• Title/Summary/Keyword: 항우울

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Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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A DOUBLE BLIND CROSS-OVER COMPARISON OF ANTIDEPRESSANT AND ANTIANXIETY EFFECTS OF PAROXETINE AND PLACEBO IN CHILD-ADOLESCENT AND ADULT DEPRESSIVE NEUROSIS (소아 ${\cdot}$ 청소년 및 성인 우울신경증 환자에 대한 Paroxetine의 항우울 및 항불안 효과 검증 : 위약과의 이중맹 교차 비교실험)

  • Kim, S. Peter;Hong, Kyung-Sue
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.5 no.1
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    • pp.83-92
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    • 1994
  • Paroxetine is a potent and selective serotoin re-uptake inhibitor. It is well known as an effective and safe antidepressant and increasingly used for neurotic or non-psychotic depression with anxiety symptoms. The present study assessed antidepressant and antianxiety efficacy and tolerability of paroxetine against placebo in child-adolescent and adult depressive neurosis patients. 232 subjects aged 8-55 years and meeting DSM-III-R criteria for depressive neurosis or dysthymia were divided into 8 subgroups according to their sex and age(8-11 yeard old, 12-17 years old, 18-35 years old and 36-55 years old subgroup in each male and female group). In each subgroup, the randomly assigned half of the patients were treated with paroxetine(10-30mg/day) and the others with placebo for the first 2 weeks in double blind fashion. After 1 week of drug-washout period, paroxetine and placebo groups were crossed over. The depression and anxiety symptoms were assessed with Hamilton Depression Scale(HDS) and Hamilton Anxiety Scale(HAS) at baseline and every 1 week during the trial periods. The levels of reduction in HDS and HAS scores from baseline after 2-week trial were compared between paroxetine- and placebo- treated periods by paired t-test. In all the 8 subgroups, statistically significant differences between paroxetine and placebo were found on the antidepressant efficacy after 2-week treatment. The antidepressant efficacy of paroxetine compared to placebo was most prominent in child and adolescent female groups. On anxiety symptoms, paroxetine was also significantly more effective than placebo. The antianxiety efficacy of paroxetine compared to placebo was most prominent in male and female child groups and young adult female group aged 18-35 years. As for the adverse effects of paroxetine, 3 out of 232 subjects reported mild indigestion and abdominal pain. however, in all the 3 cases, the symptoms improved without reduction of dosage or discontinuation of the drug. In conclusion, paroxetine showed significantly higher antidepressant and antianxiety efficacy compared to placebo in child-adolescent and adult depressive neurosis patients after 2-week treatment. Further trials of paroxetine in depressive neurosis are warranted to elucidate the long-term antidepressant and antianxiety efficacy of paroxetine.

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Phosphodiesterase-억제제와 항우울성 약물들의 Thrombin성 혈소판-응집반응에 미치는 억제작용에 관한 연구

  • 최상현;임숙영;김종오;전보권
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.155-155
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    • 1993
  • 항우울약인 rolipran(RP)등 phosphodiesterase-억제 약(PDE-1)들이 thrombin(TB: 0.25 U/ml)에 의한 혈소판 응집에 미치는 작용을 가토-혈소판에서 일차 검토하였다. 신 PDE-1인 KR-30075(KR)의 $IC_{50}$/은 sodim nitroprusside의 것보다 낮았고 PDE-1들은 혈소판내 cAMP와 cGMP를 증가시켰으며 특히 KR은 타 PDE-1와 달리 I $P_3$를 감소시켰다. 아울러 rolipram은 cGMP와 I $P_3$를 증가시켰으나, amitriptyline(AT), sertraline(57), chlorpromazine(CP) 및 spermine은 I $P_3$를 증가시켰다. 그러나 이들과 PDE-1들은 강도의 차이는 있으나 모두 TB에 의한 혈소판응집을 모두 억제하였다. 따라서, PDE-1 중 IBMX(2$\times$$10^{-5}$M), KR(5$\times$10$_-7/M), 및 rolipram(10$_{-3}$M) 그 외에 항우울약인 AT(1.5 $\times$10$_-4/M) 와 ST(10$_-4/M) 및 항정신병약인 CP(10$_-4/M)둥이 혈소판내 I $P_3$, [C $a^{++}$], Tx $B_2$, 및 PG $I_2$ 함량과 단백-인산화의 TB에 의한 변동에 미치는 영향을 검토하였다. 그 결과 TB에 의한 혈소판내 I $P_3$, [C $a^{++}$], Tx $B_2$, 및 PG $I_2$ 함량의 증가가 PDE-1들과 항우울약들에 의하여 억제되었다 단, 항우울성약들과 CP는 정상 혈소판 I $P_3$를 증가시켰다. 아울러 혈소판-단백인산학에서 TB는 41-43 kD와 20 kD의 인산화를 현저히 증가시키며 19 kD의 인산화는 감소시켰고, PKC의 기질인 41-43 kD와 20 kD의 단백인산화가 PDE-1들과 항우울약들 뿐 아니라 CP에 의하여 현저히 억제되었다. 단, 20 kD 인산화에 대한 AT의 억제작용은 미약하였고, cAMP와 PDE-1들은 22kD 인산화를 증가시켰다. AT, ST, 및 CP는 A23187에 의한 41-43 kD 인산화는 현저히 억제하나 20 kD 인산화에는 영향을 미치지 않았고, PMA(3.2$\times$$10^{-7}$ M)에 의한 단백인산화에 대하여는 더 미약한 억제-효과를 나타내었다. 이상의 결과는 PDE-1과 항우울약들의 항혈소판작용은 PKC-기질인 41-43 kD와 20 kD의 인산화를 억제함에 기인되는 것으로 사료된다.다. 것으로 사료된다.다.

