\u3068\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u4ee5\u524d\u306e\u8a18\u4e8b\u3067\u7d39\u4ecb\u3057\u305fSNRI\u306f\u3001\u30bb\u30ed\u30c8\u30cb\u30f3\u3068\u30ce\u30eb\u30a2\u30c9\u30ec\u30ca\u30ea\u30f3\u3068\u3044\u30462\u3064\u306e\u795e\u7d4c\u4f1d\u9054\u7269\u8cea\u306b\u4f5c\u7528\u3057\u307e\u3057\u305f\u304c\u3001SSRI\u306f\u3082\u3063\u3071\u3089\u30bb\u30ed\u30c8\u30cb\u30f3\u306b\u306e\u307f\u4f5c\u7528\u3059\u308b\u306e\u304c\u7279\u5fb4\u3067\u3059\u3002<\/p><\/div>\n<\/div>\n

\n
\n
\n
SNRI\u306b\u3064\u3044\u3066\u306f\u3053\u3061\u3089<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n
\n

\u2462\u30ec\u30af\u30b5\u30d7\u30ed\u304c\u4f7f\u7528\u3067\u304d\u308b\u75c5\u6c17<\/h2>\n<\/div>\n
\n
2016\u5e74\u73fe\u5728\u3001\u30ec\u30af\u30b5\u30d7\u30ed\u304c\u4f7f\u7528\u3067\u304d\u308b\u75c5\u6c17\u306f\u3001\u4ee5\u4e0b\u306e2\u3064\u3067\u3059 (1)\u3002<\/p>\n

\u25cf\u3046\u3064\u75c5\u30fb\u3046\u3064\u72b6\u614b
\u25cf\u793e\u4f1a\u4e0d\u5b89\u969c\u5bb3<\/div>\n<\/div>\n

\n

\u2463\u30ec\u30af\u30b5\u30d7\u30ed\u306e\u5264\u5f62\uff08\u85ac\u306e\u5f62\uff09<\/h2>\n<\/div>\n
\n
\u73fe\u5728\u3001\u65e5\u672c\u3067\u4f7f\u7528\u3055\u308c\u3066\u3044\u308b\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306e\u5264\u5f62\u306f\u300110mg\u306e\u9320\u52641\u7a2e\u985e\u3060\u3051\u3067\u3059\u3002
\u307e\u305f\u3001\u30b8\u30a7\u30cd\u30ea\u30c3\u30af\u533b\u85ac\u54c1\u3082\u767a\u58f2\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3002<\/div>\n<\/div>\n
\n

\u2464\u30ec\u30af\u30b5\u30d7\u30ed\uff08\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\uff09\u306e\u7279\u5fb4<\/h2>\n<\/div>\n
\n
SSRI\u306b\u306f\u3001\u305f\u304f\u3055\u3093\u306e\u7a2e\u985e\u304c\u3042\u308a\u307e\u3059\u304c\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306f\u4ed6\u306eSSRI\u3068\u3069\u3046\u3044\u3063\u305f\u70b9\u304c\u7570\u306a\u308b\u306e\u3067\u3057\u3087\u3046\u304b\u3002<\/p>\n

\u305d\u306e\u7279\u5fb4\u306f\u3001\u3072\u3068\u3053\u3068\u3067\u3044\u3048\u3070\u3001\u6700\u521d\u304b\u3089\u91cf\u3092\u5909\u3048\u305a\u306b\u4f7f\u3048\u308b\u3001\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n

\u3068\u3044\u3046\u306e\u3082\u4ed6\u306eSSRI\u306f\u3001\u6700\u521d\u306f\u5c11\u91cf\u304b\u3089\u521d\u3081\u3066\u3001\u5f90\u3005\u306b\u91cf\u3092\u5897\u3084\u3059\u4f7f\u3044\u65b9\u3092\u3059\u308b\u306e\u3067\u3059 (4, 5)\u3002\u3053\u308c\u306f\u3001\u4f7f\u7528\u958b\u59cb\u76f4\u5f8c\u306f\u85ac\u306b\u8eab\u4f53\u304c\u6163\u308c\u3066\u304a\u3089\u305a\u3001\u5410\u304d\u6c17\u306a\u3069\u306e\u526f\u4f5c\u7528\u3092\u751f\u3058\u3084\u3059\u3044\u305f\u3081\u3067\u3059\u3002<\/p>\n

