• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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• pp.238.2-239
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• 2003

The purposes of this study were to evaluate the relationship between the genetic polymorphisms in CYP2D6*10 allele, MDR1 (exon 21 and 26) gene and risperidone pharmacokinetics in healthy male Korean subjects. A single dose of 2 mg risperidone tablet was given orally to 23 healthy male Korean volunteers. Blood samples were taken during the 12 hours after the dose. Serum concentrations of risperidone and 9-hydroxyrisperidone were measured using HPLC with UV detector. 23 subjects were genotyped for CYP2D6*10 allele, MDR1 G2677 T and C3435T by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). (omitted)

• 생물정신의학
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• 제2권2호
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• pp.281-286
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• 1995

Objects : Manic phase of bipolar disorder is treated with a combination of mood stabilizer and antipsychotic drug, especially in the acute phase. Such combined treatment is often required for the clinical management of manic symptoms until therapeutic effects of mood stabilizer become evident. The present study was the first open trial to evaluate the efficacy of risperidone, and safety of the combination of mood stabilizer and risperidone in the treatment of acute manic patients. Method : This study was performed as an open clinical study. The subjects of this study were 42 patients who had been admitted with first manifestations or acute exacerbations of illness were selected, using DSM-III-R criteria for bipolar disorder, manic episode. Patients were rated using the the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI), Extrapyramidal Symptom Rating Scale(ESRS). Other adverse events were assessed by a symptom checklist and by observation by medical personnel. Vital signs were monitored in a standard way and electrocardiography, routine laboratory analysis were performed. Results : Thirty patients(67%) completed the 12-week trial period. The CGI showed a good therapeutic effect with a minimal incidence or severity of side effects. The majority of patients showed a continuos reduction in their BPRS scores. The extrapyramidal symptoms assessed on ESRS generally showed mild to moderate degree. laboratory porameters showed no significant changes during the course of treatment. Conclusion : The results of the study showed a good efficacy of the risperidone in manic patients and further controlled studies are warranted.

• 생물정신의학
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• 제7권1호
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• pp.99-106
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• 2000

Background : In spite of relative high risk of extrapyramidal side effect and tardive dyskinesia, it is common clinical practice to use antipyschotics in treatment of bipolar I disorder. But in Korea, there has been few study about clinical factors related with antipsychotics treatment in bipolar disorder patients. So the author studied about the clinical factors related with antipsychotics treatment in bipolar inpatients focusing on the comparison of risperidone and classical antipsychotics. Method : By reviewing medical record retrospectively, datas about patient-related, illness-related, and treatment-related clinical factors on antipsychotics use were collected. Association between antipsychotics dose and duration and clinical factors were analysed by statistical method. Results : Aggressive behavior was only statistically significant factor associated with antipsychotics use. And in the case of aggression, maintenance dose of risperidone was not changed(p=0.84), but dose of classical antipsychotics was increased significantly(p=0.005). Total hospital days and antipsychotics treatment duration showed no difference between risperidone and classical antipsychotics treatment groups. Conclusion : Clinical factors associated with antipsychotics use was aggressive behavior. In the case of aggression, risperidone required lesser dose increment compared with classical antipsychotics.

• Journal of Pharmaceutical Investigation
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• 제34권2호
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• pp.139-145
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• 2004

The purpose of the present study was to evaluate the bioequivalence of two risperidone tablets, Risperdal (Janssen Korea Co., Ltd.) and Rispen (Myung In Pharm. Co., Ltd), according to the guidelines of Korea Food and Drug Administration (KFDA). The risperidone release from the two risperidone formulations in vitro was tested using KP VIII Apparatus II method with various of dissolution media (pH 1.2, 4.0, 6.8 buffer solution and water). Twenty four healthy male subjects, $23.33\;{\pm}2.10$ years in age and $69.24{\pm}8.05\;kg$ kg in body weight, were divided into two groups and a randomized $2\;{\times}\;2$ cross over study was employed. After one tablet containing 2 mg as risperidone was orally administered, blood was taken at predetermined time intervals and the concentrations of risperidone in serum were determined using HPLC method with UV detector. The dissolution profiles of two formulations were similar at all dissolution media. Besides, the pharmacokinetic parameters such as $AUC_t$,$C_{max},\;and\;T_{max}$ were calculated and ANOVA test was utilized for the analysis of the parameters using logarithmically transformed $AUC_t$,$C_{max}$ and untransformed $T_{max}$. The results showed that the differences between two formulations based on the Risperdal were 0.20, -1.29 and -11-09% for $AUC_t$,$C_{max},\;and\;T_{max}$, respectively There were no sequence effects two formulations in parameters. The 90% confidence intervals using logarithmically transformed data were within the acceptance range of log(0.8) to log(1.25) (e.g.,$log(0.90){\sim}log(1.30)$ and $log(0.84){\sim}log(1.09)$ for$AUC_t$ and $C_{max}$, respectively). Thus, the criteria of the KFDA guideline for the bioequivalence were satisfied, indicating Rispen tablet and Risperdal tablet were bioequivalent.