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Anti-depressant and anti-anxiety effects of Saccharomyces cerevisiae extract and its hydrolyzed fraction (효모 추출물 SCE 및 그 분획 SCE-40의 항 우울 및 항 불안 효과)

  • Jung, Eun-Yee;Jeong, Min-Suk;Kwon, Young-Bae;Choi, Yoon-Suk;Pyun, Kwang-Ho;Kim, Ki-Won;Shim, In-Sop
    • Science of Emotion and Sensibility
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    • v.10 no.2
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    • pp.243-252
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    • 2007
  • Anti-depressant and anti-anxiety effects of Saccharomyces cerevisiae extract and its hydrolyzed fraction. The purpose of the present study was to examine the effect of Saccharomyces cerevisiae extract (SCE) and its hydrolyzed fraction (SCE-40) on depression and anxiety-related behaviors in mice. Actions of SCE and SCE-40 on serotonin, norepinephrine and GABAergic systems in the rat cerebral cortex membranes were also examined. SCE and SCE-40 significantly reduced the immobility time in the forced swimming and tail suspension test in mice. Duration time of the open arms in the elevated plus maze test was significantly increased in the SCE and SCE-40-treated groups, compared with the saline-treated control group. SCE and its fraction SCE-40 significantly inhibited serotonin and norepinephrine transporter and GABA receptor binding, compared to the saline-treated group. In addition, serotonin and norepinephrine reuptake were significantly suppressed by SCE and SCE-40. These results demonstrate that SCE and SCE-40 produce anti-depressant and anti-anxiety effects through enhancing central serotonin, norepinephrine and GABAergic transmissions. These results suggest that SCE and SCE-40 as functional food might prove to be an effective antidepressant and anti-anxiety agent.

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Clinical Efficacy of Repetitive Transcranial Magnetic Stimulation for Treatment of Depression and Latest Trends in TMS Techniques (반복 경두개자기자극술의 우울증 치료효과 및 최신동향에 대한 고찰)

  • Kim, Shin Tae;Kim, Hae Won;Kim, Se Joo;Kang, Jee In
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.95-109
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    • 2017
  • Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique which can change cortical excitability in targeted area by producing magnetic field pulses with an electromagnetic coil. rTMS treatment has been used to treat various neuropsychiatric disorders including depression. In this review, we evaluate the literature on rTMS for depression by assessing its efficacy on different subtypes of depression and different technical parameters. In particular, we focus on the results of randomized clinical trials and meta-analyses for depression after the US Food and Drug Administration approval in 2008, which acknowledged its efficacy and acceptability. We also review the new forms of rTMS therapy including deep TMS, theta-burst stimulation, and magnetic seizure therapy (MST) that have been under recent investigation. High frequency rTMS over left dorsolateral prefrontal cortex (DLPFC), low frequency rTMS over right DLPFC, or bilateral rTMS is shown to be effective and acceptable in treatment for patients with non-psychotic, unipolar depression either as monotherapy or adjuvant. Deep TMS, theta-burst stimulation and MST are promising new TMS techniques which warrant further research.

The Effects of Saccharomyces Cerevisiae Yeast Extract SCP-20 on Stress Response, Anxiety and Depression : A Double-Blind Placebo-Controlled Trial (Saccharomyces Cerevisiae 효모 추출물 SCP-20의 스트레스 반응, 불안 및 우울에 대한 효과 : 이중 맹검 위약 통제 연구)

