• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권2호
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• pp.70-83
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• 2017

The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

• 셀메드
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• 제5권4호
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• pp.22.1-22.7
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• 2015

Depression is an important medical problem in today's world. Despite its high prevalence, treatment of depression remains problematic, as its cause is still not fully understood. Of the ways recommended to tackle this problem is implementing the potentials of various medical schools. A medical school which has played an important role in the history of medicine in the world is Persian medicine. This study was intended to identify non-pharmacological interventions for depression in the most reliable references on Persian medicine, classify these interventions and compare them with the latest medical findings. The study was set to review the most reliable references on Persian medicine. In addition, relevant keywords were used to search the PubMed and Scopus databases. In Persian medicine sources, melancholia is categorized into three main types. One type is regarded as cerebral melancholia, which resembles modern psychiatry's depression closely. Therefore, some key points put forth by Persian medicine scholars regarding melancholia can be used to answer questions concerning depressive disorders and their etiology and treatment. Although recent studies have confirmed most approaches offered by Persian medicine physicians in ancient Persia, it is imperative to design and conduct clinical trial studies according to these approaches.

• Biomolecules & Therapeutics
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• 제26권3호
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• pp.274-281
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• 2018

A previous study in humans demonstrated the sustained inhibitory effects of donepezil on acetylcholinesterase (AChE) activity; however, the effective concentration of donepezil in humans and animals is unclear. This study aimed to characterize the effective concentration of donepezil on AChE inhibition and impaired learning and memory in rodents. A pharmacokinetic study of donepezil showed a mean peak plasma concentration of donepezil after oral treatment (3 and 10 mg/kg) of approximately $1.2{\pm}0.4h$ and $1.4{\pm}0.5h$, respectively; absolute bioavailability was calculated as 3.6%. Further, AChE activity was inhibited by increasing plasma concentrations of donepezil, and a maximum inhibition of $31.5{\pm}5.7%$ was observed after donepezil treatment in hairless rats. Plasma AChE activity was negatively correlated with plasma donepezil concentration. The pharmacological effects of donepezil are dependent upon its concentration and AChE activity; therefore, we assessed the effects of donepezil on learning and memory using a Y-maze in mice. Donepezil treatment (3 mg/kg) significantly prevented the progression of scopolamine-induced memory impairment in mice. As the concentration of donepezil in the brain increased, the recovery of spontaneous alternations also improved; maximal improvement was observed at $46.5{\pm}3.5ng/g$ in the brain. In conclusion, our findings suggest that the AChE inhibitory activity and pharmacological effects of donepezil can be predicted by the concentration of donepezil. Further, $46.5{\pm}3.5ng/g$ donepezil is an efficacious target concentration in the brain for treating learning and memory impairment in rodents.

• Archives of Pharmacal Research
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• 제23권4호
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• pp.338-343
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• 2000

The effects of methanol extract of Rubus crategifolius roots and its solvent fractions were investigated on the proliferation of MCF-7 human breast carcinoma cells. The methanol extract inhibited the proliferation of MCF-7 cells in a concentration dependent manner. Moreover, their methanol soluble (W-M) fraction had the greatest inhibitory effect on the growth of MCF-7 cells. To evaluate whether the W-M fraction affects on the cell cycle of MCF-7 cells, cells treated with this fraction were analyzed with flow cytometry. The W-M fraction increased $G_0$/$G_1$phase after 24 h-treatment and induced apoptosis after 48 h-treatment. The hallmark of apoptosis, DNA fragmentation, also appeared by W-M fraction after 48 h-treatment. Furthermore, the methanol extract and its W-M fraction inhibited the activity of the topoisomerase 1 enzyme in the relaxation assay, From these results, their W-M fraction as well as methanol extract of R. crategifolius roots are necessary for further studies as a potent inhibitor of the growth of cancer cells.

