• Title/Summary/Keyword: Atypical antipsychotics

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The Effect of Atypical Anti-psychotic Agents on Obesity and Glucose Metabolism (비정형 항정신병약제가 비만과 당대사에 미치는 영향)

  • Sang Ah Lee;Suk Ju Cho;Jae Cheol Moon
    • Journal of Medicine and Life Science
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    • v.18 no.3
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    • pp.49-55
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    • 2021
  • Atypical antipsychotics are more effective than typical antipsychotics and have fewer side effects such as tardive dyskinesia and extrapyramidal symptoms; therefore, prescriptions of atypical antipsychotics are increasing. However, recently, it has been reported that atypical antipsychotics have a higher incidence of diabetes, hyperglycemia, and obesity than typical antipsychotics. Atypical antipsychotics induce obesity-inhibiting appetite-related receptors such as serotonin and dopamine. Decreased exercise due to improving psychotic symptoms, and genetic characterictics can also cause weight gain. Hyperglycemia and hypoglycemia were another metabolic problem related to treatment with atypical antipsychotics. The mechanisms of hyperglycemia were mainly related obesity, decreased anorexigenic hormones, and increased insulin resistance in multiple organs. There are also reports that genes related to diabetes have an effect on the incidence of diabetes mellitus treated with atypical antipsychotics. On the other hand, although it is not clear why hypoglycemia occurs, it documented in case reports all over the world. There are more reports of atypical antipsychotics than typical antipsychotics and these are frequently reported in Asians. Further research on the mechanism of hypoglycemia related to atypical antipsychotics is strongly recommended.

Pharmacotherapy in Child and Adolescent Psychiatric Field: Atypical Antipsychotics (소아청소년정신과 영역의 약물치료 : 비전형항정신병약물)

  • Yoo, Han-Ik K.;Paik, Kyoung-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.19 no.2
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    • pp.89-103
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    • 2008
  • Although the scientific evidence is not entirely supportive, atypical antipsychotics have been used widely for the treatment of children and adolescents with mental illnesses as alternatives to typical antipsychotics which have more serious unwanted adverse effects than atypical neuroleptics. On the basis of clinical experiences and research data, atypical antipsychotics have been prescribed for adolescents with schizophrenia, manic or mixed episodes of bipolar disorders, tic disorders, aberrant behaviors in pervasive developmental disorders, and impulsive or violent behaviors in disruptive behavior disorders. Due to their efficacy and relatively more tolerable side effects, the use of atypical antipsychotics has become increasingly popular in child and adolescent psychiatry. However, we should pay attention to the limitations associated with short-term clinical experiences and the lack of well-designed controlled studies, especially in terms of adverse effects including those involving metabolic processes.

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Association between the Weight Gain and Treatment Response to Atypical Antipsychotics in Korean Patients with Schizophrenia (한국인 정신분열병 환자에서 비정형 항정신병 약물의 치료반응과 체중증가의 관련성에 대한 연구)

  • Lee, Jae-Byung;Ham, Byung-Joo;Lee, Hwa-Young;Lee, Min-Soo
    • Korean Journal of Biological Psychiatry
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    • v.18 no.4
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    • pp.225-231
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    • 2011
  • Objectives Atypical antipsychotics show better treatment efficacy, safety and tolerability than typical antipsychotics. Among the adverse events observed during treatment with antipsychotics, extrapyramidal syndrome (EPS) and negative symptoms has been greatly reduced. But still, weight gain is receiving growing attention. The aim of this study was to investigate the association between therapeutic response to atypical antipsychotics and weight gain in admission status. Methods The study was conducted for Korean inpatients with schizophrenia in a university hospital in Seoul, between Jan 2006 and Dec 2010. Data was collected by reviewing the medical record of 39 consecutively hospitalized patients with Schizophrenia (DSM-IV) at a university hospital. Positive and Negative Symptom Scale (PANSS), Body Mass Index (BMI) and body weights were measured. Results No significant difference was observed for sex, age, illness onset age, family history of schizophrenia, numbers of hospitalization before treatment, educational years, marriage status, occupational status and subtype of schizophrenia between weight gainers and non-weight gainers. Regarding treatment response to atypical antipsychotics, weight gainers show significantly more PANSS decrease than non-weight gainers during admission period. Conclusions Our findings suggest that it appears to be more likely to respond to atypical antipsychotics in weight gainers than non-weight gainers (that weght gainers appear to be more likely to respond to atypical antipsychotics than non-weight gainers). These results show that the antipsychotic-induced body weight gain is associated with therapeutic response of antipsychotics in Korean inpatients with schizophrenia.

