• 대한상한금궤의학회지
• /
• 제6권1호
• /
• pp.79-88
• /
• 2014

Objective : We report efficacy of Daeseunggi-tang on auditory hallucination in schizophrenia. From this, we can expect therapeutic possibility of herbal medicine chosen by 'A disease pattern identification diagnostic system based on Shanghanlun provisions' in schizophrenia. Methods : Daeseunggi-tang written in YangMyeong-JiWiByeong is applied to 31-year-old patient who diagnosed as schizophrenia and hospitalized for 3months taking antipsychotics. The patient was treated for a year. Results : Scores in Auditory Hallucination appended to PANSS and K-BDI were highly decreased. The patient takes no antipsychotics anymore for now. Conclusions : Auditory hallucination in Schizophrenia which needs antipsychotics can be managed by herbal medicine chosen by 'A disease pattern identification diagnostic system based on Shanghanlun provisions'.

• 수면정신생리
• /
• 제17권1호
• /
• pp.5-10
• /
• 2010

Restless legs syndrome (RLS) is a common sensorimotor disorder that is characterized by an urge to move the legs and peculiar, unpleasant sensations deep in the legs and its prevalence in the general population is between 3.2% and 15%. RLS significantly impairs patients' lives, often by severely disrupting sleep. However, both clinicians and patients under-recognize the RLS. RLS phenotypes include an idiopathic form and secondary form that is usually resulted from various causative conditions. The pathophysiology of RLS may be related with the dopaminergic system, which is closely linked to a number of psychotropic medications, including antidepressant and antipsychotics. Several antidepressants and antipsychotics have been shown to induce or exacerbate RLS. We need pay attention to the fact that commonly prescribed medications can be the cause of RLS.

• 대한조현병학회지
• /
• 제24권1호
• /
• pp.36-43
• /
• 2021

Objectives: Despite the high discontinuation rate of clozapine in refractory schizophrenia, there is limited evidence regarding the suggested treatment after clozapine discontinuation. Methods: The medical records of 37 patients who discontinued clozapine were retrospectively reviewed. The prescription patterns of antipsychotics, mood stabilizers, and antidepressants were compared at three points before and after clozapine treatment and at the most recent visit. Results: After clozapine discontinuation, 75.6% of the subjects were receiving antipsychotic polypharmacy, and 32.4% were taking more than 3 antipsychotics. The frequently used antipsychotics were olanzapine (21.5%), quetiapine (21.5%), and paliperidone (12.7%). The rates of augmentation with mood stabilizers and antidepressants were 43.2% and 29.7%, respectively. Furthermore, valproate was the most commonly used mood stabilizer (87.5%). Conclusion: Antipsychotic polypharmacy and augmentation are inevitable in schizophrenia patients for whom clozapine has been discontinued. Further research is required to improve the outcomes of polypharmacy and augmentation in schizophrenia patients.

• 대한간호학회지
• /
• 제35권3호
• /
• pp.526-534
• /
• 2005

Purpose: This study was designed to investigate the effects of a network program to prevent obesity and improve dietary habits for patients taking antipsychotics or antidepressants. Method: Thirty-seven patients in two hospitals were assigned to a control group (21 patients) or an intervention group ( 16 patients). The intervention group was evaluated to analyze the effect of the network program for six weeks after the program. Result: There was a difference in the rate of increased body weight between the control group and the intervention group. Notably, the body weight of both groups before the intervention was significantly increased. However, after the intervention the body weight of the intervention group rarely increased, whereas, the body weight of the control group was significantly increased as expected. There was an observed difference in diet between the control group and the intervention group. After the intervention, caloric intake per day of the intervention group decreased. Also, the duration of the meal of the intervention group after the intervention was longer than before. Conclusion: The network program for preventing obesity and improving dietary habits of patients taking antipsychotics or antidepressants was effective. The study shows that a network program can be an important part of a nursing intervention in clinical practice.

• 한국임상약학회지
• /
• 제30권2호
• /
• pp.92-101
• /
• 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
• /
• 제7권1호
• /
• pp.14-20
• /
• 2000

Recently atypical antipsychotics have been used as first line agent in the treatment of schizophrenia, and also played a significant role in the treatment of many kinds of psychiatric disorders. The pharmacokinetic and pharmacodynamic properties of these newer antipsychotics are well known through preclinical and early clinical trials. However, it is important to note the limitations of the results due to its relatively short experience. Clozapine is eliminated principally by the hepatic P450 1A2 and 3A4 cytochrome enzymes. 1A2 inducers such as carbamazepine and smoking can reduce its half-life, while 1A2 inhibitors such as SSRIs, especially fluvoxamine can increase its duration of action. Carbamazepine should be avoided in a patient on clozapine because of carbamazepine's potential effects on bone marrow. Benzodiazepines tend to increase the chances of sedation, delirium and respiratory depression. Risperidone is metabolized to 9-hydroxyriperidone by the hepatic P450 2D6 cytochrome enzymes. Fluoxetine and paroxetine, 2D6 inhibitors interfere with metabolism, but 9-hydroxyrisperidone has similar biological activity as parental drug, so it has little affect on the outcome. Olanzapine shows minimal capacity to inhibit cytochrome P450 isoenzymes and shows minimal chance of drug interaction. It is eliminated principally by the hepatic P450 1A2 and 2D6 cytochrome enzymes.