\u3053\u308c\u306b\u5bfe\u3057\u3066\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306f\u6700\u521d\u304b\u30891\u65e51\u56de10mg\u3092\u5915\u98df\u5f8c\u306b\u4f7f\u7528\u3067\u304d\u307e\u3059 (1)\u3002\u3082\u3061\u308d\u3093\u3001\u85ac\u306e\u52b9\u679c\u304c\u306a\u3044\u5834\u5408\u3001\u5897\u91cf\u3059\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u304c\u3001\u3053\u306e\u91cf\u306e\u307e\u307e\u901a\u5e38\u306f\u7d99\u7d9a\u3057\u307e\u3059\u3002<\/p>\n

\u305d\u306e\u305f\u3081\u3001\u3057\u3087\u3063\u3061\u3085\u3046\u98f2\u3080\u91cf\u3092\u8abf\u7bc0\u3057\u306a\u304f\u3066\u6e08\u3080\u5206\u3001\u624b\u9593\u304c\u6e1b\u308b\u308f\u3051\u3067\u3059\u3002\u60a3\u8005\u3055\u3093\u306b\u3057\u3066\u307f\u3066\u3082\u3001\u3053\u308d\u3053\u308d\u3068\u4f7f\u3044\u65b9\u304c\u5909\u308f\u308b\u306e\u306f\u6df7\u4e71\u306e\u3082\u3068\u306a\u306e\u3067\u3001\u3053\u308c\u306f\u30e1\u30ea\u30c3\u30c8\u3067\u3059\u3002<\/p><\/div>\n<\/div>\n

\n

\u2465\u30ec\u30af\u30b5\u30d7\u30ed\uff08\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\uff09\u306e\u6cbb\u7642\u52b9\u679c<\/h2>\n<\/div>\n
\n

\u3046\u3064\u75c5\u30fb\u3046\u3064\u72b6\u614b\u306b\u5bfe\u3059\u308b\u52b9\u679c<\/h3>\n<\/div>\n
\n
\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306e\u6cbb\u7642\u52b9\u679c\u306f\u3001\u4ed6\u306e\u6297\u3046\u3064\u85ac\u3068\u6bd4\u8f03\u3057\u3066\u3001\u512a\u52a3\u304c\u3042\u308b\u306e\u3067\u3057\u3087\u3046\u304b\uff1f<\/p>\n

\u7d50\u8ad6\u3092\u3044\u3048\u3070\u3001\u3053\u308c\u3068\u3044\u3063\u305f\u52b9\u679c\u306e\u5dee\u306f\u306a\u3044\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u3068\u3044\u3046\u3088\u308a\u3082\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u3092\u542b\u3081\u305fSSRI\u3068\u3001SNRI\u306a\u3069\u306e\u6297\u3046\u3064\u85ac\u306f\u3001\u3069\u308c\u3082\u6cbb\u7642\u52b9\u679c\u306e\u70b9\u3067\u306f\u5927\u5dee\u304c\u306a\u3044\u3068\u77e5\u3089\u308c\u3066\u3044\u307e\u3059 (6, 7)\u3002<\/p>\n

\u305d\u306e\u305f\u3081\u3001\u6709\u52b9\u6027\u306e\u89b3\u70b9\u304b\u3089\u3001\u7279\u5b9a\u306e\u85ac\u306b\u3053\u3060\u308f\u308b\u5fc5\u8981\u306f\u7279\u306b\u3042\u308a\u307e\u305b\u3093\u3002<\/p><\/div>\n<\/div>\n

