• Korean Journal of Biological Psychiatry
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• v.2 no.1
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• pp.140-143
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• 1995

Tardive dyskinesia(TD), typically appearing as an undesirable side effect of a long term antipsychotic drug treatment has gained increased attention in recent times due to the discovery of many TD variants. This is a single case study of a patient who has undergone more than 8 years of high dosage antipsychotic treatment. After altering the type and dosage of antipsychotic medication 3 months prior to visit, the patient showed relatively abrupt onset symptoms of severe tremor and dystonia. These symptoms, appearing in clear consciousess, got better to a certain degree after 48 hours, worsened for 12 hours, and then improved again. Subsequently there was no continuing movement disorder. Several tests and consultation were carried out. However except for the medication factor, no other possible causes for such disabling symptoms were found. This clinical condition was thought to be akin to tardive tremor, a variant of TD. Furthermore, the course was atypical.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.179-187
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• 1997

The clinical efficacy of serotonin reuptake inhibitors such as clomipramine in the treatment of obsessive compulsive disorder(OCD) has fueled interest in the neurobiological basis of this illness. OCD is responsive exclucively to potent serotonin reuptake inhibitors clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine and this point forms the important evidence supporting a cental role for serotonin in the pathogenesis of the disorder. Other serotonergic medications such as lithium, buspirone, trazodone, or fenfluramine may be useful as adjuvant treatments in treatmentrefractory OCD and adjuvant antipsychotics are useful in tic disorders, personality disorders, and psychotic disorders. This paper reviews results of treatment studies, investigations of biological markers, and neuroendocrine challenges and implications for the role of serotonin in pathophysiology and treatment of OCD.

• Korean Journal of Biological Psychiatry
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• v.4 no.2
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• pp.162-167
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• 1997

There is no doubt that dopamine plays a critical role in the etiopathogenesis of schizophrenia. However, there appeared some limitations in explaining the complex phenomena of schizophrenia. Recent research data suggest that dysfunction in serotonergic system may be involved. Before the dopamine hypothesis of schizophrenia became established, the interest in serotonin(5-hydroxytryptamine, 5-HT) as an etiological substrate of this illness occurred. Recently the importance and extent of 5-HT's involvement in the pathophysiology and mechanism of action of antipsychotic drug is actively investigated. In recent years, therapeutic success of clozapine and risperidones has increased attention on the interaction between the 5-HT and dopamine systems in schizophrenia. This led to the concept of serotonin-dopamine antagonist for antipsychotics. The authors review the evidence for the role of 5- HT in schizophrenia and serotonin-dopamine interaction.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.68-71
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• 2007

Quetiapine is an atypical antipsychotic drug with a benign side effect profile. However, recent studies have reported that thyroid dysfunction is associated with quetiapine treatment. The authors report a patient with DSM-IV bipolar I disorder who developed subclinical hypothyroidism during quetiapine treatment. The patient showed no significant clinical symptoms, but only abnormal thyroid function test findings including antithyroglobulin antibody. The abnormal thyroid function test findings were normalized after discontinuation of quetiapine. The subclinical hypothyroidism developed during quetiapine treatment may be associated with autoimmune process.

• Korean Journal of Biological Psychiatry
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• v.5 no.1
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• pp.138-141
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• 1998

Neuroleptic malignant syndrome (NMS) is an uncommon but potentially fatal idiosyncratic reaction to neuroleptics, characterized by muscular rigidity, fever, autonomic dysfunction, and altered consciousness. The major theories to explain NMS is central dopaminergic blockade, but it is unclear. Risperidone is a new antipsychotic drug, a benzisoxazole derivative that blocks dopamine $D_2$ receptor and serotonin type 2 receptor. The comparatively greater serotonin-blocking activity is believed to give risperidone the specific property of not causing any more extrapyramidal side effects than conventional antipsychotics at the optimal dose of 4-8mg/day. It is postulated that risperidone is unlikely to cause NMS. Here, we report a case of risperidone induced neuroleptic malignant syndrome.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.1
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• pp.67-70
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• 2005

Pimozide and haloperidol are typical antipsychotics. They share a similarity in pharmacotherapeutic and adverse effect profiles. Cardiovascular effects may be seen as alterations in heart rate, blood pressure, and cardiac conduction. Conduction disturbances may occur ranging from asymptomatic prolongation of the QT interval to fatal ventricular arrhythmia. So in the case of anti psychotics overdose, the patient must be carefully monitored by continuous electrocardiography (ECG). We experienced a 34-year-old woman of schizophrenia with recurrent ventricular tachycardia after pimozide and haloperidol overdose. Initially she was slightly drowsy, however her ECG showed normal sinus rhythm. After 6 hours on emergency department entrance, her ECG monitoring showed ventricular tachycardia and we successfully defibrillated. There were five times events of ventricular arrhythmia during the in-hospital stay. She was discharged 5 days later without any other complications.

