• Korean Journal of Biological Psychiatry
• /
• v.24 no.3
• /
• pp.134-141
• /
• 2017

Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

• Korean Journal of Biological Psychiatry
• /
• v.14 no.2
• /
• pp.99-105
• /
• 2007

Objectives : The purpose of present study was to investigate the effect, safety and tolerability of risperdal sachet(oral solution) with lorazepam tablet versus intramuscular haloperidol and lorazepam injection for management of acute psychotic symptom in the elderly with organic mental disorder. Methods : Total 37 patients who have dementia, medical or physical diseases, associated with acute psychotic symptom were randomly assigned to oral treatment with 1mg of risperdal sachet(oral solution) plus 1mg of lorazepam(N=17) or to intramuscular treatment with 2.5mg of haloperidol plus 2mg of lorazepam (N=20). The change of CGI scores was used for the evaluation of efficacy. Results : Mean score improvements at 15, 30, 60, and 120 minutes after treatment were statistically significant at each time point in both groups(p<0.001) and were similar in both groups(p=0.189). Conclusion : A single oral dose of risperdal sachet(oral solution) plus lorazepam was as effective and tolerable as parenterally administered haloperidol plus lorazepam for the rapid control of acute psychotic symptom in the elderly with organic mental disorder.

• Korean Journal of Biological Psychiatry
• /
• v.29 no.1
• /
• pp.22-31
• /
• 2022

Objectives Recently, weight loss has emerged as a national concern in South Korea, and this has resulted in an increase in the frequency of use of central nervous system (CNS)-stimulating appetite suppressants. This study aimed to collect cases of psychotic disorders and bipolar disorders triggered by phentermine and phendimetrazine and explore the clinical features and courses. Methods In this retrospective study, we analyzed the electronic medical records of patients and selected eight patients who developed psychotic symptoms and manic symptoms for the first time after taking phentermine and phendimetrazine. All cases were reviewed, and their clinical features and course were summarized. Results All eight patients developed psychotic symptoms, and one had accompanying manic symptoms. The final diagnosis was appetite-suppressant-induced psychotic disorder in four patients, schizophrenia in three, and appetite-suppressant-induced bipolar disorder in one. In addition, three patients were diagnosed as having substance-use disorder. The key psychotic symptoms of these patients were hallucinations and paranoia. Conclusions These case findings suggest that phentermine and phendimetrazine can cause psychotic disorder, bipolar disorder, or substance use disorder and that medical professionals and the public should practice caution when prescribing and using these drugs.

• Korean Journal of Biological Psychiatry
• /
• v.19 no.3
• /
• pp.134-139
• /
• 2012

Objectives : Proinflammatory process has been implicated as an underlying mechanism of bipolar disorder and schizophrenia. Previous studies have suggested a possible role of lymphotoxin alpha (LTA) gene in the development of schizophrenia and have prompted further investigation in bipolar patients. Association of the LTA +252A/G polymorphism with susceptibility to bipolar I disorder itself as well as with vulnerability among a subset of psychotic bipolar patients were tested. Methods : DNA extraction was done by a standard method and genotyping was carried out by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method in 114 Korean patients with bipolar I disorder and 202 healthy controls. SPSS v18.0 was used for statistical analysis. Comparisons of the genotype and allele distributions in LTA +252A/G polymorphism were made using a chi-square test. The genotype and allele associations were also evaluated using odds ratio (OR) and 95% confidence interval (CI). Statistical significance was accepted when p was < 0.05. Results : No significant association was found between the LTA +252A/G polymorphism and bipolar disorder. However, LTA +252G allele was present with significantly higher frequency among bipolar patients with psychotic features compared to those without (${\chi}^2$ = 4.69, p = 0.034, OR = 2.495, 95% CI = 1.069-5.827). Conclusion : The results suggest that the allele LTA +252G of the polymorphism may be associated with the psychotic subset of bipolar disorder but not with bipolar I disorder itself. Adequately powered subsequent studies should be conducted.

• Korean Journal of Biological Psychiatry
• /
• v.13 no.4
• /
• pp.234-243
• /
• 2006

Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

• Journal of Oriental Neuropsychiatry
• /
• v.18 no.3
• /
• pp.181-191
• /
• 2007

Jeon-zeong(癲證) is mostly caused by anxiety and melancholy, impairment of heart and the spleen, or stasis of phlegm-Gi and heart confused by phlegm. Its manifestation are characterized by depression, expressionlessness, inclination for quietness, self muttering and hallucinating, caprice in crying and laughing, paraphasia, loss of appetite, unawareness of filth and cleanness, etc. We experienced a 50year-old man who bad brief psycbotic disorder that specified with Marked Stressor and whose condition was improved through oriental medical treatment. We treated the patient with Herbal medications and Giungoroen (至言高論)-wise saying and lofty opinion) and Relaxation therapy. After being treated, the patient showed that symptoms (insomnia, anxiety, depression) was improved considerably. This result suggests that oriental medical treatment has good effect on brief psychotic disorder due to Marked Stressor.

• 월간산업보건
• /
• s.224
• /
• pp.35-38
• /
• 2006

• Korean Journal of Schizophrenia Research
• /
• v.22 no.2
• /
• 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.

• Clinical Psychopharmacology and Neuroscience
• /
• v.16 no.4
• /
• pp.434-448
• /
• 2018

Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP. Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts. Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression. Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.

• Journal of Yeungnam Medical Science
• /
• v.39 no.1
• /
• pp.58-61
• /
• 2022

Mega cisterna magna (MCM), one of the members of the Dandy-Walker complex, is a developmental malformation of the posterior fossa that is larger than 10 mm but morphologically does not affect the vermis and cerebellar hemispheres. Reports of psychiatric disorders associated with this anomaly are rare. We present the case of a patient with MCM who presented with a psychotic manic attack and was diagnosed with bipolar disorder. A 28-year-old female, single housewife, university graduate, presented with irritability, decreased sleep and appetite, distraction, and agitation. The patient also had a delusion of reference. In the clinical follow-up, an increase in energy and an increase in the amount of speech were observed. Her neurological examination was normal, and cranial magnetic resonance imaging revealed an MCM. The relationship and clinical significance of MCM with psychosis and mood disorders have not yet been fully elucidated. It is not known whether this association is accidental or based on etiological commonality. The purpose of this case report is to review the relationship between the cerebellum and psychiatric symptoms and to contribute to the literature.