• 생물정신의학
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• 제15권2호
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• pp.101-109
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• 2008

목 적 이 연구는 수컷과 암컷 생쥐에서 amisulpride를 투여하였을 때 먹이 섭취량, 체중 및 대사 지표에 대한 영향을 risperidone 및 정상 대조군과 비교하여 알아보고자 하였다. 방 법 수컷과 암컷 C57BL/6형 생쥐를 저용량 amisulpride 투여군(1.5mg/kg), 고용량 amisulpride투여군(15mg/kg), risperidone 투여군(0.1mg/kg)과 Vehicle군으로 나누었다. 약물은 21일간 매일 하루에 한 번 복강 주사를 통해 투여되었다. 체중은 일주일에 한 번씩 측정하였으며 먹이 섭취량은 매일 측정하였다. Triglyceride(TG), glucose, insulin 그리고 prolactin은 실험 종료 시에 측정하였다(실험 22일). 결 과 암컷 생쥐의 경우, 저용량과 고용량의 amisulpride 투여군에서는 유의한 체중 증가를 보였으며, risperidone 역시 유의한 체중 증가를 보였다. 그러나, 두 amisulpride군의 증가량은 risperidone군의 증가량에 비해 수치적으로 작았다. 수컷 생쥐의 경우, 고용량의 amisulpride만이 유의한 체중 증가를 가져왔다. 체중 증가를 보였던 집단 중에서, 고용량의 amisulpride를 투여하였던 수컷 생쥐만이 유의하게 증가된 먹이 섭취량과 연관성이 있었다. 암컷 생쥐에서 체중 증가를 보였던 군들은 먹이 섭취량과 유의한 상관성을 보이지 않았다. 수컷 생쥐에서, 두 개의 amisulpride 투여군 모두는 vehicle에 비해 유의하게 높은 혈장 insulin 수치를 보였다. 암컷과 수컷 생쥐에서, 저용량과 고용량의 amisulpride 투여군은 vehicle과 비교하여 유의하게 높은 혈장 prolactin수치를 보였다. Triglyceride는 모든 집단에서 유의하게 변화하지 않았으며 glucose는 수컷 risperidone 투여군에서만 유의하게 변화하였다. 결 론 Amisulpride는 암수 생쥐에서 체중 증가를 일으키지만, 대사 이상에 대한 결과는 성별에 따라 차이가 있었다. 본 연구의 결과는 amisulpride에 의한 체중 증가에 암수 생쥐에서 서로 다른 기전이 작용할 가능성을 시사한다.

• 대한소아치과학회지
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• 제35권1호
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• pp.47-56
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• 2008

리스페리돈(risperidone)은 세계적으로 가장 널리 처방되고 있는 정신분열증 치료제로서 소아자폐증의 선택약물로 FDA 승인을 받았으며 틱장애, 뚜렛장애의 치료제로도 쓰이고 있다. 치과와 관련된 리스페리돈의 이상반응으로 구강건조가 보고되고 있으며 그 기전은 밝혀지지 않은 상태이다. 본 연구의 목적은 리스페리돈이 타액분비 기전의 중요한 요소인 세포내 칼슘농도에 미치는 영향을 세포수준에서 밝히고자 하는 것이다. 세포내 칼슘농도를 측정하기 위해 Human salivary gland cell line(HSG)에 Fura-2/AM을 세포내로 부하한 뒤 340 및 380 nm의 파장으로 교대로 여기시킬 때 방출되는 형광강도를 500 nm 파장에서의 비율로 측정하였다. 각 실험 후 형광강도의 비율을 실제 세포내 칼슘농도로 보정하기 위한 calibration 실험을 시행하였다. 카바콜, ATP, 히스타민을 처리하여 세포내 칼슘농도의 변화를 측정하고 리스페리돈의 전처리가 이에 미치는 효과를 비교하였으며 다음과 같은 결과를 얻었다. 1. HSG에서 카바콜, ATP, 히스타민 처리로 인해 세포내 칼슘농도가 증가하였으며 리스페리돈을 전처리한 경우 카바콜과 ATP의 작용에는 영향을 주지 않았으나 히스타민의 작용을 억제하였다. 2. HSG의 세포내 칼슘 변화에 미치는 히스타민의 효과는 농도의존적인 양상을 보였으며 50% 유효농도($EC_{50}$)는 $3.3{\pm}0.5\;{\mu}M$이었다. 3. 히스타민에 의한 HSG에서 칼슘 변화에 미치는 리스페리돈의 저해 효과는 농도의존적인 양상을 보였으며 대조군의 효과를 50% 억제하는 농도($IC_{50}$)는 $104.4{\pm}14\;nM$로 리스페리돈의 적정혈중농도 이하에 해당되었다. 4. 리스페리돈은 히스타민에 의한 소포체에서의 칼슘 유리와 세포 밖 칼슘 유입을 모두 유의성 있게 억제하였다(p<0.05). 항정신병 약물은 장기간 복용하고 적정혈중농도가 계속 유지되기 때문에 이러한 약물이 타액분비감소를 일으킬 경우 다발성우식증 등 심각한 치과적 질환을 야기할 수 있으므로 이에 대한 예방 및 치료방안이 필요하리라 사료된다.