NEW DRUG THERAPY IN CHILD AND ADOLESCENT PSYCHIATRY ATYPICAL ANTIPSYCHOTICS (소아청소년 정신과 영역에서의 새로운 약물치료 ; 비정형 항정신병약물)

  • Bahn, Geon-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.14 no.1
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    • pp.26-35
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    • 2003
  • Conventional antipsychotics are commonly used to treat children and adolescents suffered from schizophrenia to other neuropsychiatric conditions. Regrettably, studies for typical antipsychotics report high rates of sedation, orthostatic hypotension, and extrapyramidal side effects. Over the past few years, atypical antipsychotics have been prescribed for use in adults with psychotic symptoms. Child psychiatrists have begun using these drugs to children and adolescents hoping safe and better alternatives to the conventional antipsychotics. However, there is not enough short-term and almost no long-term data about atypical antipsychotics for pediatric patients. Therefore, the purpose of this article is to review what is known about the use of the atypical antipsychotics in young patients. To do so, an appropriate approach to the use of these drugs in child and adolescent patients my be offered.

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The Mechanisms of Atypical Antipsychotics-Induced Weight Gain and Related Pharmacogenetics (비전형적 항정신병약물에 의한 체중증가의 기전 및 약리유전학)

  • Lee, Joon-Noh;Yang, Byung-Hwan
    • Korean Journal of Biological Psychiatry
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    • v.10 no.1
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    • pp.3-19
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    • 2003
  • The use of atypical antipsychotics is limited by occurrence of adverse reactions such as weight gain, despite of their benefits. This article provides a comprehensive review and discussion of the most significant findings regarding obesity-related pathways and integrates these with the known mechanism of atypical antipsychotic action. The focus of this article is primarily on the genetics of obesity related pathways that may be disrupted by atypical antipsychotics. This review also discussed weight gain, hyperglycemia or occurrence of diabetes while being treated with atypical antipsychotics from the point of view of pharmacogenetics. Pharmacogenetic research seeks to uncover genetic factors that will help clinicians identify the best treatment strategies for their patients. It will aid clinically in the prediction of response and side effects, such as antipsychotic-induced weight gain, and minimize the current "trial and error" approach to prescribing in the near future. This article also presents the genetics of both central and peripheral pathways putatively involved in antipsychotic-induced weight gain while providing a comprehensive review of the obesity literature. This article also review obesity related candidate molecules which may be disrupted during atypical antipsychotic drug treatment.

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Pharmacophore Hypothesis for Atypical Antipsychotics

  • Sekhar, Kondapalli Venkata Gowri Chandra;Vyas, Devambhatla Ravi Kumar;Nagesh, Hunsur Nagendra;Rao, Vajja Sambasiva
    • Bulletin of the Korean Chemical Society
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    • v.33 no.9
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    • pp.2930-2936
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    • 2012
  • A three-dimensional pharmacophore hypothesis was developed for atypical antipsychotics in order to map common structural features of highly active compounds by using HipHop in CATALYST program. The pharmacophore hypotheses were generated using 12 compounds as training set and validated using 11 compounds as test set. The most predictive hypothesis (Hypo1) comprises five features viz. two hydrophobic regions, two hydrogen bond acceptor lipid and one aromatic ring. In the absence of information like crystallized structure of 5-$HT_{2A}$ receptor and binding mode of antipsychotics with 5-$HT_{2A}$ receptor, this hypothesis will serve as a potentially valuable tool in the design of novel atypical antipsychotics acting primarily at 5-$HT_{2A}$ and $D_2$ receptors.