• 생물정신의학
• /
• 제21권2호
• /
• pp.49-56
• /
• 2014

Objectives Previous literature on the prescription change among patients with schizophrenia mainly focused on antipsychotics. This study investigated chronological change in the patterns of discharge medication among inpatients with schizophrenia at a psychiatric inpatient unit of a university-affiliated hospital. Methods All admission records at a psychiatric unit of Hanyang University Guri Hospital with discharge diagnosis of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed including the demographic and clinical data and discharge medications. The data were gathered from a total of 207 patients (95 in 1990s and 112 in 2000s). Results The frequency in use of atypical antipsychotics (p < 0.01), antidepressants (p < 0.05), beta-blockers (p < 0.01), and benzodiazepine (p < 0.01) was significantly higher in 2000s. Anticholinergic drugs were less likely used in 2000s (p < 0.01). We did not find significant differences in the equivalent dose of antipsychotic drugs, the use of mood stabilizers and cholinergic drugs between two time frames. Conclusions Increased proportion of atypical antipsychotics and decreased use of anti-parkinsonian drugs are in line with literature. Our results show that more diverse classes of psychotic medications are used for schizophrenia in recent years. It is likely that psychiatrists are becoming more conscious of negative symptoms, anxiety, and depression in the pharmacotherapy of schizophrenia as well as positive symptoms of the illness.

• 대한조현병학회지
• /
• 제22권2호
• /
• pp.42-50
• /
• 2019

Objectives: In this preliminary study, we investigated the clinical characteristics of patients who were first diagnosed with psychotic disorder and explored the impact of the adherence to antipsychotics on long-term medical use. Methods: All national health insurance claims related to psychotic disorders including gender, age, income, and drug compliance, from January 1, 2008 to December 31, 2015, were examined. With trend test using Medication Possession Ratio (MPR), we compared the medical use between the compliant group (MRP≥0.8) and the comparative non-compliant group (0.2≤MPR<0.8). Results: Among 28,095 participants in total, 16,239 patients (57.8%) were diagnosed as schizophrenia; the 30s were the most common (n=7,151, 25.5%). Drug compliance was generally low regardless of the diagnosis and was the lowest among 20s with the 40-60% range of income. The compliant group showed lower psychiatric and medical use than the comparative group in the following years (p<0.0001). Conclusion: These findings suggest that patients in the 20s and 30s with the 40-60% range of income, who are diagnosed with schizophrenia at the first psychiatric visit, may need more clinical and political attention. The results also emphasize the importance of initial drug adherence to antipsychotics in reducing long-term psychiatric costs.

• 생물정신의학
• /
• 제10권2호
• /
• pp.107-115
• /
• 2003

Objective:The purpose of this study was to know about the mechanism of pathogenesis of type 2 diabetes mellitus by using of blood glucose, glucoregulatory factor, insulin resistance in schizophrenic patients receiving antipsychotics. Method:Modified oral glucose tolerance tests were performed in 20 schizophrenic patients receiving haloperidol, risperidone and olanzapine. Insulin, glucagon, C-peptide and cortisol were measured in 0, 15, 45, 75 minutes after glucose loading, and insulin resistance was calculated by HOMA(homeostasis model assessment) method. Result:Olanzapine-treated patients had significant glucose elevation 45 minutes after glucose challenge. Also modest increases in HOMA IR values were detected in patients treated with olanzapine. Conclusion:Olanzapine treatment of non-diabetic patients with schizophrenia can be associated with type 2 diabetes mellitus through the elevation of glucose and insulin resistance. Elevated insulin resistance may be a causative mechanism of type 2 diabetes mellitus in patients receiving olanzapine.

• 대한간호학회지
• /
• 제23권1호
• /
• pp.130-141
• /
• 1993

This study was to find out variables influenced on the medication patterns (voluntary medication, in-voluntary medication) of antipsychotics taken by schizophrenic outpatients. Purposes of this study were to be identified that there was the significant difference between the group of voluntary medication and involuntary, and that which variables had infuence on outpsychotics medication. The sample consisted of 30 patients takeing their pills voluntary (voluntary medication group), and 15 patients involuntary(involuntary medication group) at a psychiatry hospital and a psychiatric unit of a The findings of the study are as follows : university hospital in Daegu. Data were collected from September to October, 1991 through interview using questionare about antipsychotics medication. Data were analyzed by the technique of two group discriminant function analysis using SPSS pc$^{+}$ 1) Discriminant function discriminating between voluntary medication and involuntary medication was significant at the level of 10% significance (sig.=.055, p〈.10) Hit-ratio was very high (91. 1％) 2) One of General variables, SEX, was significant of discriminating between two medication patterns at the level of 10% significance. 3) One of Family Environmental Variables, BROTH(a number of brother), were significant between two medication patterns. (p〈.10) 4) One of Therapeutic Environmental Variables, FAMHX, was significant between two medication patterns at the level of 10% significance. 5) One of Variables Related to Drug and Medication, NECESS, was significant between two medication patterns. (p〈.05) 6) Variables Related to Disease was not significant between two medication patterns.s.