• Title/Summary/Keyword: Psychotropic

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Characterization of in vitro Metabolites of Methylenedioxy Designer Drugs

  • Jun Sang Yu;So Young Jo;Il-Ho Park;Hye Hyun Yoo
    • Mass Spectrometry Letters
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    • v.14 no.1
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    • pp.1-8
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    • 2023
  • Eutylone, dibutylone, and dimethylone are potential psychotropic designer drugs. The purpose of this study was to investigate the in vitro metabolic pathways of synthetic cathinones with methylenedioxy groups. The three methylenedioxy derivatives were incubated with human liver microsomes. The metabolites were characterized based on liquid chromatography and quadrupole-time-of-flight mass spectrometry. Eutylone, dibutylone, and dimethylone were metabolized to yield three, six, and four metabolites, respectively. Reduction and demethylenation were the major metabolic pathways for all three drugs tested. However, dibutylone and dimethylone showed an additional metabolite generated via N-oxidation. These results provide evidence for the in vivo metabolism of methylenedioxy synthetic cathinones, and could be applied to the analysis of synthetic cathinones and their relevant metabolites in biological samples.

Clinical Characteristics and Use of Psychotropic Agents among HIV-Infected/AIDS Patients Referred for Psychiatric Consultation (일 병원 정신건강의학과로 자문의뢰 된 HIV 감염/후천성면역결핍증 환자의 임상적 특성과 향정신약물 사용)

  • Shin, Sang-Ho;Kim, Hyun-Chung;Yoo, So-Young;Shin, Hyoung Shik;Won, Sung-Doo;Lee, So Hee
    • Korean Journal of Psychosomatic Medicine
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    • v.22 no.1
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    • pp.31-39
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    • 2014
  • Objectives : This study aimed to investigate the psychiatric status of HIV-infected/AIDS inpatients in a general hospital over the past 2.5 years. Methods : A retrospective chart review was conducted of psychiatric consultations performed between January 1, 2011, and July 30, 2013. The records of 97 HIV-infected/AIDS patients were analyzed. These included a total of 282 psychiatric consultations. Results : Of the 97 patients, 91(93.8%) were male, the mean age was 48 years, and mean number of consultations was 2.8. Depressed mood was reported in 102 consultations(23.8%), insomnia in 60(14.0%), and anxiety in 31(7.2%). Psychiatric disorders diagnosed on initial consultation included depressive disorder(37 patients ; 37.0%), cognitive disorder(11 ; 11.0%), and delirium(9 ; 9.0%). Recommended psychotropic medication included Lorazepam(99 ; 17.2%), Escitalopram(90 ; 15.7%), and Quetiapine(84 ; 14.6%). Conclusions : The main complaints of HIV-infected/AIDS patients were depressed mood, insomnia, and suicidal ideation(including suicide attempts). In total, 85(93.3%) patients of those consulted were diagnosed as meeting the criteria for a psychiatric condition. However, considering that only 16.9% of patients consulted received follow-up treatment, longitudinal research is needed to examine the influence of psychiatric disorders on the transmission of HIV-infection/AIDS, as well as on prognosis and treatment adherence.

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Risperidone as a Janus in Mood Disorder (기분장애에서 risperidone의 양면성)

  • Yoon, Doh Joon
    • Korean Journal of Biological Psychiatry
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    • v.4 no.2
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    • pp.198-210
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    • 1997
  • To examine the double-faced thymoleptic(antidepressant and antimanic) effects of risperidone in mood disorders, this article reviews the psychotropic-induced mania, thymoleptic effects of antipsychotics, therapeutic effects of risperidone and risperidone(RIS)-induced mania(RIM) in mood disorders, risk factors of RIM, possible neurochemical mechanism of these thymoleptic effects, pathophysiological and clinical significance of thymoleptic effects, and suggestive clinical guideline of RIS in mood disorders. RIS appeared effective for bipolar disorder at a lower dose than that recommended for schizophrenia, especially in the cases of maintenance of mood stabilizers, and gradual titration from low doses. Manic induction/exacerbation can occur by chance during RIS treatment in mood disorders, schizoaffective disorders, and schizophrenias. The possible risk factors for RIM are refractory mood disorder, especially in bipolar I disorder with poor initial response ; refractory schizoaffective disorders, especially in bipolar type with poor initial response ; refractory chronic schizophrenias, especially with initial responses ; psychotic features ; higher initial doses ; rapid titration ; combined therapy with antidepressants in refractory depression ; and RIS monotherapy in mania/hypomania. RIS is a drug that preferentially block 5-HT2 receptors. The effects of low dose are due mainly to the blockade of 5-HT2 receptors. There are more gradual increase in D2 blockade with increasing dose and this D2 blocking properties become apparent at higher doses. This may be related to a modulation of dopaminergic transmission by 5-HT2 antagonism at lower doses with the direct action of RIS on DA receptors coming into play at higher dose. The serotonergic antagonistic effect may be important for its effects on depressive symptoms. This, together with adequate blo-ckade of D2 receptors, may not necessarily lead to destabilization of mood disorder, but rather to more therapeutic effects. Therefore, this dose-receptor affinity relationship with both antidepressant and antimanic effects according to treatment duration can explain a continuum of antidepressant effect, antimanic effect, behavioral stimulation, and manic/hypomanic induction/exacerbation. It was the recognition of a useful psychiatric side effects by a thoughtful observer with fertile minds that led to their ultimate utilization as psychotropic drugs, i.e., phenothiazine, MAOI, TCA, and lithium. And, in vivo pharmacological challenge by novel psychotropics, as a neurochemical probe, with more specific actions is a useful tool to select pharmacologically homogeneous subgroup of the same phenotypical(clinical) condition, to further study the unknown underlying pathogenesis of various mental illnesses. Finally, RIS may be a useful alternative or adjunctive drug for patients with mood disorders without psychotic features or refractory to treatment with standard antipsychotic drugs. The more conservative doses(tirated slowly from 1-3 mg/d) of RIS, and maintenance of mood stabilizer in the cases with risk factors of RIM are recommended in mood disorder.