• Sleep Medicine and Psychophysiology
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• v.18 no.2
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• pp.67-71
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• 2011

Schizophrenia is a chronic, currently incurable, and devastating syndrome. Although sleep disturbances are not primary symptoms of schizophrenia, they are important aspects of schizophrenia. Difficulties initiating or maintaining sleep are frequently encountered in patients with schizophrenia. Many schizophrenics report low subjective sleep quality. Measured by polysomnography, increased sleep latency as well as reduced total sleep time, sleep efficiency, slow wave sleep, and rapid eye movement sleep latency (REM latency), are found in most patients with schizophrenia and appear to be an important aspect of the pathophysiology of this disorder. Some literatures suggest that worsening sleep quality precedes schizophrenic exacerbations. Co-morbid sleep disorders such as obstructive sleep apnea (OSA) and restless legs syndrome (RLS), and sleep-disrupting behaviors associated with schizophrenia may lead to sleep disturbances. Clinicians should screen the patient with sleep complaints for primary sleep disorders like OSA and RLS, and carefully evaluate sleep hygiene behaviors of all patients with schizophrenia who complain of sleep disturbances.

• The Korean Journal of Pain
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• v.27 no.3
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• pp.294-296
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• 2014

Burning Mouth Syndrome (BMS) is defined as a chronic orofacial pain syndrome, without evidence of mucosal lesions and other clinical signs of disease or laboratory abnormalities. Patients with BMS complain of burning pain in the mouth, xerostomia and taste disturbances. It is more common among women and the median age of occurrence is about 60 years. BMS may be primary or secondary to other diseases. The mainstay in the treatment of BMS includes antidepressants, benzodiazepines, and anticonvulsants. A few cases of BMS caused due to medication have been reported. The causative drugs include angiotensin-converting enzyme inhibitors, anticoagulants, antipsychotics, antiretrovirals, and benzodiazepines. This is a case report of a patient on antidepressants who developed symptoms of BMS thereby causing a dilemma in management.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.501-504
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• 2018

Autoimmune hemolytic anemia is a disease characterized with destruction of erythrocytes as a result of antibody produce against patient's own erythrocytes and anemia. Autoimmune hemolytic anemia can be roughly stratified into two groups according to serological features and secondary causes including drugs induced hemolytic anemia. Drugs induced autoimmune hemolytic anemia is very rare in pediatric patients. Even though hematological side effects such as leucopenia, agranulocytosis, eosinophilia, thrombocytopenic purpura and aplastic anemia might occur due to psychotropic drug use; to the best of our knowledge there is no autoimmune hemolytic anemia case due to quetiapine, an atypical antipsychotics, in literature. We hereby describe the first child case of autoimmune hemolytic anemia during quetiapine treatment.We also are pointing out that one should keep in mind serious hematological side effects with atypical antipsychotic drug use with this case report.

• Korean Journal of Schizophrenia Research
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• v.24 no.1
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• pp.1-7
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• 2021

Clozapine is the first and most effective atypical antipsychotic drug for treatment-resistant schizophrenia (TRS). After withdrawal of clozapine due to concerns of agranulocytosis, clozapine was reintroduced with a comprehensive safety monitoring system, the clozapine patient monitoring system (CPMS). The reintroduction was a response to the pressure from psychiatrists and patients with TRS and their families. Clozapine is still the best single agent for the treatment of TRS. However, approximately 30% of patients with TRS still show psychotic symptoms. In patients with clozapine-resistant schizophrenia (CRS), augmentation of other antipsychotic agents could be considered after a thorough evaluation of proper clozapine treatment. In this review, the status of clozapine in patients with TRS and CRS will be discussed.