• 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.25 no.2
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• pp.120-128
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• 2017

Objectives : Although antipsychotics are commonly used to control symptoms of delirium, there is a lack of research on the prescription pattern and its clinical effects. The purpose of this study was to investigate the effect of antipsychotics prescription pattern on clinical course of delirious patients consulted to psychiatry. Methods : During the period from July 2016 to February 2017, 212 patients who were referred for delirium were reviewed for their medical records. The duration of delirium was monitored using CAM-ICU, and duration of admission, mortality, and delirium at discharge were reviewed. Clinical course was compared among three groups according to the antipsychotic drug administration pattern: Continuous use group, optimal use group and PRN use group. Results : The pattern of taking antipsychotic medication longer than duration of delirium did not associated with better clinical course compared with the pattern of adapting to the period of delirium and rather increased the risk of taking antipsychotic medication at discharge. When used for a shorter period than the delirium period, it was associated with poor clinical course. Conclusions : The results of this study suggest that a strategy to administer antipsychotics for a minimum period, according to periods of delirium, is appropriate. Also, efforts are needed to minimize the use of antipsychotic drugs after recovery from delirium.

• 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.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.112-118
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• 2022

Objectives : Zolpidem is a common drug used in insomnia. However, there are several reports of side effects of the central nervous system or sleep related behavior in patients who took zolpidem. This study was conducted to investigate risk factors affecting sleep related behavior after taking zolpidem in inpatients. Methods : From January 1, 2019 to December 31, 2019, medical records of patients who took zolpidem hospitalized at Inha University Hospital were reviewed retrospectively. Results : 907 patients who took Zolpidem, 102 (11.2%) showed sleep related behavior, and if they were 65 years of age or older, men, taking antipsychotics, and taking antipsychotics and benzodiazepines at the same time, they were significantly more likely to show sleep related behavior. Conclusions : Risk factors for sleep-related behavior after use of zolpidem are estimated gender, elderly, antipsychotics, and combination of antipsychotics and benzodiazepines.

• Proceedings of the PSK Conference
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• 2005.04a
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• pp.131-132
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• 2005

• The Korean Journal of Pain
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• v.32 no.1
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• pp.1-2
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• 2019

• Korean Journal of Biological Psychiatry
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• v.3 no.1
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• pp.22-29
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• 1996

The introduction of chlorpromazine in the 1950's revolutionized the treatment of schizophrenia and ultimately led to the development of selective $D_2$ antagonists such as haloperidol, a goal in keeping with the prevalent theories at that time. However, limitations in the efficacy of these agents, a growing awareness of their side effects, and theoretical shifts in our understanding of schizophrenia have encouraged ongoing efforts to develop better 'atypical' antipsychotics. Clozapine, and subsequently risperidone, represent examples of these novel compounds, both of which incorporate shared serotonin-dopamine antagonism(SDA). The next years will be dominated by further development of SDA compounds, although a number of other lines of investigation are also being pursued.

• Archives of Obesity and Metabolism
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• v.1 no.1
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• pp.39-42
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• 2022

Obesity is a chronic disease associated with severe complications. A major complication of obesity is depression, which can worsen obesity and vice versa. In addition, most antidepressants or antipsychotics cause weight gain, and the relationship between obesity and depression is clinically critical. However, treatment of obese patients with major depressive disorder is complicated. Bariatric physicians should provide appropriate behavioral interventions alongside pharmacological treatment, considering psychiatric symptoms, drug side effects, and drug interactions. Two successful cases of moderate-to-severe obese patients with major depressive disorder who had been treated for obesity using behavioral intervention therapy along with liraglutide will be discussed. This report highlights the safety and efficacy of liraglutide treatment of obesity in patients with depression who take antidepressants and antipsychotics.

• Journal of Korean Neuropsychiatric Association
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• v.57 no.4
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• pp.287-300
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• 2018

Of the different phases of bipolar disorder, bipolar depression is more prevailing and is more difficult to treat. However, there is a deficit in systemic research on the pharmacological treatment of acute bipolar depression. Therefore, consensuses on the pharmacological treatment strategies of acute bipolar depression has yet to be made. Currently, there are only three drugs approved by the Food and Drug Administration for acute bipolar depression : quetiapine, olanzapine-fluoxetine complex, and lurasidone. In clinical practice, other drugs such as mood stabilizers (lamotrigine, lithium, valproate) and/or the other atypical antipsychotics (aripiprazole, risperidone, ziprasidone) are frequently prescribed. There remains controversy on the use of antidepressants in bipolar depression. Here, we summarized the evidence of current pharmacological treatment options and reviewed treatment guidelines of acute bipolar depression from recently published studies.

• Korean Journal of Biological Psychiatry
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• v.3 no.2
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• pp.251-257
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• 1996

Selective serotonin reuptake inhibitors(SSRIs), as haloperidol, ore metabolized in the cytochrome P450IID6. They can cause inhibition of metabolism of antipsychotics to elevate the serum level of antipsychotics and exacerbate the extrapyramidal symptoms when co-administered with antipsychotics. Among these SSRIs, there ore a few studies about paroxetine compared to fluoxetine or sertraline. In this study, we have intended to know the drug interaction of paroxetine and haloperidol when co-administered two drugs for the chronic schizophrenics by assessing the changes of positive, negative symptoms and extrapyramidal symptoms. for this purpose, we selected 29 subjects, the chronic schizophrenics with no physical problems. They were under maintenance therapy of haloperidol. They ore randomly assigned to placebo group(n=12) and drug group(n=17) by using double blind method. And then, placebo or paroxetine 20mg were administered to the subjects of each groups during 8 week period. We have assessed their psychopathology and extrapyramidal symptoms using Positive and Negative Syndrome Scale(PANSS), Hamilton Rating Scale lor Depression(HRSD), Simpson-Angus Scale at 0, 2, 4, 6, 8 weeks and serum haloperidol, reduced haloperidol levels at 0, 4, 8 weeks during the period. The results ore analysed by using repeated measure MANOVA. 27 subjects have completed the study during 8 weeks. among the subjects, 1) PANSS, HRSD ; no significant difference between groups. 2) Simpson-Angus Scale ; no significant change according to the time and no significant difference between the groups(no group and time effect). 3) Haloperidol and reduced haloperidol level ; no significant change. When co-administered paroxetine and haloperidol, there ore no significant changes of the psychopothology and no significant changes of the extrapyramidal symptoms. In this result, paroxetine seems to be not to affect the metabolism of haloperidol.