\n

\u4e0d\u5b89\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u52b9\u679c<\/h3>\n<\/div>\n
\n
\u3053\u3061\u3089\u306b\u3064\u3044\u3066\u3082\u3001\u4ed6\u306eSSRI\u3068\u306e\u5927\u304d\u306a\u52b9\u679c\u306e\u9055\u3044\u306f\u77e5\u3089\u308c\u3066\u3044\u307e\u305b\u3093\u3002<\/p>\n

\u30d7\u30e9\u30b7\u30fc\u30dc\u3068\u6bd4\u8f03\u3057\u305f\u5834\u5408\u306b\u306f\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u306e\u65b9\u304c\u660e\u3089\u304b\u306b\u52b9\u679c\u306f\u9ad8\u3044\u306e\u3067\u3059\u304c (8)\u3001SSRI\u540c\u58eb\u3067\u306f\u307b\u3068\u3093\u3069\u5909\u308f\u3089\u306a\u3044\u3068\u8003\u3048\u3066\u3001\u73fe\u72b6\u306f\u554f\u984c\u306a\u3044\u3067\u3057\u3087\u3046\u3002<\/p>\n

2008\u5e74\u3068\u3084\u3084\u53e4\u3044\u6587\u732e\u306b\u306f\u306a\u308a\u307e\u3059\u304c\u3001\u751f\u7269\u5b66\u7684\u7cbe\u795e\u533b\u5b66\u4f1a\u4e16\u754c\u9023\u5408 (WFSBP) \u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u3082\u3001\u30a8\u30b9\u30b7\u30bf\u30ed\u30d7\u30e9\u30e0\u3092\u542b\u3081\u305f\u3059\u3079\u3066\u306eSSRI\u304c\u3001\u3082\u3063\u3068\u3082\u63a8\u5968\u5ea6\u306e\u9ad8\u3044\u300cRecommendation Grade 1\u300d\u306b\u5206\u985e\u3055\u308c\u3066\u3044\u307e\u3059 (9)\u3002<\/p><\/div>\n<\/div>\n

\"ezzrv\"<\/p>\n

\n

\u300c\u4f53\u91cd\u3084\u98df\u6b32\u304c\u5897\u3048\u308b\u300d\u304c\u79d1\u5b66\u7684\u306b\u8003\u3048\u306b\u304f\u30442\u3064\u306e\u6839\u62e0<\/h3>\n<\/div>\n
\n
\u3053\u306e\u8a18\u4e8b\u3092\u66f8\u304f\u306b\u3042\u305f\u3063\u3066\u3001Google\u3067\u300c\u30ec\u30af\u30b5\u30d7\u30ed\u300d\u3068\u691c\u7d22\u3092\u304b\u3051\u3066\u307f\u305f\u3068\u3053\u308d\u3001\u300c\u30ec\u30af\u30b5\u30d7\u30ed\u3000\u592a\u308b\u300d\u3068\u3044\u3046\u8907\u5408\u30ad\u30fc\u30ef\u30fc\u30c9\u304c\u51fa\u3066\u304d\u307e\u3057\u305f (10)\u3002<\/p>\n

\u30d2\u30c3\u30c8\u3057\u305f\u30a6\u30a7\u30d6\u30b5\u30a4\u30c8\u306e\u3044\u304f\u3064\u304b\u3092\u8997\u3044\u3066\u307f\u305f\u3068\u3053\u308d\u3001\u3069\u3046\u3082\u30ec\u30af\u30b5\u30d7\u30ed\u3092\u542b\u3081\u305fSSRI\u3092\u670d\u7528\u3059\u308b\u3068\u592a\u308b\u3001\u3068\u4e00\u90e8\u3067\u306f\u4fe1\u3058\u3089\u308c\u3066\u3044\u308b\u3088\u3046\u3067\u3059\u3002<\/p>\n

