• 수면정신생리
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• 제5권2호
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• pp.155-169
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• 1998

Attentional dysfunction is considered as one of the core deficits in schizophrenic process. The findings, pathophysiological mechanisms, and their clinical implications of clinical and experimental neurocognitive tests for the attentional impairment in schizophrenics are reviewed. The influences of psychopathology, antipsychotic treatment, and chronic institutionalization are also included in the review. In contrast, there are only a few evidences that attentional dysfunction would be a core deficit of depressive, manic, and anxiety disorders. Some recent findings of attentional impairment in these disorders are reviewed.

• 신경정신의학
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• 제57권3호
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• pp.230-234
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• 2018

A large proportion of patients with schizophrenia show a poor response to first-line antipsychotic drugs, which is termed treatment-resistant schizophrenia. Previous studies found that a different neurobiology might underlie treatment-resistant schizophrenia, which necessitates the development of different therapeutic approaches for treating treatment-resistant schizophrenia. This study reviewed previous studies on the pathophysiology of treatment-resistant schizophrenia and the pharmacological intervention, and forthcoming investigations of treatment-resistant schizophrenia are suggested.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권1호
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• pp.14-19
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• 2014

Objectives : This study was conducted in order to describe prescribing practices in treatment of pediatric bipolar disorder in a Korean inpatient sample. Methods : We performed a retrospective chart review of 66 youths who had been hospitalized and diagnosed with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition criteria. Demographics, clinical characteristics, medications used, doses, and related adverse events were examined. Results : Mood stabilizers and/or atypical antipsychotic medications were the primary treatment. Risperidone, valproate, and lithium were the most commonly used. Thirty seven patients (58.1%) were treated with combination therapy of an atypical antipsychotic and mood stabilizer for improvement of manic/mixed symptoms. Conclusion : Combination pharmacotherapy was necessary for most patients in this admission sample group. Conduct of further studies will be needed for evaluation of treatment response according to the clinical characteristics, and the safety and efficacy of treatment for child and adolescent bipolar disorder.

• 생물정신의학
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• 제8권1호
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• pp.106-110
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• 2001

Background : Dopamine receptors have been regarded as a strong candidate involved in etiology of schizophrenia and a target for various antipsychotic drugs. The purpose of our study was to investigate whether dopamine $D_1$ receptor(DRD1) gene polymorphisms would predict the treatment response to antipsychotics in schizophrenia. Method : One hundred thirty-four schizophrenic patients, who met DSM-IV criteria for schizophrenia were entered into a 48 -week study. The psychopathology of the patients was assessed at baseline, 12th, 24th 48th weeks of treatment by PANSS. Responders were defined by a 20% of the reduction in total PANSS score at end point. The genomic DNA fragment corresponding to nucleotides of dopamine $D_1$ receptor gene was amplified by polymerase chain reaction(PCR). Result: Neither allelic frequencies nor genotypes for dopamine $D_1$ receptor differed significantly between responders and non-responders. Also, there was no difference of changes of PANSS scores among three genotype groups of the dopamine $D_1$ receptor. Conclusion : Allelic variation in the dopamine $D_1$ gene is not associated with individual differences in antipsychotic response.

• 생물정신의학
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• 제10권2호
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• pp.177-185
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• 2003

Object:We investigated the relationship between prolactin response to antipsychotics and clinical courses of psychotic symptoms and DAT gene polymorphisms. Method:Twenty-four acute psychotic inpatients completed the 12-week trial of risperidone. Serum prolactin, BPRS, ESRS and hyperprolactinemia-related symptoms were measured at baseline, 2, 4, 8 and 12 weeks after medication. The DAT gene polymorphisms were analyzed. Results:The serum prolactin was significantly increased over time. According to the prolactin level at 2-week, the subjects were divided into the severe group(serum prolactin>60ng/mL, N=15) and the mild group (serum prolactin<60ng/mL, N=9). The prolactin levels of the mild group didn't increase beyond 60ng/mL throughout 12 weeks. Severe group had slower decrement of BPRS scores than those of mild group. Six females in severe group complained of irregular menstruations, but no female in mild group. Most patients had 10 allele of DAT gene. Conclusion:This study suggests that the magnitude of prolactin elevation at the 2-week of risperidone medication is correlated with severity of hyperprolactinemia throughout treatments. Our results did not show the relationship between prolactin responses and DAT gene polymorphisms.

• 생물정신의학
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• 제1권1호
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• pp.124-128
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• 1994

항정신병약물 perphenazine 20mg/day, chlorpromazine 100mg/day. trifluoperazine 15mg/day 등을 투여중인 정신분열증 42세 여자 환자에서 심실성 빈맥의 하나인 torsade de pointes이 나타난 사례를 보고한다. 본 환자는 항정신병약물을 복용하여 오던 중 여러차례 실신과 호흡곤란을 경험하였으며, 심전도상에 QT 간격의 연장과 함께 다양한 모양의 QRS 파를 동반한 심실성 빈맥의 소견이 있어 torsade de pointes을 의심할 수 있었다. 심혈관계에 영향이 적은 항정신병약물인 haloperidol로 바꾼 후 부정맥의 소견이 없다가 퇴원 후 haloperidol을 증량하는 과정에 흉부 불편감, 실신의 증상과 함께 QT 간격의 연장이 다시 발생하여 torsade de pointes이 나타난 원인이 항정신병약물 때문이라는 것을 확인할 수 있었다. 항정신병약물을 사용중인 환자에서 발생하는 급사의 원인으로 심실성 빈맥이 가장 흔하게 제기되고 있다. 따라서 항정신병약물을 처방하는 임상의들은 이에 대한 충분한 지식과 주위가 필요할 것으로 생각된다.

