• Title/Summary/Keyword: antidepressants

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Korean Guidelines for the Treatment of Panic Disorder 2018 : Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Panic Disorder (2018 한국형 공황장애 치료지침서 : 초기 및 유지 약물치료 전략)

  • Kim, Min-Kyoung;Lee, Jae-Hon;Gim, Minsook;Kim, Won;Moon, Eunsoo;Seo, Ho-Jun;Koo, Bon-Hoon;Yang, Jong-Chul;Lee, Kang Soo;Lee, Sang-Hyuk;Kim, Chan-Hyung;Yu, Bum-Hee;Suh, Ho-Suk
    • Anxiety and mood
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    • v.14 no.2
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    • pp.53-62
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    • 2018
  • Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for treatment of panic disorder (PD) 2018. In this paper, we discussed the consensus among psychiatrists, regarding initial and maintenance treatment strategies for pharmacological treatment of PD in Korea. Methods : Based on current treatment guidelines published by the American Psychiatric Association, the National Institute for Clinical Excellence, and the Canadian Psychiatric Association, we developed questionnaires pertinent to initial and maintenance treatment strategies for pharmacological treatment of PD. Seventy-two experts in PD answered questionnaires. We classified expert opinions into three categories, first, second, and third-line treatment strategies, by analyzing the 95% confidence interval. Results : Antidepressants, benzodiazepine anxiolytics, and cognitive-behavioral therapy (CBT) were recommended as treatments of choice (ToC), and first-line strategies for initial treatment of PD. Escitalopram, paroxetine, sertraline, and venlafaxine were preferred from among many anti-panic drugs. Mean starting dose of anti-panic drugs for initial treatment of PD was relatively lower, than that for other psychiatric illnesses such as major depressive disorder. In the case of maintenance treatment of PD, antidepressants and CBT were selected as ToC and first-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study provides information about consensus among Korean experts regarding pharmacological treatment strategies for patients with panic disorder.

The Role of Autophagy in Depression (우울증에서 자가소화작용의 역할)

  • Seo, Mi Kyoung;Park, Sung Woo;Seog, Dae-Hyun
    • Journal of Life Science
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    • v.32 no.10
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    • pp.812-820
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    • 2022
  • Depression is a psychiatric disorder characterized by depressed mood, anhedonia, fatigue, and altered cognitive function, leading to a decline in daily functioning. In addition, depression is a serious and common mental illness not only in an individual's life but also in society, so it must be actively treated. Autophagy is involved in the pathophysiological mechanism of mental illness. According to a recent study, it is known that autophagy-induced apoptosis affects neuroplasticity and causes depression and that antidepressants regulate autophagy. Autophagy is a catabolic process that degradation and removes unnecessary organelles or proteins through a lysosome. And, it is essential for maintaining cellular homeostasis. Autophagy is activated in stress conditions, and depression is a stress-related disease. Stress causes damage to cellular homeostasis. Recently, although the role of autophagy mechanisms in neurons has been investigated, the autophagy of depression has not been fully studied. This review highlights the new evidence for the involvement of autophagy in the pathophysiological mechanisms and treatment of depression. To highlight the evidence, we present results from clinical and preclinical studies showing that autophagy is associated with depression. Understanding the relevance of autophagy to depression and the limitations of research suggest that autophagy regulation may provide a new direction for antidepressant development.

MANAGEMENT OF THE CHILD WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDERS (ADHD) (주의력 결핍장애아동의 치료)

  • Ahn, Dong-Hyun;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.77-88
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    • 1990
  • Management of the child with Attention-Deficit Hyperativity Disorder(ADHD) reguires a comprehensive approach of cognitive-behavioral, educational, and pharmacological interventions. Establishing the valid diagnosis is the first step of management. After the diagnosis is made, the clinician must then interpret the diagnosis and its impliations to the child, parents, and teachers. The pharmacotherapy is most effeceive, and the CNS stimulants (methylphenidate) is drug of choice. Although generally not as effective as stimulants, triacyclic antidepressants, clonidine, antipsychotics offer the alternatives to stimulants therapy. Additional treatments, including psychotherapy, cogntive-behavioral approach, educational infervention, parental counseling are also essential in managing the child with ADHD. Finally, controversial approaches-diet therapy, mineral therapy, hypoglycemia, megavitamin therapy, refined sugars, neurophysiological retraining approaches are reviewed.

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Development of New Surfaces and Materials for Separation Science

  • Linford, Matthew R.
    • Proceedings of the Korean Vacuum Society Conference
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    • 2015.08a
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    • pp.59.1-59.1
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    • 2015
  • In the Linford group at Brigham Young University we have recently developed three new sets of materials for three different areas of separations science: thin layer chromatography (TLC), high performance liquid chromatography (HPLC), and solid phase microextraction (SPME). First, via microfabrication we have grown patterned carbon nanotube (CNT) forests on planar substrates that we have infiltrated with inorganic materials such as silicon nitride. The coatings on the CNTs are conformal and typically deposited in a process like low pressure chemical vapor deposition. The resulting materials have high surface areas, are porous, and function as effective separation devices, where separations on our new TLC plates are typically significantly faster than on conventional devices. Second, we used the layer-by-layer (electrostatically driven) deposition of poly (allylamine) and nanodiamond onto carbonized poly (divinylbenzene) microspheres to create superficially porous particles for HPLC. Many interesting classes of molecules have been separated with these particles, including various cannabinoids, pesticides, tricyclic antidepressants, etc. Third, we have developed new materials for SPME by sputtering silicon onto cylindrical fiber substrates in a way that creates shadowing of the incoming flux so that materials with high porosity are obtained. These materials are currently outperforming their commercial counterparts. Throughout this work, the new materials we have made have been characterized by X-ray photoelectron spectroscopy, time-of-flight secondary ion mass spectrometry, scanning electron microscopy, transmission electron microscopy, etc.