\u5b9f\u969b\u306b\u670d\u7528\u3057\u305f\u500b\u3005\u4eba\u306e\u4f53\u9a13\u8ac7\u3092\u5426\u5b9a\u3059\u308b\u6c17\u306f\u3042\u308a\u307e\u305b\u3093\u304c\u3001\u5ba2\u89b3\u7684\u306a\u30c7\u30fc\u30bf\u3092\u53c2\u7167\u3059\u308b\u306b\u3001\u79d1\u5b66\u7684\u306b\u306f\u3053\u3046\u3057\u305f\u3053\u3068\u306f\u8003\u3048\u306b\u304f\u3044\u3068\u3044\u308f\u3056\u308b\u3092\u5f97\u307e\u305b\u3093\u3002<\/p>\n

\u305d\u306e\u6839\u62e0\u306f\u5927\u304d\u304f2\u3064\u3042\u308a\u307e\u3059\u30021\u3064\u76ee\u306f\u3001SSRI\u304c\u4f53\u91cd\u3084\u98df\u6b32\u5897\u52a0\u306b\u76f4\u63a5\u3064\u306a\u304c\u308b\u4f5c\u7528\u30e1\u30ab\u30cb\u30ba\u30e0\u3092\u6709\u3057\u3066\u3044\u306a\u3044\u3068\u3044\u3046\u7406\u8ad6\u7684\u306a\u6839\u62e0\u3002\u3082\u30461\u3064\u306f\u3001\u5b9f\u969b\u306b\u4f7f\u7528\u3057\u3066\u4f53\u91cd\u5897\u52a0\u306b\u3064\u3044\u3066\u691c\u8a0e\u3055\u308c\u305f\u81e8\u5e8a\u7814\u7a76\u3092\u3082\u3068\u306b\u3057\u305f\u6839\u62e0\u3067\u3059\u3002<\/p><\/div>\n<\/div>\n

\n

\u672c\u6765\u3067\u3042\u308c\u3070\u98df\u6b32\u306f\u6e1b\u308b\u306f\u305a<\/h3>\n<\/div>\n
\n
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\n

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\n

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\n

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\n

\u53c2\u8003\u6587\u732e<\/h2>\n<\/div>\n
\n
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(4) \u30eb\u30dc\u30c3\u30af\u30b9\u9320\u3000\u6dfb\u4ed8\u6587\u66f8\u3000\u30a2\u30c3\u30f4\u30a3\u5408\u540c\u4f1a\u793e
(5) \u30d1\u30ad\u30b7\u30eb\u9320\u3000\u6dfb\u4ed8\u6587\u66f8\u3000\u30b0\u30e9\u30af\u30bd\u30fb\u30b9\u30df\u30b9\u30af\u30e9\u30a4\u30f3\u682a\u5f0f\u4f1a\u793e<\/div>\n<\/div>\n
\n
(6) Hansen R, t al. Meta-analysis of major depressive disorder relapse and recurrence with second-generation antidepressants. Psychiatr Serv. 2008 Oct;59(10):1121-30. PMID: 18832497
(7) \u65e5\u672c\u3046\u3064\u75c5\u5b66\u4f1a\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30f3 \u65e5\u672c\u3046\u3064\u75c5\u5b66\u4f1a\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30f3 \u2161.\u3046\u3064\u75c5\uff08DSM -5\uff09\/ \u5927\u3046\u3064\u75c5\u6027\u969c\u5bb3 2016<\/div>\n<\/div>\n
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(8) Baldwin DS, et al. Efficacy of escitalopram in the treatment of social anxiety disorder: A meta-analysis versus placebo. Eur Neuropsychopharmacol. 2016 Jun;26(6):1062-9. PMID: 26971233
(9) Bandelow B, et al. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders – first revision. World J Biol Psychiatry. 2008;9(4):248-312. PMID: 18949648
(10) Google\u691c\u7d22\u3000https:\/\/www.google.co.jp\/<\/a>
(11) Lam DD, et al. Serotonin 5-HT2C receptor agonist promotes hypophagia via downstream activation of melanocortin 4 receptors. Endocrinology. 2008 Mar;149(3):1323-8. Epub 2007 Nov 26. PMID: 18039773<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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