• 한국임상약학회지
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• 제22권1호
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• pp.65-72
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• 2012

Antidepressants are frequently prescribed for a wide range of symptoms. Surveys in several countries have suggested that negative attitudes towards antidepressants are common. However, there has been limited research associated with the attitudes in Korea. Therefore, this quantitative descriptive study describing the perception and attitudes toward antidepressants was performed using healthy people and outpatients who are not taking antidepressants. The surveys by means of self-reporting questionnaires showed negative attitudes towards antidepressants (74.2%). But, 74.2% of above participants gave positive answers to take antidepressants when they are counseled by medical professionals. Higher rates of negative attitudes were found in younger age group ("it causes addiction") and healthy volunteers and urban area groups ("it causes physical harm"). Study participants without experiences in taking antidepressants showed more negative attitudes although the difference was not statistically significant. Based on the results, accurate and objective information about antidepressants needs to be provided by well-trained health professionals.

• 생물정신의학
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• 제23권1호
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• pp.1-11
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• 2016

Development of various antidepressants such as monoamine oxidase inhibitors, tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, and noradrenergic and specific serotonergic antidepressant has led to a tremendous progression of pharmaceutical treatment for depression, but still there are some limitations of current antidepressants, such as treatment-resistant depression and delayed onset of antidepressants. The pathogenesis of depression is unclear because depression is a heterogeneous disease state, and the mechanisms of antidepressants remain uncertain as well. Nevertheless, in an attempt to develop novel antidepressants, some trials have been conducted based on the potential biological mechanism discovered in the numerous research results. This review will provide information about the potential novel antidepressants and the current states of clinical studies using them. In particular, some potential novel antidepressants anti-inflammatory agents, antioxidants, anticholinergics, modulators of Hypothalamic Pituitary Adrenal Axis, glutamate, and opioid systems, as well as some neuropeptides such as susbstance P, neuropeptide Y, and galanin will be discussed.

• 정신신체의학
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• 제16권1호
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• pp.52-58
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• 2008

연구목적 : 항우울제는 정신과 의사뿐만 아니라 많은 비정신과 의사들에 의해 처방 되어지는 정신과 약물이다. 하지만 항우울제에 대해 부정적인 인식이 높은 게 현실이다. 따라서 본 연구는 대학병원 외래를 방문한 일반 환자군들을 대상으로 항우울제에 대한 전반적인 인식과 태도를 알아봄으로써, 항우울제 및 정신과 약물에 대한 사회적 편견 및 오해를 줄여 나가고, 지역사회 정신건강 발전에 도움이 되는 기초 자료로 삼고자 연구를 시행하였다. 방법 : 일 지역 대학병원에 내원한 내과계열 및 외과계열 외래 환자들 200명을 대상으로 정신과 전공의 2인 및 수련의가 외래 대기실에서 환자들을 면담하여 연구 목적을 설명하고, 항우울제에 대한 인식과 태도에 대해 평가하기 위하여 12문항으로 고안한 자가 보고형 설문지를 사용하였다. 결과 : 1) 내과 및 외과 계열 환자들 모두에서 항우울제에 대한 부정적인 인식이 매우 높았다. 2) 외과계열 외래 환자들이 내과 계열 환자들보다 항우울제 약물이 몸에 해롭다고 생각하는 비율이 더 높았다. 3) 항우울제 복용 경험이 없는 환자들이 항우울제에 대해서 부정적인 인식과 태도를 갖고 있었다. 4) 항우울제 복용 거부 이유로는 약물 부작용에 대한 두려움이 높았다. 결론 : 항우울제의 처방시 일반인들의 항우울제에 대한 부정적인 인식을 이해하고, 항우울제에 대해 근거있고 객관적인 사실을 설명하는 적극적인 노력이 더욱 필요하다.

• 생물정신의학
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• 제6권1호
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• pp.34-40
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• 1999

New antidepressants have become available for clinical use in the 1990s. Before this decade, the drugs available to treat depression consisted essentially of monoamine oxidase inhibitors, tricyclic antidepressants, and lithium. Following the introduction of SSRIs, the options have expanded and now include SSRIs, nefazodone, venlafaxine, mirtazapine, reboxetine, tianeptine. Newer antidepressants possess a variety of pharmacological characteristics that are relevant to the choice of an antidepressant for clinical use. This review summarizes some of the major pharmacological characteristics among the drugs.