• 대한불안의학회지
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• 제4권1호
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• pp.19-27
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• 2008

Objective : This study was conducted to evaluate the changes in the levels of neurotransmitters and cortisol in patients with chronic posttraumatic stress disorder (PTSD) and to evaluate their correlation with symptoms after long-term pharmacological treatment. Methods : Twenty-eight Vietnam veterans with chronic PTSD and 34 non-PTSD patients were consecutively recruited. The Combat Exposure Scale (CES), Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (M-PTSD), Clinician Administered PTSD Scale (CAPS), Hamilton Rating Scale for Depression (HRSD) and Hamilton Anxiety Scale (HAS) were used to evaluate symptom severity. High performance liquid chromatography (HPLC) was used to measure the plasma levels of epinephrine, norepinephrine, and dopamine, and a radioimmunoassay (RIA) was performed to evaluate the plasma level of cortisol. Results : Plasma cortisol was significantly lower in PTSD patients than in control subjects, while there was no significant difference in plasma epinephrine, norepinephrine and dopamine between the two groups. The scores of M-PTSD, CAPS, HAMD and HAMA were signigicantly higher in PTSD patients than control group. Conclusion : After long-term treatment, the levels of neurotransmitters in PTSD patients returned to within the normal range, and the patients' symptoms showed some improvement. However, the core symptoms of PTSD continued to appear intermittently, and they are thought to be associated with hormonal systems, such as the HPA axis. It is also suggested that PTSD should be considered to be a complex disorder associated with multiple systems and that combinations of the effective medications for each system should be used to treat patients with PTSD.

• 대한본초학회지
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• 제36권1호
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• pp.67-76
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• 2021

Objective : Yukgunja-tang is one of the herbal prescriptions widely used for functional indigestion. In this study, we evaluated the pharmacological effect through the Yukgunja-tang formulation development. Methods : The RAW 264.7 cells were pretreated with Yukgunja-tang tablet (YGJT-T : 50, 100 and 200 ㎍/㎖) and then stimulated with lipopolysaccharide (LPS : 500 ng/㎖). Cell viability, inflammatory mediators such as nitric oxide (NO) and prostaglandin E2 (PGE2) and inflammatory cytokines (IL-1β, IL-6, and TNF-α) were measured. Also, ICR mice induced acute gastritis by oral administration of 150 mM HCl in 60% ethanol. The YGJT-T (30 mg/kg) was pretreated for 3 days, and 150 mM HCl in 60% ethanol was orally administered 1 hour after the last drug treatment. Mice were sacrificed 1 hour after oral administration of 150 mM HCl in 60% ethanol. The gastric mucosa was observed, and inflammatory cytokines in the gastric tissue were measured. Results : The marker components of YGJT-T were determined by simultaneous analysis using HPLC. In RAW 264.7 cells, pretreatment of YGJT-T was non-toxic and inhibited the production of inflammatory mediators such as NO and PGE2 and suppressed inflammatory cytokines. In addition, pretreatment of YGJT-T improved bleeding and edema due to gastric lesions caused by acute gastritis and suppressed inflammatory cytokines. Conclusion : In summary, our results confirmed that treatment with YGJT-T has anti-inflammatory and anti-gastritis effects in vitro and in vivo. Therefore, in this study, YGJT-T could support a potential strategy for the prevention and treatment of gastritis.

• 생물정신의학
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• 제8권1호
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• pp.37-46
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• 2001

Whenever a clinician manages the patients with depression, he may meet various problems that make it difficult to treat them. Even though he has good skills and knowledge about depression, some barriers will be appear during his practice. In general, the difficulties in treating depression are treatment-resistance, adverse effects of antidepressants, pregnancy in female patients, comorbid medical conditions, poor compliance, drug-drug interactions, and so on, which are related with pharmacological treatments. Here, only the two of them, the treatment-resistant depression and difficult problems concerned with pregnancy, were discussed. Some level of treatment resistance is the norm rather than the exception. As the treatment failure stems from inadequate treatment, it is important that the clinician should prescribe medications with sufficient doseage and adequate duration. And to overcome the treatment resistant depression the polypharmacy is necessary, in that case, the side effects and toxicities should be explored and managed immediately. So the clinician have to learn more about the pharmacokinetic and pharmacodynamic mechanisms of each drugs used in treatment of depression. When the risk of the fetus by the exposure is higher than the risk of untreated maternal psychiatric disorder, psychotropic medications should be used during pregnancy. Women who are maintained on psychotropics and become pregnant, as well as women with the new onset of psychiatric symptoms during pregnancy, should be carefully reassessed. However, data concerning the potential risk of long-term behavioral changes following prenatal exposure to psychotropics is rare, so further longitudinal follow-up studies are needed.