The Prescribing Patterns of Antipsychotic Drugs and Antiparkinsonian Drugs in Elderly Patients with Dementia (노인 치매 환자의 항정신병약물 및 항파킨슨약물 처방 현황)

  • Yoon, Soo Mi;Lee, Sungwon;Chang, Ji-Eun;Lee, Young Sook;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.81-86
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    • 2020
  • Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

Differential Effects of Typical and Atypical Antipsychotics on MK-801-induced EEG Changes in Rats

  • Kwon, Jee-Sook;Kim, Ki-Min;Chang, Su-Min;Kim, Choong-Young;Chung, Tai-Ho;Choi, Byung-Ju;Lee, Maan-Gee
    • The Korean Journal of Physiology and Pharmacology
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    • v.9 no.1
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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.

The Development of Behavioral Modification Program on Weight Reduction in Overweight Patients taking Atypical Antipsychotics - Preliminary Study - (비정형 항정신병약물 복용 중인 과체중 환자에서 체중 감량을 위한 행동수정요법의 개발 - 예비연구 -)

  • Shin, Hong Beom;Park, Jong Ho;Cha, Bo Seok;Kim, Byung Soo;Lee, Suk Kyung;Kim, Hak Lyung;Kim, Yong Sik;Ahn, Young Min;Kang, Ung Gu
    • Korean Journal of Biological Psychiatry
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    • v.10 no.2
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    • pp.186-196
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    • 2003
  • Objects:The authors devebped a behavioral modification program for oveweight outpatients with schi-zophrenia and bipolar disorder will had teen treated with atypical antipsychotics, and evaluated the applicability of this program to outpatients Methods:Two men and nine women who had been treated with atypical antipsychotics and will had gained at least 5 percent of their pre-treatment body weight for 10 weeks, attended a behavioral modification program. The patients' weight, body mass index and the diet-activity scale were assessed and were compared with those of a matched comparison group will dd not attend the behavioral modification program Results:The body weight of patients who attended the behavioral modification program reduced with statistical significance, The treatment group showed significant improvement in diet-related items but not in activity-related items of the diet-activity scale Conclusions:This study suggested the applicability of a eehavioral mcdification program on weight reduction to overweight patients taking atypical antipsychotics for the frrst time in Korea Additional large scale studies are needed to validate the effectiveness of this program.

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Antipsychotics for patients with pain

  • Shin, Sang Wook;Lee, Jin Seong;Abdi, Salahadin;Lee, Su Jung;Kim, Kyung Hoon
    • The Korean Journal of Pain
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    • v.32 no.1
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    • pp.3-11
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    • 2019
  • Going back to basics prior to mentioning the use of antipsychotics in patients with pain, the International Association for the Study of Pain (IASP) definition of pain can be summarized as an unpleasant experience, composed of sensory experience caused by actual tissue damage and/or emotional experience caused by potential tissue damage. Less used than antidepressants, antipsychotics have also been used for treating this unpleasant experience as adjuvant analgesics without sufficient evidence from research. Because recently developed atypical antipsychotics reduce the adverse reactions of extrapyramidal symptoms, such as acute dystonia, pseudo-parkinsonism, akathisia, and tardive dyskinesia caused by typical antipsychotics, they are expected to be used more frequently in various painful conditions, while increasing the risk of metabolic syndromes (weight gain, diabetes, and dyslipidemia). Various antipsychotics have different neurotransmitter receptor affinities for dopamine (D), 5-hydroxytryptamine (5-HT), adrenergic (${\alpha}$), histamine (H), and muscarinic (M) receptors. Atypical antipsychotics antagonize transient, weak $D_2$ receptor bindings with strong binding to the $5-HT_{2A}$ receptor, while typical antipsychotics block long-lasting, tight $D_2$ receptor binding. On the contrary, antidepressants in the field of pain management also block the reuptake of similar receptors, mainly on the 5-HT and, next, on the norepinephrine, but rarely on the D receptors. Antipsychotics have been used for treating positive symptoms, such as delusion, hallucination, disorganized thought and behavior, perception disturbance, and inappropriate emotion, rather than the negative, cognitive, and affective symptoms of psychosis. Therefore, an antipsychotic may be prescribed in pain patients with positive symptoms of psychosis during or after controlling all sensory components.