• 약학회지
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• 제57권4호
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• pp.289-292
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• 2013

A total of 2,080 forensic autopsies in Seoul, Incheon and Gyeonggi province were performed by the National Forensic Service (NFS) in 2010. After analysing blood samples collected at autopsies by GC-MS and LC-MS/MS, the types and prevalence of drugs and poisons in blood were investigated using our laboratory information management system. Among 2,080 cases, 1,061 cases (51%) were positive for drugs and poisons. Surprisingly, antidepressants were identified in 137 cases which comprised 13% of the positive cases. Twelve different kinds of antidepressants were determined: Amitriptyline, fluoxetine, nortriptyline, trazodone, imipramine, mirtazapine, citalopram, venlafaxin, clomipramine, paroxetine, sertraline and bupropion. Amitriptyline was the most frequently detected antidepressant and was identified in 39 cases. Moreover, amitriptyline, fluoxetine, and nortriptyline were included in the list of the 20 most commonly encountered drugs or poisons in the analysis of blood collected at autopsies from 2007 to 2009, indicating the prevalence of their use. In this study, the 137 antidepressant-related deaths were classified by the mode of death to predict the prevalence of these drugs. As a result, those deaths were divided into four groups based on the cause and mode of death: 56 cases of suicide with fatal concentrations of antidepressant drugs in blood, 6 homicidal cases directly or indirectly related to antidepressants, 59 natural deaths with antidepressants detected in blood and 16 deaths caused by fire or other accidents with antidepressants detected in blood. Because incidents involving antidepressants have been increasing, especially in suicides or homicides, it is necessary for the health authorities and law enforcement administrations to cooperate and share the statistical data for curbing the abuse of antidepressants. This report is expected to provide the reference data related with antidepressants for the investigation of the deaths.

• The Korean Journal of Physiology and Pharmacology
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• 제2권3호
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• pp.307-312
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• 1998

This study was performed to investigate the mechanism of central analgesic effects of antidepressants. Thirty four male rats were anesthetized with pentobarbital sodium (40 mg/kg, ip). A stainless steel guide cannula and a PE tube (PE10) were implanted into the lateral ventricle and cisterna magna area. Stimulating and recording electrodes were implanted into the incisor pulp and anterior digastric muscle. Electrodes were led subcutaneously to the miniature cranial connector sealed on the top of the skull with acrylic resin. The jaw opening reflex was used in freely moving rats, and antidepressants were administered intracisternally in order to eliminate the effects of anesthetic agents on the pain assessment and evaluate the importance of the central action site of antidepressants. After 48 hours of recovery from surgery, digastric electromyogram (dEMG) of freely moving rats was recorded. Electrical shocks (200 ${\mu}sec$ duration, 0.5-2 mA intensity) were delivered at 0.5 Hz to the dental pulp every 2 minute. Intracisternal administration of $15\;{\mu}g$ imipramine suppressed dEMG elicited by noxious electrical stimulation in the tooth pulp to $76{\pm}6%$ control. Intracisternal administration of $30\;{\mu}g$ desipramine, nortriptyline, or imipramine suppressed dEMG remarkably to $48{\pm}2,\;27{\pm}8,\;or\;25{\pm}5%$ of the control, respectively. Naloxone, methysergide, and phentolamine blocked the suppression of dEMG produced by intracisternal antidepressants from $23{\pm}2\;to\;69{\pm}4%,\;from\;32{\pm}5\;to\;80{\pm}9%,\;and\;from\;24{\pm}6\;to\;77{\pm}5%$ of the control, respectively. These results indicate that antidepressants produce antinociception through central mechanisms in the orofacial area. Antinociception of intracisternal antidepressants seems to be mediated by an augmentation of descending pain inhibitory influences on nociceptive pathways.

