• Title/Summary/Keyword: 정신 약물

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Factors Associated with the Use of Over-the-Counter Medications in the Elderly Living Alone (독거노인의 일반의약품 사용에 영향을 미치는 요인)

  • Yoon, Yeosong;Paik, Ki Chung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.172-178
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    • 2018
  • Objectives : This study aimed to describe the use of over-the-counter (OTC) drugs and to identify predictors for their use in the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,099 subjects. Data regarding socio-demographic status, medical condition, cognition, mood disorder and use of OTC drugs were collected using self-administered questionnaire and from a specific semi-structured interview by a trained nurse. Data regarding use of OTC drugs were analyzed using descriptive statistics. Logistic regression analysis was applied to examine factors associated with the use of OTC drugs. Results : The use of OTC drugs were reported by 35.4% of the subjects. Analgesics (13.6%) was the most frequent drugs. Depression (OR=1.10, 95% CI=1.10-1.87) and comorbidities measured by cumulative illness rating scale (CIRS) (OR=1.08, 95% CI=1.03-1.12) were significantly associated with the use of OTC drugs in the elderly living alone. Conclusions : Depression and severity of underlying medical conditions could be a predictor of the use of OTC drugs in the elderly living alone. The clinicians should be vigilant regarding the potential use of nonprescription medications in the elderly.

Adverse Effect of Newer Antidepressant : Nausea and Vomiting, Weight Gain, Sexual Dysfunction - Mechanisms, Epidemiology, and Pharmacological Management - (새로운 항우울제의 부작용: 오심 및 구토, 체중증가, 성 기능장애 - 발병기전, 역학, 약물학적 처치를 중심으로 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.81-92
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    • 2013
  • Newer antidepressants are commonly used in clinical practice to treat psychiatric disorder and psychosomatic disorder including chronic pain syndrome, fibromyalgia, headache. However there are many unexpected adverse effects of these drugs such as nausea and vomiting, weight gain, sexual dysfunction. These are 3 most well-recognized common adverse effects of newer antidepressant and are most common causes of treatment failure. I reviewed mechanisms, epidemiology, and pharmacological management of these adverse effects of newer antidepressants. In this paper, newer antidepressants include selective serotonin reuptake inhibitor(fluoxetine, fluvoxamine, citalopram, escitalopram, sertraline, paroxetine), serotonin norepinephrine reuptake inhibitor(venlafaxine, duloxetine), norepinephrine and dopamine reuptake inhibitor(bupropion), noradrenergic and specific serotonergic antidepressant(mirtazapine), and reversible inhibitor of MAO-A(moclobemide). I suggest that psychiatrists and clinicians in the psychosomatic field should know mechanisms, epidemiology, and management of these common and well-recognized adverse effects of newer antidepressants. Therefore it will be helpful to recognize easily and treat well for patients with psychiatric disorder and psychosomatic disorder using newer antidepressants.

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Non-Pharmacological Interventions for Behavioral and Psychological Symptoms of Neurocognitive Disorder (신경인지장애의 정신행동증상에 대한 비약물학적 개입)

  • Hyun Kim;Kang Joon Lee
    • Korean Journal of Psychosomatic Medicine
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    • v.31 no.1
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    • pp.1-9
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    • 2023
  • Patients with neurocognitive disorder show behavioral psychological symptoms such as agitation, aggression, depression, and wandering, as well as cognitive decline, which puts a considerable burden on patients and their families. For the treatment of behavioral psychological symptoms, patient-centered, non-pharmacological treatment should be used as a first line approach. This paper describes non-pharmacological interventions to manage and treat behavioral psychological symptoms in patients with neurocognitive disorder. In order to control behavioral psychological symptoms such as agitation, depression, apathy, insomnia, and wandering, it is important to identify and evaluate factors such as environmental changes and drugs, and then solve such problems. Non-pharmacological interventions include reassurance, encourage, distraction, and environmental change. It is necessary to understand behavior from a patient's point of view and to approach the patient's needs and abilities appropriately. Reminiscence therapy, music therapy, aroma therapy, multisensory stimulation therapy, exercise therapy, light therapy, massage therapy, cognitive intervention therapy, and pet therapy are used as non-pharmacological interventions, and these approaches are known to improve symptoms such as depression, apathy, agitation, aggression, anxiety, wandering, and insomnia. However, the quality of the evidence base for non-pharmacological approaches is generally lower than for pharmacological treatments. Therefore, more extensive and accurate effectiveness verification studies are needed in the future.