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Venlafaxine-Induced Acute Toxic Hepatitis (Venlafaxine에 의한 급성 독성 간염 1예)

  • Na, Kyeong-Sae;Hwang, Hee-Sung;Kim, Shin-Gyeom;Lee, So-Young-Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.18 no.3
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    • pp.159-162
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    • 2011
  • Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.

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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Neurobiology of Depression (우울증의 신경생물학)

  • Kim, Young-Hoon;Lee, Sang-Kyeong;Rhee, Chung-Goo;Kim, Jeong-Ik
    • Korean Journal of Biological Psychiatry
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    • v.6 no.1
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    • pp.3-11
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    • 1999
  • At the beginning, researches on the biology of depression or affective illness have focused mainly on the receptor functions and neuroendocrine activities. And the studies of the past years did not break new theoretical background, but the recent advances in the research on the molecular mechanisms underlying neural communication and signal transduction do add some insights to many established ideas. This article will overview some of the more recent advances in the clinical researches of depression. Our major concerns to be presented here include the followings : (1) alterations in the post-synaptic neural transduction ; (2) changes in the neurons of hypothalamic neuropeptides ; (3) decreased peptidase enzyme activities ; (4) associations of hypothalamic-pituitary-adrenal axis abnormalities with serotonin neurotransmission ; (5) role of serotonin transporter ; (6) changes in the responsiveness of intracellular calcium ion levels ; (7) the inositol deficiency theory of lithium and depression ; (8) the transcription factors including immediate early genes ; (9) recent genetic studies in some families. This brief overview will suggest that changes in DNA occur during antidepressant therapy. These changes at the DNA level initiating a cascade of events underlying antidepressant modality will give us the insights on the molecular biological basis of the pathogenesis of depression and cues for a new class of antidepressants.

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Analysis of Frequently Diagnosed Gastrointestinal Disorders and Therapeutic Regimens in the Outpatients (외래환자의 위장관계 다빈도 질환과 처방 분석)

  • Kim, Min Jeong;Choi, Kyung Eob
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.22-32
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    • 1997
  • The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.

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A Review of Burning Mouth Disorders (구강작열감질환에 관한 고찰 및 의료분쟁 증례보고)

  • Hur, Yun-Kyung;Jung, Jae-Kwang;Choi, Jae-Kap
    • The Journal of the Korean dental association
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    • v.48 no.9
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    • pp.688-695
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    • 2010
  • Burning mouth disorders (sometimes referred to as burning mouth syndrome) are characterized by a burning sensation in the tongue or other oral sites, usually in the absence of clinical and laboratory findings. Affected patients often present with multiple oral complaints, including burning, dryness and taste alterations. Burning mouth complaints are reported more often in women, especially after menopause. Typically, patients awaken without pain, but report increasing symptoms through the day and into the evening. Conditions that have been reported in association with burning mouth syndrome include chronic anxiety or depression, various nutritional deficiencies, diabetes and changes in salivary function. However, these conditions have not been consistently linked with the syndrome, and their treatment has had little impact on burning mouth symptoms. Recent studies have pointed to dysfunction of several cranial nerves associated with taste sensation as a possible cause of burning mouth disorders. The most common central mechanism that likely explains burning mouth disorders is a centrally mediated continuous neuropathic pain. Given in low dosages, benzodiazepine, tricyclic antidepressants or anticonvulsants may be effective in patients with burning mouth disorders.

Traditional Korean Medical Treatment for Chemotherapy-induced Peripheral Neuropathy - a Case Report (항암제 투여 후 발생한 수족비증(手足痺症) 환자 치험례)

  • Yoo, Seung-Yeon;Jeong, Jong-Soo;Park, Jae-Woo;Yoon, Seong-Woo
    • Journal of Korean Traditional Oncology
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    • v.12 no.1
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    • pp.83-89
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    • 2007
  • Chemotherapy has many known side effects. Neuropathy is a common side effect when using cisplatin. The clinical course varies and depends on the agents used and their cumulative dose. Although symptoms can resolve completely, in most patients chemotherapy-induced peripheral neuropathy is either only partially reversible or completely irreversible. Current management for chemotherapy-induced peripheral neuropathy is symptomatic relief using membrane stabilizing medications and antidepressants. Dysaesthesia and pain involving the feet and hands are described in traditional korean medicine. In traditional korean medicine, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. We report a case of a 52 years old female patient treated with acupuncture and bleeding treatment for the goal of improving the symptoms of chemotherapy induced peripheral neuropathy. Further study and other medical method will be needed in order to improve the effect and determine the long-term effect of traditional korean medicine in treating Chemotherapy-induced Peripheral Neuropathy.

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