• 한국임상약학회지
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• 제26권2호
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• pp.107-114
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• 2016

Background: Depression is the leading cause of lowering the quality of life of cancer patients and lung cancer is the most likely to cause depression. It is necessary to find out depression-related factors in lung cancer patients. Methods: The study was a retrospective cohort study using medical records, and was a non-equivalent comparison group design. It involved patients diagnosed of lung cancer at the Konkuk University Medical Center from January to December 2012. Between antidepressants prescription group and non prescription group, socio-demographic factors, clinical factors, treatment-related factors and other factors were analyzed statistically. Results: Antidepressant prescription group consisted of 23 people and non-prescription group of 206 people. Prescription rate of quetiapine was the highest 47.8% (11/23), followed by escitalopram (43.5%, 10/23), amitryptyline and trazodone (30.4%, 7/23). The prescription group was prescribed with an average of 1.9 antidepressants. Antidepressants were prescribed after average of 248 days from lung cancer diagnosis and prescription period per patient was average 177.5 days. According to the result of univariate logistic regression analysis between 2 groups, factors such as number of outpatient visit, number of admission, days of hospitalization, sleep disorder, and comorbidity were found to be statistically significant (p < 0.05). However, According multivariate logistic regression analysis showed that number of admission, days of hospitalization and sleep disorder were statistically significant (p < 0.05) excluding comorbidity. Conclusion: About 10% of lung cancer patients had received a prescription for antidepressants after lung cancer diagnosis. A sleep disorder, number of hospitalization and length of stay were identified as factors influencing the prescribing antidepressants.

• Biomolecules & Therapeutics
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• 제1권1호
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• pp.121-124
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• 1993

To elucidate the effect of antipsychotics and antidepressants on phosphoinositide(Pl) second massenger system, we studied the dose-dependent inhibition of the phosphoinositide-specific phospholipase C(PLC) isozymes, ${\beta}_1,\;{\gamma}_1$ and${\delta}_1,$ by fluphenazine and haloperidol as antipsychotics, and amitriptyline, maprotiline and mianserin as antidepressants. All the antipsychotics and antidepressants tested showed inhibition on at least one of the PLC isozymes with $IC_{50}$ at the concentration between 25 and $250 {\mu}M.$ Maprotiline, mianserin and amitriptyline inhibited 80 to 90% of the activities of all three PLC isozymes at the concentration of $250{\mu}M,$ while haloperidol and fluphenazine inhibited PLC ${\beta}_1$ and${\gamma}_1$ But baclofen didn't inhibit any PLC isozyme. These results suggested that PLC isozymes are inhibited by antipsychotics and antidepessants even though the concentration is high, and these drugs may affect PI signal transduction system by direct inhibition of PLC isozymes.

• 정신신체의학
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• 제15권1호
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• pp.7-13
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• 2007

항우울제는 정신과 의사뿐만 아니라 많은 비정신과 의사들에 의해 사용되어지는 정신과 약물이다. 특히 기질적 원인이 뚜렷한 신체질환과 관련된 우울증과 통증에 대하여 오래전부터 삼환계 항우울제가 사용되어 그 효과가 입증되어 왔으며 최근 새롭게 사용되는 세로토닌 관련 항우울제의 효과가 보고되면서 사용의 폭이 더욱 넓어지고 있다. 여기에서는 신체질환에 대한 우울증의 영향과 항우울제 치료, 통증에 대한 항우울제의 진통 효과와 몇 가지 정신신체질환에 대한 항우울제 사용에 대하여 지금까지의 연구 문헌을 검토 및 정리하였다. 우울증이 정신신체질환의 치료 결과에 미치는 영향에 대해서는 아직도 논란중이지만 기존의 신체질환 치료와 함께 적절한 항우울제의 병합 또는 보조적 사용으로 긍정적인 치료 결과와 환자의 삶의 질을 향상시키는 것으로 생각된다.

• 생물정신의학
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• 제13권4호
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• pp.244-251
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• 2006

Depression is a frequent cause of suicide. Although there have been reports that SSRIs might increase suicidal ideations and behaviors, most studies found antidepressants are effective treatments of suicidal ideations and behaviors. Antidepressants have also been shown to have prophylactic effects in preventing suicidal behaviors. Most double-blind studies do not suggest a causal relationship between antidepressant and the increased suicidality. Our review results suggest that the undertreatments of depression are more significant problems with the use of antidepressants in suicidal patients.