DEVELOPMENTAL PSYCHOPHARMACOLOGY - DEVELOPMENTAL PHARMACOKINETICS, PHARMACODYNAMICS AND PHARMACOGENETICS - (발달학적 정신약물학 - 발달학적 약동학, 약역학 및 약물유전학 -)

  • Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.2
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    • pp.157-173
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    • 2003
  • The history of pediatric psychopharmacology is very short and the research on safety, efficacy and side effects is preliminary and long-term effect on growth and maturation is not well known yet. Clinical findings have shown that the responses to antidepressants, antipsychotics, CNS stimulants and steroids in children and adolescents might be different from adult populations. Based on these findings, this paper reviewed three issues, Firstly, in developmental pharmacokinetics. the author discussed the developmental factors affecting drug absorption, distribution, protein-binding, metabolism and excretion. Secondly, in developmental pharmacodynamics, developmental characteristics of dopamine, serotonin, norepinephrine receptors and their clinical implications were reviewed. Lastly, in pharamcogenetic part, the clinical utility of pharmacogenetics, pharmacokinetic aspects of pharmacogenetics, the pharmacodynamic aspects of pharmacogenetics, the association studies of dopamine-related alleles in neuropsychiatric disorders such as attention-deficit hyperactivity disorders or Tourette’s disorders, pharmacogenetic studies dopamine-related alleles and the pharmacogenetic studies of serotonin-related alleles. Based on these preliminary research, future pharmacogenetic applications in childhood and adolescent psychiatry were also discussed.

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항마약성 약물의 효능검색 (인삼을 중심으로)

  • 김학성
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.281-281
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    • 1994
  • 1) 인삼 엑기스는 morphine의 진통력을 길항하지 않으나 사포닌은 진통력을 길항한다. 2) 인삼 엑기스는 morphine의 내성 및 의존성 형성을 억제한다. 3) 인삼 엑기스는 몰핀의 역내성 (정신독성) 형성을 억제한다. 4. 결론 : Morphine의 진통력 길항작용, 내성 및 의존성 형성 억제 작용, 정신독성 형성억제작용 (자발운동에 대한 역내성 형성 억제 작용)등은 항마약성 약물의 효능검색에 좋은 지표가 될 것으로 사료된다.

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Psychiatric Treatment of Chronic Pain Disorder (만성 통증장애의 정신과적 치료)

  • Rho, Seung-Ho
    • Korean Journal of Psychosomatic Medicine
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    • v.7 no.2
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    • pp.256-262
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    • 1999
  • Because chronic pain disorder may has multiple causes or contributing factors, including physical, psychological, and socio-environmental variables, the treatment of patients with the disorder requires biopsychosocial approaches in a multidisciplinary setting. In treating chronic pain, it is important to address functioning as well as pain, and treatment should be to increase functional capacity and manage the pain as opposed to curing it. Therefore treatment goal should be adaptation to pain or minimizing pain with corresponding greater functioning. Treatment begins with the initial assessment, which includes evaluation of psychophysiologic mechanisms, operant mechanisms, and overt psychiatric comorbidity. Psychiatric treatment of the patients requires adherence to sound pharmacologic and behavioral principles. There are four categories of drugs useful to psychiatrist in the management of chronic pain patients : 1) narcotic analgesics, 2) nonsteroidal antiinflammatory drugs, 3) psychotropic medications, and 4) anticonvulsants, but antidepressants are the most valuable drugs in pharmnacotherpy for them. Psychological treatments tend to emphasize behavioral and cognitive-behavioral modalities, which are divided into self-management techniques and operant techniques. Psychodynamic and insight-oriented therapies are indicated to some patients with long-standing interpersonal dysfunction or a history of childhood abuse.