• 생물정신의학
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• 제10권1호
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• pp.54-61
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• 2003

Object : This cross-sectional study was performed in order to evaluate the prevalence of tardive dyskinesia among the hospitalized schizophrenic patients. Methods : Four hundred nineteen hospitalized schizophrenic patients(male=263, female=156) were recruited for this study. They were treated with antipsychotics for more than 3 months. The prevalence of tardive dyskinesia was assessed by the Abnormal Involuntary Movement Scale. Results : The prevalence of tardive dyskinesia was 35.6%(Male=36.9%, Female 33.3%). There were no significant differences in the prevalence of tardive dyskinesia among male and female schizophrenic patients. The prevalence of tardive dyskinesia among the patients over 30years old was much higher than those below 30years old. There were no significant correlations between the prevalence of tardive dyskinesia and the duration of hospitalization, the total amount of antipsychotics. The frequently involved parts of the body in the schizophrenic patients who have tardive dyskinesia were tongue, upper extremity, lips and perioral area, jaw, lower extremity, muscles of facial expression trunk, respectively. Conclusions : There was significant correlation between the age and the prevalence of tardive dyskinesia in the antipsychotic-treated schizophrenic patients. There were no correlations between the prevalence of tardive dyskinesia and gender difference, the duration of hospitalization, the total amount of antipsychotics.

• The Korean Journal of Physiology and Pharmacology
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• 제9권1호
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• pp.17-22
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• 2005

We examined whether the abnormal EEG state by NMDA receptor blocker MK-801 can be reversed by typical and atypical antipsychotics differentially by comparing their spectral profiles after drug treatment in rats. The spectral profiles produced by typical antipsychotics chlorpromazine (5 mg/kg, i.p.) and haloperidol (0.5 mg/kg, i.p.) were differ from that by atypical antipsychotic clozapine (5 mg/kg, i.p.) in the rats treated with or without MK-801 treatment (0.2 mg/kg, i.p.) which produce behavioral abnormalities like hyperlocomotion and stereotypy. The dissimilarity between the states produced by antipsychotics and the control state was examined with the distance of the location of the canonical variables calculated by stepwise discriminant analysis with the relative band powers as input variables. Although clozapine produced more different state from normal state than typical antipsychotics, clozapine could reverse the abnormal schizophrenic state induced by MK-801 to the state closer to the normal state than the typical antipsychotics. The results suggest that atypical anesthetic can reverse the abnormal schizophrenic state with negative symptom to the normal state better than typical antipsychotic. The results indicate that the multivariate discriminant analysis using the spectral parameters can help differentiate the antipsychotics with different actions.

• 한국임상약학회지
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• 제30권2호
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• pp.92-101
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• 2020

Background: Delirium is a neuropsychiatric disorder characterized by sudden impairments in consciousness, attention, and perception. The evidence of successful pharmacological interventions for delirium is limited, and medication recommendations for managing delirium are not standardized. This study aimed to provide evidence of antipsychotics for symptomatic treatment of delirium in cancer patients receiving palliative care. Methods: We retrospectively reviewed adult cancer patients in palliative care who received antipsychotic delirium treatment at Severance Hospital between January 2016 and June 2019. The efficacy was evaluated primarily by resolution rates. The resolution of delirium was defined as neurological changes from drowsiness, confusion, stupor, sedation, or agitation to alertness or significant symptomatic improvements described in the medical records. The safety was studied primarily by adverse drug reaction incidence ratios. Results: Of the 63 enrolled patients, 60 patients were included in the statistical analysis and were divided into three groups based on which antipsychotic medication they were prescribed [quetiapine (n=27), haloperidol (n=25) and co-administration of quetiapine and haloperidol (n=8)]. The resolution ratio showed quetiapine to be more effective than haloperidol (p=0.001). No significant differences were seen in adverse drug reaction rates among the three groups (p=0.332). Conclusions: Quetiapine was considered the most effective medication for delirium, with no significant differences in adverse drug reaction rates. Therefore, quetiapine may be considered a first-line medication for treating delirium in cancer patients receiving palliative care. However, further studies comparing more diverse antipsychotics among larger populations are still needed.

• 생물정신의학
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• 제5권1호
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• pp.122-128
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• 1998

본 연구는 만성 정신분열병 여성환자에서 항정신병약물에 대한 estrogen병합투여 효과를 정신병리 측면에서 조사한 것이다. Estrogen 투약군과 대조군으로 나누어 8주에 걸쳐 시행하였고, 그 결과를 PANSS, CGI를 통하여 비교하였다. 8주간의 연구기간 동안 PANSS, CGI모두에서 투약군이 대조군보다 유의한 호전을 보였다. 투약군에서 연구 8주동안의 PANSS 각 소항목군의 변화율은 양성증상 30.52%, 음성증상 15.06%, 일반정신병리증상 13.60%로 양성증상이 다른 군에 비하여 큰 호전을 보였다. 이상의 연구결과는 만성정신분열병의 치료에 있어 기존의 항정신병 약물과 estrogen의 병합투여가 치료적 효과적가 있다는 것을 제시하였다. 또한 estrogen의 항정신병적 효과의 기전은 명확치 않지만, estrogen이 뇌에서 도파민과 세로토닌체계에 영향을 주어 정신분열병의 호전에 기여했을 것으로 추측된다.