• Title/Summary/Keyword: Pharmacological treatment

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The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III) - Pharmacological Treatment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(III) - 약물치료 -)

  • Kim, Hyo-Won;Kim, Eunjoo;Kim, Ji-Hoon;Park, Jangho;Bahn, Geon Ho;Lee, Yeon Jung;Jhung, Kyungun;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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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.

Non-pharmacological interventions for depression in Persian medicine

  • Yousofpour, Mohammad;Kamalinejad, Mohammad;Esfahani, Mohammad Mahdi;Iran-nejad, Sharzad;Shorofi, Seyed Afshin;Shams, Jamal
    • CELLMED
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    • v.5 no.4
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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.

The Effects of Donepezil, an Acetylcholinesterase Inhibitor, on Impaired Learning and Memory in Rodents

  • Shin, Chang Yell;Kim, Hae-Sun;Cha, Kwang-Ho;Won, Dong Han;Lee, Ji-Yun;Jang, Sun Woo;Sohn, Uy Dong
    • Biomolecules & Therapeutics
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    • v.26 no.3
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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.

Activity of Crude Extract of Rubus crataegifolius Roots as a Potent Apoptosis Inducer and DNA Topoisomerase I Inhibitor

  • Lee, Ji-Hyeon;Ham, Yoon-Ah;Choi, Sang-Ho;Im, Eun-Ok;Jung, Jee-H;Im, Kwang-Sik;Kim, Dong-Kyoo;Ying-Xu;Wang, Min-Wei;Kim, Nam-Deuk
    • Archives of Pharmacal Research
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    • v.23 no.4
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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.

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The Changes in Biogenic Amines and Cortisol in Patients with Posttraumatic Stress Disorder After Long-Term Pharmacological Treatment (외상후 스트레스장애 환자에서 장기 치료에 따른 카테콜아민과 코르티솔 변화)

  • Kang, Suk-Hoon;Chung, Moon-Young;Kim, Tae-Yong;Chung, Hae-Gyung
    • Anxiety and mood
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    • v.4 no.1
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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.

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Development of tablets and evaluation of ingredient content and pharmacological effects of Yukgunja-tang (육군자탕의 정제 개발과 성분함량 및 약리효과 평가)

  • Kim, Myoung-Jin;Choi, Hye-min;Yu, Byung-Woo;Hong, Young-Ju;Ra, Chae-Suk;Kim, Min-Ju;Kim, Jung-Ok
    • The Korea Journal of Herbology
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    • v.36 no.1
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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.

Difficult Clinical Problems of Treatment in Depression (우울증 치료에서의 어려운 문제들)

  • Min, Kyung-Joon
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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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.

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A Comparative Study for Effects of Chongmyungtang and Chocolate Mixed Chongmyungtang on Learning and Memory Impairment (총명탕과 초콜릿 첨가 총명탕의 학습 및 기억장애에 대한 효능 비교연구)

  • Kim, Seong-Joon;Park, Won-Sang;Choi, Hyeon;Kim, Bum-Hoi;Shin, Jung-Won;Sohn, Young-Joo;Sohn, Nak-Won;Jung, Hyuk-Sang
    • Herbal Formula Science
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    • v.16 no.1
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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.

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Well-being of young and middle aged diabetic patients with medication according to combination of non-pharmacological treatment: a path analysis (청장년층 약물치료 당뇨환자의 비약물적치료 병행 여부에 따른 웰빙: 경로분석)

  • Kim, Sun-Kyung;Kim, Yu-Mi;Kim, Sun-Ae
    • Journal of the Korea Convergence Society
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    • v.11 no.6
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    • pp.401-410
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    • 2020
  • The purpose of this study was to investigate predictors and mediating effects of physical activity and nourishment regulation on well-being among young and middle aged patients on DM medication and to compare between those with non-pharmacological treatment and those without. Data were obtained from 2017 community health survey including 1,480 DM patients with oral medication in the age between 20 and 49. Using SPSS 25.0 and AMOS 25.0, path analysis was performed to explore the association between personal factors (socio-economic status, health habit, eating habit and compliance of health examination) and well-being, along with mediating effects of physical activity. Results demonstrated the different mediating role of physical activity. In medication only group, there was no direct effect of physical activity and no indirect effect of personal factors. Direct effect of physical activity and indirect effects of predictors were found in those with non-pharmacological treatment group. When developing strategies to enhance well-being of young and middle aged diabetic patients, proper reflection of their age specific traits and disease management capability are essential.

Management of Weight Gain and Obesity Associated With Antipsychotics (항정신병약물 사용과 연관된 체중 증가와 비만의 관리)

  • Lee, Na-Hyun;Lee, Jae-Chang
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.86-94
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    • 2021
  • Objectives : The risk of weight gain is high when using antipsychotic drugs, and the prevalence of obesity in people with mental illness is high. Obesity management in psychiatric patients is important because obesity causes various complications and lowers treatment adherence and quality of life. Methods : In this review, we summarized the management strategies for obesity that can occur when using antipsychotic drugs through a web search. Results : Evaluate obesity-related risk factors and related indicators from the beginning of treatment, and conduct regular monitoring. If an antipsychotic drug is used and obesity is induced, a change to a drug with a low metabolic risk may be attempted. Sufficient interventions are also needed on the need to manage obesity, a healthy diet, and exercises in patients and their families. If weight loss is not achieved and obesity-related complications are associated, the use of anti-obesity drugs may be considered. Pharmacological treatment approaches should be carefully considered. Conclusions : Non-pharmacological and pharmacological therapies can be applied to manage weight gain and obesity caused by the use of antipsychotic drugs. When using anti-obesity drugs, the characteristics of mental disorders, drug safety, and drug interactions should be considered.