  • Lee, Ha-Min;Jung, Young-Eun;Chae, Jeong-Ho
    • Anxiety and mood
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    • v.5 no.1
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    • pp.8-13
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    • 2009
  • Objective : SCP-20, a yeast hydrolysate from Saccharomyces cerevisiae, has exhibited anti-stress, anti-anxiety, and antidepressant effects in animal studies. The objective of this study was to test the effects of SCP-20 on healthy controls and to assess its effects on stress response, depression and, anxiety. Methods : Sixty-one healthy volunteers (30 male, 31 female) were recruited and screened for significant psychiatric and medical conditions. Baseline measures of stress, anxiety, and depression were taken using questionnaires such as the Stress Response Inventory (SRI), Beck's Anxiety Inventory (BAI), Beck's Depression Inventory (BDI), and the physiological measure of heart rate variability (HRV). Each subject was assigned randomly to a group taking capsules containing either 70% SCP-20 (i.e. the SCP70 group), 99.5% SCP-20 (i.e. the SCP99.5 group), or a placebo. Follow up measures were taken at week 4. Results : Subjects taking SCP-20 showed significant improvement in SRI and BAI scores compared to those taking placebo. For BDI scores, there was no significant difference between groups. No significant adverse effects were reported. Conclusions : This study suggests that SCP-20 is effective in alleviating stress and anxiety symptoms in healthy individuals, and has little or no side effects. However, the role of of SCP-20 in alleviating depression needs further clarification. Studiess examining its effects in psychiatric populations are needed to establish its role in alternative medicine.

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항스트레스 식품.소재의 시장동향

  • Seok, Ho-Mun
    • Bulletin of Food Technology
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    • v.20 no.1
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    • pp.215-223
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    • 2007
  • 현대는 누구나 다소 스트레스의 영향 아래 생활하고 있다. 이와 같은 스트레스가 인체에 미치는 영향에 대해서는 최근 상세히 조사.연구되어 불면이나 우울증 등 여러 가지 질병을 일으킨다는 것이 보고되어 있다. 이 중 식품분야에서는 항스트레스 대책의 일환으로서 뇌.신경계에 작용하여 스트레스 완화효과를 기대할 수 있는 GABA나 PS, 아데닌과 같은 기능성소재가 제안되고 있다. 본문에서는 항스트레스를 컨셉트로 한 상품 및 소재의 연구.개발상황에 대해 살펴보고자 하였다.

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The Anti-depressive Effect of Samul-tanggahyangbuja on Chronic Mild Stress in Ovariectomized Rats (만성 스트레스 모델에서 사물탕가향부자의 항우울 효과)

  • Jeong, Ji-Hye;Choi, Chang-Min;Seo, Yun-Jung;Cho, Han-Baek;Kim, Song-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.4
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    • pp.30-47
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    • 2013
  • Objectives: The purpose of the present study is to investigate anti-depressive effects of Samul-tanggahyangbuja (SGH) on ovariectomized and chronic mild stress (CMS) induced rats. Methods: Ovariectomized rats were exposed to CMS for 4 weeks. Changes of depression behavior were tested by using sucrose intake test (SIT), elevated plus maze (EPM), forced swimming test (FST) and Morris water maze test (MWMT) in rats until being orally medicated with SGH (100 or 400 mg/kg/day). In addition, the serum levels of corticosterone (CORT), IL-4, IL-$1{\beta}$ and changes of 5-HT in the brain were measured. Results: 1. SGH 400 mg/kg treated group (SGH 400) significantly increased amount of sucrose intake compared with the control group (p<0.05). 2. SGH 100 mg/kg treated group (SGH 100) and SGH 400 significantly increased the time spent in the open arms of the EPM compared with the control group (p<0.01). SGH 400 also significantly increased the number of crossing of the open and closed arms compared with the control group (p<0.05). 3. SGH significantly shortened the immobility time in FST compared with the control group (SGH 100 p<0.05, SGH 400 p<0.01). 4. SGH significantly increased performance of acquisition trials compared with the control group (p<0.05, on day 4, 5 of SGH 100 and 400). SGH 400 also significantly increased performance of retention trials compared with the control group (p<0.05). 5. The serum levels of corticosterone and IL-4 were not significantly different among the groups. There were no changes on the serum levels of corticosterone, IL-$1{\beta}$ and IL-4 after administration with SGH. 6. SGH 400 significantly increased the level of 5-HT in the hippocampus compared with the control group (p<0.05). SGH significantly increased the levels of 5-HT in the hypothalamus compared with the control group (SGH 100 p<0.05, SGH 400 p<0.01). Conclusions: These results suggest that SGH has the anti-depressive effect on ovariectomized rat and affect 5-HT system rather than hypothalamic-pituitary-adrenal (HPA) axis and immune system.

Role of p11 (S100A10) in Depression and Antidepressant Effects (우울증과 항우울작용에 관한 p11(S100A10)의 역할)

  • Park, Sung Woo;Seo, Mi Kyong;Lee, Jung Goo;Kim, Young Hoon
    • Korean Journal of Biological Psychiatry
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    • v.23 no.1
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    • pp.24-28
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    • 2016
  • p11 protein (S100A10) is downregulated in depressive-like states of human and rodent. Antidepressant drug treatment increases p11 levels in rodent models. We reviewed studies demonstrating that p11 levels are regulated in depression and by antidepressant treatment and that p11 upregulation exerts antidepressant effects. Current studies on p11 underscore the importance of p11 as a potential antidepressant target.