心因性めまいに対する加味帰脾湯

抄録

　There are two types of psychogenic dizziness, the narrowly defined type (pure) and the type with a broader definition. The narrow one refers to pure psychotic dizziness, which is a manifestation of underlying psychiatric disorders, including major depression, anxiety disorder, and somatoform disorder. The latter refers to the symptom mainly arising from vestibular dysfunction, and comorbid psychiatric disorders could modify or cause further deterioration of the severity of dizziness. There are no objective examinations for the diagnosis of psychogenic dizziness. The important steps for the diagnosis are a precise evaluation of the vestibular functions as well as a precise psychiatric evaluation. Questionnaires, including the Japanese version of the Dizziness Handicap Inventory and Japanese version of the Hospital Anxiety and Depression Scale, are useful for the psychiatric evaluation. The characteristic “tear drop” type gravichart in posturography may be useful to define the type of psychogenic dizziness. Kamikihito is one of the herbal drugs originally prescribed for patients with insomnia, anxiety, neuralgia, or anemia. Kamikihito is considered as an anxiolytic in herbal medicine. Patients with psychogenic dizziness can be treated with kamikihito. The dizzy patients who already prescribed benzodiazepines, and patients. Patients with psychogenic dizziness who show poor response to benzodiazepines are potential candidates for treatment with kamikihito. The possible indications for kamikihito are discussed in the text.