• 생물정신의학
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• 제4권2호
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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.

• 한국산학기술학회논문지
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• 제13권5호
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• pp.2125-2132
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• 2012

Fluoxetine과 tianeptine은 보편적으로 사용되는 항우울제 (AD)이며, haloperidol과 risperidone도 많이 사용되는 항정신성 (APD) 약물로 다양한 이온채널을 조절한다. TREK2 채널은 우울증과 정신분열증 같은 정신질환에 대한 병태생리학적으로 중요한 역할을 하는 TREK1 채널과 생리학적 성질이 매우 비슷하여, 정신성 및 우울증 약물의 TREK2 채널에 대한 효과가 TREK1과 유사하게 나타날 가능성이 있다. Excised inside-out 팻취 방법을 사용하여, 클론된 TREK2 채널이 발현된 CHO 세포에서 항정신성 약물과 항우울제의 효과를 조사했다. Fluoxetine (선택적 세로토닌 방출 억제제, SSRI)은 TREK2 채널을 농도 의존적으로 억제하였으나 ($IC_{50}=13{\mu}M$), tianeptine (선택적 세로토닌 재흡수 증가제, SSRE)은 TREK2 채널 활성을 감소시키지 않고 증가시켰다. Haloperidol은 TREK2 채널을 농도 의존적으로 억제하였으나 ($IC_{50}=44{\mu}M$), risperidone은 고농도 ($100{\mu}M$)에서도 TREK2 채널 활성을 완전히 억제 시키지 못했다. 본 연구는 tianeptine 보다 fluoxetine이 TREK2 채널을 더 잘 억제하고 risperidone 보다 haloperidol에 더 잘 억제됨을 보여 주었고, TREK2 채널에 대한 항정신성 약물과 항우울제의 차별적 작용이 약물 부작용의 어떤 기전에 기여 할 수 있음을 제시한다.

• 생물정신의학
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• 제11권1호
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• pp.61-63
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• 2004

We describe the case of a 73 year-old female patient, YSG, who initially presented with a manic episode without any previous psychiatric history and was later diagnosed as having a meningioma in the left frontal lobe. YSG's symptoms were characterized by hyperactivity, insomnia, aggressive behavior with an auditory hallucination. She showed no abnormal signs on a complete neurologic examination. A gadolinium-enhanced MRI study showed a huge, extra-axial mass with homogenous enhancement in the left high convexity of the frontal lobe. Her manic symptoms subsided after administration of risperidone 1mg and valproic acid 500mg daily, for three weeks without surgical resection of the tumor. These findings suggest that YSG's mania might have resulted from the left-sided frontal tumor, and that her symptoms were treated rapidly by small doses of risperidone combined with valproic acid. Medical staff who care for manic patients should be aware of this possibility of a organic lesion without evidence of neurologic disease.

• Archives of Pharmacal Research
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• 제26권11호
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• pp.951-959
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• 2003

A series of typical (chlorpromazine, haloperidol and thioridazine) and atypical (risperidone, quetiapine, clozapine and olanzapine) antipsychotics were tested for effects on integrated bioenergetic functions of isolated rat liver mitochondria. Polarographic measurement of oxygen consumption in freshly isolated mitochondria showed that electron transfer activity at respiratory complex I is inhibited by chlorpromazine, haloperidol, risperidone, and quetiapine, but not by clozapine, olanzapine, or thioridazine. Chlorpromazine and thioridazine act as modest uncouplers of oxidative phosphorylation. The typical neuroleptics inhibited NADH-coenzyme Q reductase in freeze-thawed mitochondria, which is a direct measure of complex I enzyme activity. The inhibition of NADH-coenzyme Q reductase activity by the atypicals risperidone and quetiapine was 2-4 fold less than that for the typical neuroleptics. Clozapine and olanzapine had only slight effects on NADH-coenzyme Q reductase activity, even at 200 $\mu$ M. The relative potencies of these neuroleptic drugs as inhibitors of mitochondrial bioenergetic function is similar to their relative potencies as risk factors in the reported incidence of extrapyramidal symptoms, including tardive dyskinesia (TD). This suggests that compromised bioenergetic function may be involved in the cellular pathology underlying TD.