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A Review on the Cause of Fever During Clozapine Treatment (클로자핀 투약시 나타나는 발열의 원인)

  • Jihye, Song;Sungsuk, Je;Jaejong, Lee;Seungyun, Lee;Seung-Hoon, Lee;Eunyoung, Lee;Hyungseok, So;Hayun, Choi;Jinhee, Choi
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.66-72
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    • 2022
  • Clozapine is accepted as the "gold standard" antipsychotics for treatment-resistant schizophrenia. Clozapine rarely causes extrapyramidal syndrome and tardive dyskinesia, which are common with other antipsychotics, and only a transient elevation of hyperprolactinemia has been reported. Despite such clinical usefulness, there are limitations to the use of clozapine due to adverse drug reactions (ADR). Fever is a common in adverse drug reactions associated with clozapine. At initiation of clozapine most fatal ADR such as agranulocytosis and neuroleptic malignant syndrome associated with fever, in which case clozapine should be discontinued immediately. However, as benign causes of fever are much more frequent than life-threatening ADR, clozapine should not be discontinued unconditionally in the event of fever during clozapine initiation. In addition, fever may occur at any time during the maintenance of clozapine treatment. In particular, since the risk of pneumonia does not decrease over time, and clozapine has a higher risk of pneumonia than other antipsychotic drugs, it is recommended to adjust clozapine dosage through therapeutic drug monitoring.

Pharmacological Treatment of Anxiety Disorders in Medical Illness (내과질환에 동반된 불안증상에 대한 약물치료)

  • Woo, Jong-Min;Lee, Chang-Soo
    • Korean Journal of Psychosomatic Medicine
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    • v.15 no.1
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    • pp.3-6
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    • 2007
  • Anxiety disorders are common illness to general physician. The comorbidity between anxiety disorders and medical illness is not only a diagnostic issue, but also has implications of the course of the disease and its outcome. The comorbid condition requires consideration of each individual illness, their psychological and physiological condition. This article aims to review the literature on the prevalence of anxiety disorders in patients prescribing to psychiatrists and to discuss pharmacological treatment options for patients with a comorbid anxiety disorder and medical illness.

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The Effect of Second-Generation Antipsychotics Administration for 1-Year on the Platelet Activities in Patients With Schizophrenia: Retrospective Study (조현병 환자에서 1년간의 2세대 항정신병약물 지속적 투여가 혈소판 활성도에 미치는 영향: 후향적 연구)

  • Yoon-Seok, Oh;Jong Wook, Lee;Hong-Seok, Oh;Seung-Jun, Kim;Na-Hyun, Lee;Woo Young, Im;Ji-Woong, Kim
    • Korean Journal of Psychosomatic Medicine
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    • v.30 no.2
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    • pp.165-171
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    • 2022
  • Objectives : This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. Methods : The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. Results : The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. Conclusions : This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.

Relationship Between Neurologic Soft Signs and Neuroleptic Treatment in Patients with Schizophrenia (정신분열증에서의 연성 신경학적 증상과 항정신병 약물 치료의 관련성)

  • Chae, Jeong-Ho;Chung, Chan-Ho;Hahm, Woong;Lee, Kyu-Hang;Lee, Chung-Kyoon
    • Korean Journal of Biological Psychiatry
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    • v.1 no.1
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    • pp.117-123
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    • 1994
  • This study was performed to examine the role of neuroleptics may in the development of neurologic soft signs in patients with schizophrenia. Neurologic soft signs were evaluated in 28 neuroleptic naive patients with schizophrenia or schizophreniform disorder and 31 neuroleptic non-naive patients with schizophrenia using a structured tool for measuring neurologic abnormalities, Neurological Evaluation Scale-Korean version(NES-K). Relationship to dose, duration and neurological side effects of neuroleptic treatment were also evaluated. Total scores of NES-K in neuroleptic naive group were significantly higher than those of non-naive group. Scores of motor coordination, sequencing of complex motor acts and others items in functional subcategories were also significantly higher in drug-naive patients. The sensory integration item was not different between two groups. After controlling covariates such ac dose of neuroleptics, age and sex, total scores, motor coordination and others items of NES-K were significantly higher in neuroleptic naive group. However there was no difference between drug naive and non-naive group in the sequencing of complex motor acts item due to effects of these covariates. In neuroleptic non-naive group the dosage of neuroleptics correlated with the motor coordination item, nor were there relationships between duration and side effects of neuroleptic treatment and neurologic soft signs. These findings suggest that neuroleptic treatment may play a only relative role in the development of neurologic soft signs in patients with schizophrenia and these abnormalities may be one of possible trait markers of schizophrenia. To elucidate this opinion, well-controlled, prospective study in same subjects will be helpful.

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