• 대한한의학방제학회지
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• 제16권1호
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• pp.131-145
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• 2008

With tablets and powder, decoction has been a widely-used method of medicine formula. However, for these formulas have unique bitter tastes and flavors of herbal component materials as it is, the compliance of herbal medicine is severly decreased especially for female and younger patients. Consequently, expected treatment effects can't be acquired completely. If loathsome tastes and flavors of decoction were effectively reduced while pharmacological activity were kept intact, the compliance could be promoted Chong-Myung-Tang has been widely prescribed for student patients with memory This study shows that Chong-Myung-Tang+chocolate have no difference from Chong-Myung-Tang in terms of pharmacological activity. Sensory difference with net chocolate was also surved. In order to observe the difference of Chong-Myung-Tang+chocolate and Chong-Myung-Tang, memory impairment was induced by intraventricular injection of $A{\beta}_{25-35}$ peptides on mice and Chong-Myung-Tang and Chong-Myung-Tang+chocolate were administered orally for 14 days. In water maze task, improvement of learning ability during acquisition period and significant increase of memory score during retention period resulted from the treatment of Chong-Myung-Tang and Chong-Myung-Tang+chocolate with respect to the $A{\beta}-injected$ control animals. Furthermore, the $A{\beta}_{25-35}$ toxicity on the hippocampus was assessed with immunohistochemistry (Bax, TUNEL), and differences in antioxidant activity was observed through TBARS and DPPH test. We employed sensory tests using chocolate flavor, herb flavor, and bitter taste & hardness as standards to show sensory differences with net chocolate. In this study, it is demonstrated that Chong-Myung-Tang+chocolate do not disturb the pharmacological activity of Chong-Myung-Tang, and have no sensory difference with net chocolate. Chong-Myung-Tang+chocolate can be used to enhance the compliance remarkably and thought of as an effective, functional formula to maximize expected treatment.

• 한국융합학회논문지
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• 제11권6호
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• pp.401-410
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• 2020

본 연구는 당뇨병을 진단받고 약물요법 중인 청장년층을 비약물적 요법을 병행하는 집단과 그렇지 않은 집단으로 나누어 웰빙에 영향을 미치는 주요 변수들의 관계를 규명하고, 신체활동의 관련성을 알아보고자 한다. 본 연구의 자료는 2017년 지역사회건강조사(CHS) 자료를 활용하여 경구약물치료 중인 20세~49세의 당뇨환자 1,480명을 연구 대상자로 분석하였다. 자료분석은 SPSS 25.0과 AMOS 25.0을 이용하여 개인특성요인(사회경제적 수준, 식습관, 건강 습관, 건강검진이행)의 웰빙에 대한 경로분석을 실시하고 신체활동의 매개효과를 검증하였다. 본 연구의 주요 결과로는 집단 간 신체활동의 매개효과에서 차이가 확인되었다. 약물요법만 시행하는 집단의 경우 신체활동의 매개효과는 확인되지 않았다. 비약물적 요법을 병행하는 그룹에서는 신체활동의 직접적 효과와 개인특성요인들의 간접적 효과가 확인되었다. 본 연구결과를 바탕으로 약물치료를 시작한 청장년층 환자들의 특성과 질병관리 수준을 반영한 웰빙 향상 전략 수립이 필요하다.

• 정신신체의학
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• 제29권2호
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• pp.86-94
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• 2021

연구목적 항정신병약물 사용시 체중 증가 위험이 높고, 정신질환자의 비만 유병률도 높다. 비만은 다양한 합병증을 유발하고 치료 순응도와 삶의 질을 저하시키기 때문에 정신질환자의 비만 관리는 중요하다. 방 법 본 종설에서는 학술 검색을 통하여 항정신병약물 사용시 발생할 수 있는 비만의 관리 전략에 대해 정리해 보았다. 결 과 치료 초기부터 비만관련 위험 요인과 관련 지표(체중, 체질량지수, 허리둘레,공복혈당 및 공복지질, 혈압)에 대해 평가하고, 정기적인 모니터링을 시행한다. 항정신병약물을 사용하며 비만이 유발된 경우 대사성 위험이 적은 약제로 변경을 시도할 수 있다. 환자 및 가족에서 비만 관리 필요성과 식이 및 운동 조절 등에 대한 충분한 안내도 필요하다. 비약물적 치료를 통해 적절한 체중 감량이 이뤄지지 않는 경우 항비만약물들의 사용도 고려할 수 있다. 결 론 항정신병약물 사용시 유발되는 체중 증가와 비만 관리를 위하여 비약물적, 약물적 요법을 적용할 수 있다. 항비만약물을 사용할 경우에는 정신질환의 특성, 약물의 안정성, 약물 상호작용을 고려해야 한다.