Nihon rinsho. Japanese journal of clinical medicine
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In our consumer-oriented society, poor sleep patterns and hectic lifestyle are detrimental to harmonious physiological and metabolic body systems, with severe impact on public health. Circadian rhythms generated by a trillion peripheral cellular clocks throughout the body, governing most aspects of human physiology and behavior, are threatened to be compromised. We recently reported that arrhythmic mice lacking the clock genes Cry1 and Cry2(Cry-null mice) show salt-sensitive hypertension due to abnormally high synthesis of the mineralocorticoid aldosterone in the zoma glomerulosa of the adrenal gland. The clock-controlled enzyme, a new type 3beta-hydroxyl-steroid dehydrogenase, is claimed to be a possible cause of hypertension.
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For the appropriate use of psychotropic drugs, such as hypnotics, antidepressants and antipsychotics, knowledge of the pharmacokinetic characteristics and the interactions of these drugs are required. The mechanisms of drug interaction can be subdivided into pharmacokinetic interactions and pharmacodynamic interactions. ⋯ If such interactions cause an increase of systemic exposure to psychotropic drugs, adverse effects are likely, while a decrease exposure may lead to treatment failure. In this article, we review drug interactions of psychotropic drugs from the viewpoints of clinical evidence, mechanism, and management.
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Suicide rate in Japan is 25/100,000 in a year. The rate is higher than those in other developed countries. Physical illness is a risk factor for suicide. ⋯ In addition, palliative care for distressing physical and psychological symptoms is also important. In process of identification of mental illness and distressing physical symptoms, communications between medical staff and patients are essential. Enhancing communication skills of medical staff may be a key point to prevent suicide.