• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.361-375
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• 2018

We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted. In addition, the GRADE (the Grading of Recommendations, Assessment, Development and Evaluation) approach was applied to explicitly assess the quality of the evidence. A total of 30 studies including 17 RCTs and 13 observational studies were selected. The group treated with LAI SGAs was characterized by significantly lower relapse rates, longer times to relapse and fewer hospital days, but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs. Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia, LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms. Additionally, the use of LAI SGAs should be combined with appropriate measures to reduce dopamine $D_2$ antagonism-related symptoms.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.155-162
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• 2015

Objectives Second-generation antipsychotics (SGAs) are frequently used in the treatment of bipolar disorder. However, there is still no consensus on their risk of tardive movement syndromes especially for first-generation antipsychotics (FGAs)-naïve patients. This study aimed to investigate the prevalence and associated factors of SGAs-related tardive dyskinesia and tardive dystonia in patients with bipolar disorder, in a naturalistic out-patient clinical setting. Methods The authors assessed 78 non-elderly patients with bipolar (n = 71) or schizoaffective disorder (n = 7) who received SGAs with a combined use of mood stabilizers for more than three months without previous exposure to FGAs. Multiple direct assessments were performed and hospital records longer than one recent year describing any observed tardive movement symptoms were also reviewed. Results The prevalence rates of tardive dyskinesia and tardive dystonia were 7.7% and 6.4%, respectively. These patients were being treated with ziprasidone, risperidone, olanzapine, quetiapine, or paliperidone at the time of the onset of the movement symptoms. Tardive dyskinesia was mostly observed in the orolingual area, and tardive dystonia was most frequently detected in oromandibular area. A past history of acute dystonia was significantly associated with presence of both tardive movement syndromes. Conclusions Our findings suggest that SGAs-related tardive movement syndromes occur in a substantial portion of bipolar disorder patients. Acute dystonia, a reported risk factor of tardive movement syndromes in the era of FGAs is confirmed as a risk factor of both tardive dyskinesia and tardive dystonia that were induced-by SGAs.

• Journal of Oriental Neuropsychiatry
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• v.24 no.3
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• pp.257-262
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• 2013

Objectives : Aripiprazole is unique drug among the SGA (Second generation antipsychotics) in its pharmacology and pharmacokinetics,but is similar in clinical efficacy. Aripiprazole acts as a partial agonist at dopamine D2 receptors, activating the receptor but eliciting a reduced response compared to the natural neurotransmitter. There are some side effects of aripiprazole, the most common side effects of aripiprazole are headache, nausea, vomiting, insomnia, tremor, constipation and EPS. Difficulty in opening eyes is not defined EPS yet, but it is a rare but important side-effect symptom of aripiprazole. Methods : This article is about a case of side-effect symptom of aripiprazole, 26-year-old single female suffering from schizophrenia had difficulty in opening eyes while she was taking antipsychotics. During the hospitalization, the relaxation therapy is helpful not only to reduce tension in the eyelids but also to headache. Results : It is important that early recognition of aripiprazole-induced oculogyric dystonia can prevent life-threatening complications. Education medical staff to this easily treatable reaction will improve overall quality of health care. Conclusions : This case notifies the need for awareness of the risk of acute oculogyric dystonia in adolescent female patients receiving aripiprazole.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.165-171
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• 2022

Objectives : This study was conducted to investigate the effect of 1-year administration of second-generation antipsychotics (SGAs) on the platelet activity in patients with schizophrenia through a retrospective review of the medical records. Methods : The mean platelet component (MPC) value was used as an index of the platelet activity. The included subjects (N=24) were the patients who were confirmed to have taken SGAs continuously for one year after the first MPC measurement had been performed. The change of MPC was verified through a paired sample t-test. Results : The result revealed that the mean MPC value was significantly decreased from 26.5±1.4 g/dL to 25.6±1.8 g/dL after 1-year administration of SGAs from the time of the first MPC measurement. Conclusions : This study suggests that 1-year administration of SGAs may be related with increased platelet activity, and that close monitoring for risks such as cerebrovascular/cardiovascular or thromboembolic diseases may be necessary during SGAs treatment in clinical practice.