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The Lived Experience of the Women with Schizophrenia Taking Antipsychotic Medication (여성 정신분열병 환자의 항정신성 약물 복용 체험)

  • Song, Eun-Ju
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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    • pp.382-392
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    • 2011
  • Purpose: This study was done to identify some natural meaning through the dosage experience of psychoactive drugs in women patients with schizophrenia. Methods: The Hermeneutic phenomenology written by van Manen was used. The period for data collection was from November 2009 to January 2010. This study took place in mental health hospitals and mental health centers in two cities in North Jeolla Province. Nine patients with schizophrenia participated. Data collection was done through individual in-depth interview. Results: The seven natural subjects demonstrated by participants from this study were 'Pills forcibly taken like veiled threats', 'A terrible side effect, a side effect rooted slowly', 'Shame which cannot be hidden as a woman', 'A bad medicine took away from motherhood', 'The fate of a wife who can't be equal', 'A struggle for the complete recovery without promise', and 'Participants want the future without medicine'. Conclusion: The results of this study indicate that the urgent need to develop a safe and believable psychoactive drug for woman patients considering the time of menstruation, pregnancy, childbirth, and child raising.

Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry (신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로)

  • Ryu, Seong-Gon;Kwon, Hee-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.25-30
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    • 2008
  • With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

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Influences of the Psychotropic Drugs on the Brain Amine Concentration (Part 1) (향정신성약물(向精神性藥物)이 뇌(腦) amine 함량(含量) 변동(變動)에 미치는 영향(影響)(제 1 보고)(第 1 報告))

  • Lee, Se-Kyu;Kim, Hei-Sung
    • The Korean Journal of Pharmacology
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    • v.6 no.1
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    • pp.15-22
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    • 1970
  • The present study is concerned with the demonstration of the relationship between the behavior and the brain concentration of noradrenaline resulted from pretreatment of amphetamine in isolated or aggregated rats. The experimental subjects were rats weighing from 120g to 200g housed 1, 2, and 6 in a cage. Analeptic activity of amphetamine was measured by determining the sleeping time induced by pentobarbital sod. The noradrenaline content in brain was determined with Aminco-Bowmann's spectro-photofluorometer by Lee's modification of Shore and Olin method. Results: 1) The analeptic activity of amphetamine on the sleeping time induced by pentobarbital sod. was more increased in the grouped rats than in isolated animal. 2) In being isolated and grouped rats, the sleeping time induced pentobarital sod, was markedly prolonged by pretreatment of amphetamine. 3) Means of housing rats, e.g., isolation or aggregation did not seem to affect the brain noradrenaline depleting action. 4) Repeated daily parenteral administration of amphetamine sulfate for a period 1 to 3 weeks resulted in decrement of brain noradrenaline concentration in being isolated and grouped rats. 5) The prolongation of sleeping time of the isolated or aggregated rats, when pretreated with amphetamine, compared with that of stock rats, seems to be attributable rather to the means of housing than the variation of the noradrenaline caused by amphetamine.

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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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Neuropsychiatric Aspects of Pulmonary Disease (호흡기 질환의 신경정신과적 측면)

  • Nam, Beom-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.45-51
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    • 2009
  • Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

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Drug Treatment in Psychosomatic Disease (정신 신체의학에서 최신 치료 약물)

  • Song, Ji-Young
    • Korean Journal of Psychosomatic Medicine
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    • v.9 no.2
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    • pp.133-142
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    • 2001
  • For treating various conditions of the psychosomatic disease, not only psychotropic drugs but also drugs used in internal medicine or other than psychiatric fields would be applied. So psychiatrists who are interested in psychosomatic medicine should make expanded knowledges of those medicine. And modalities of drug treatment should be modified according to the characteristics of illness behavior and disease concept which the patient have. Some drugs used in complementary medicine could be applied to the psychosomatic illness. For example, herbs and/or aromas which have some effects without serious adverse reactions could be used carefully to the patient. And the mode of action and efficacies of them should be evaluated by doctors.

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Health Effects of Small Volatile Compounds from East Asian Medicinal Mushrooms

  • Pennerman, Kayla K.;Yin, Guohua;Bennett, Joan Wennstrom
    • Mycobiology
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    • v.43 no.1
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    • pp.9-13
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    • 2015
  • Medicinal fungi, taken whole or as various forms of extracts, have been used to alleviate, cure or prevent human ailments since pre-historic times. In particular, Asian cultures have incorporated a variety of mushrooms into their medical practices. Chemically pure, bioactive metabolites from fungi have been a mainstay of modern pharmacological research and in addition to antibiotics, include anticancer agents, immunosuppressants, enzyme inhibitors, antagonist and agonists of hormones, and a variety of psychotropic substances. However, to date not many studies have focused on the possible health benefits of odorant volatile organic compounds (i.e., gas phase compounds). An analysis of these compounds for their health related effects will expand the range of compounds available for the treatment of chronic and acute diseases. This review highlights phenolic acids and monoterpenes from Asian medicinal mushrooms (AMMs), which not only produce pleasant odors but also have antioxidant and antibacterial effects. Odorant bioactive volatile phase compounds from medicinal mushrooms remain an essentially untapped source for future medicines, and AMMs remain a promising resource for future pharmacological research.